CHSOS STUDY GUIDE 2025/2026 QUESTIONS AND
ANSWERS GRADED A++
✔✔Distributed Simulation - ✔✔The concept of simulation on-demand, made widely
available wherever and whenever it is required; DS provides an easily transportable,
self-contained 'set' for creating simulated environments, at a fraction of the cost of
dedicated, static simulation facilities (Kneebone et al, 2010). • A set of simulations
operating in a common environment and distributed to learners; a distributed simulation
may be composed of any of the three modes of simulation: live, virtual, and
constructive, and are seamlessly integrated within a single exercise (Department of
Defense Modeling and Simulation Glossary).
✔✔Durational Simulation - ✔✔• Multiple simulations that build off of one another. This
can include a simulation that focuses on an initial assessment of a simulated or
standardized patient portraying a patient role and the subsequent simulations are the
follow-up visit (e.g., initial visit, one-month visit and six-month visit, etc.). • A Durational
Simulation is the opposite of a Discrete Simulation in that changes occur in the system
between simulations.
✔✔Dryrun - ✔✔A "planning meeting with standardized learners" is used to reveal un-
intentional problems within the scenario. A designated time to explore the possibility of
errors. (Boilat et al, 2012) • A verification period prior to live encounters to ensure a
"safe and therapeutic" environment. (Greswell et al, 2018)
✔✔Educator (Simulation Educator) - ✔✔Person who uses the modality of simulation to
educate learners, utilizing evidence -based strategies. • Person who supports
healthcare professionals who are learning to manage clinical situations and provide
care that is safe, effective, efficient, timely, patient-centered, and equitable. May teach
an individual learner or a group of learners practicing to work as a team (Lindell,
Poindexter, & Hagler, 2016).
✔✔Embedded Participant - ✔✔Definition • An individual who is trained or scripted to
play a role in a simulation encounter in order to guide the scenario, and may be known
or unknown to the participants; guidance may be positive or negative, or a distractor
based on the objectives, level of the participants, and the needs of the scenario. • A role
assigned in a simulation encounter to help guide the scenario. • The embedded
participant's role is part of the situation. However, the underlying purpose of the role
may not be revealed to the participants in the scenario or simulation (INACSL, 2013).
✔✔Environmental Fidelity - ✔✔• The degree to which the simulated environment
(manikin, room, tools, equipment, moulage, and sensory props) replicates reality and
appearance of the real environment.
✔✔Evaluation - ✔✔• Determination of the value, nature, character, or quality of
something or someone (Merriam Webster) • A broad term for appraising data or placing
,a value on data gathered through one or more measurements. It involves rendering a
judgment, including strengths and weaknesses. Evaluation measures quality and
productivity against a standard of performance. Evaluation may be formative,
summative, high stakes, or related to the simulation program or process. (INACSL
Standards Committee, Glossary, 2016c)
✔✔Event - ✔✔• The occurrences that cause variation or changes in the state of a
system (Sokolowski and Banks, 2009); in health care simulation, this term is common
when programming manikins and often refers to learner actions. • An event is described
by the time it occurs and event lists can be created to drive changes in a simulation
✔✔Facilitator (Simulation Facilitator) - ✔✔• An individual who is involved in the
implementation and/or delivery of simulation activities. For example, faculty, educators,
etc. • An individual that helps to bring about an outcome (such as learning, productivity,
or communication) by providing indirect or unobtrusive assistance, guidance, or
supervision. For example: The debriefing facilitator kept the discussion flowing smoothly
✔✔Feedback• - ✔✔• An activity where information is relayed back to a learner;
feedback should be constructive, address specific aspects of the learner's performance,
and be focused on the learning objectives (Society for Simulation in Healthcare). •
Information transferred between participants, facilitator, simulator, or peer with the
intention of improving the understanding of concepts or aspects of performance
(INACSL 2013). Feedback can be delivered by an instructor, a machine, a computer, a
patient (or a simulated person), or by other learners as long as it is part of the learning
process.
✔✔Fiction Contract - ✔✔A concept which implies that an engagement in simulation is a
contract between the instructor and the learner: each has to do his or her part to make
the simulation worthwhile (Rudolph, Dieckmann, et al.). • The degree of engagement
that healthcare trainees are willing to give the simulated event. Also known as the
"suspension of disbelief", it is a literary and theatrical concept that encourages
participants to put aside their disbelief and accept the simulated exercise as being real
for the duration of the scenario.
✔✔Fidelity - ✔✔The degree to which the simulation replicates the real event and/or
workplace; this includes physical, psychological, and environmental elements. • The
ability of the simulation to reproduce the reactions, interactions, and responses of the
real-world counterpart. It is not constrained to a certain type of simulation modality, and
higher levels of fidelity are not required for a simulation to be successful. • The level of
realism associated with a particular simulation activity; fidelity can involve a variety of
dimensions, including (a) physical factors such as environment, equipment, and related
tools; (b) psychological factors such as emotions, beliefs, and self-awareness of
participants; (c) social factors such as participant and instructor motivation and goals;
(d) culture of the group; and (e) degree of openness and trust, as well as participants'
modes of thinking (INACSL, 2013);
, ✔✔Fixation Error - ✔✔A principle of crisis resource management wherein humans fail to
revise a situation assessment in risky and dynamic systems or events (Decker, 2011). •
The persistent failure to revise a diagnosis or plan in the face of readily available
evidence suggesting that a revision is necessary
✔✔Frame(s) - ✔✔• The perspectives through which individuals interpret new
information and experiences for the purpose of decision-making. • Frames are formed
through previous experiences and can be based on knowledge, attitudes, feelings,
goals, rules, and/or perceptions. • The mindset of the internal participant or facilitator;
their knowledge, thoughts, feelings, actions (speech/body language), attitudes
(verbal/non-verbal), and perceptions (adapted from Rudolph, J.W. et al, 2007, 2008).
✔✔Functional Fidelity - ✔✔• The degree in which the equipment used in the simulation
responds to the participant's actions; e.g., a static ventilator would offer low functional
fidelity compared to a working ventilator in a simulation requiring a ventilator alarm.
✔✔Gamification - ✔✔• The application of game design elements (conceptual building
blocks integral to building successful games) to traditionally nongame contexts
(Rutledge et al, 2018). • The application of the characteristics and benefits of games to
real-world processes or problems. "Gamification differs from serious games in terms of
the design intention, with gamification interventions involving the application of game
elements with a utilitarian purpose..." (Gentry et al, 2019).
✔✔Guided Reflection - ✔✔The process encouraged by the instructor during debriefing
that reinforces the critical aspects of the experience and encourages insightful learning,
allowing the participant to link theory with practice and research (INACSL, 2013). • The
facilitated intellectual and affective activities that allow individuals to explore their
experience in order to lead to new understanding and appreciations (adapted from Boud
et al, 1985).
• A mentor-facilitated process that allows the learner to "integrate the understanding
gained into one's experience in order to enable better choices or actions in the future,
as well as enhance one's overall effectiveness" (Rogers, 2001).
✔✔Gynecological / Genitourinary Teaching Associate (GTA, GUTA, MUTA) - ✔✔• A
Genitourinary Teaching Associate (GUTA) is an individual trained to teach the
techniques and protocol for performing the gender-specific physical examination to
learners, using himself or herself as a demonstration and practice model. • A
Gynecological Teaching Associate (GTA) is a female specifically trained to teach,
assess, and provide feedback to learners about accurate pelvic, rectal and/or breast
examination techniques. They also address the communication skills needed to provide
a comfortable exam in a standardized manner, while using their bodies as teaching
tools in a supportive, nonthreatening environment (ASPE). • A Male Urogenital
Teaching Associates (MUTA) is a male specifically trained to teach, assess, and
provide feedback to learners about accurate urogenital and rectal examination
techniques. They also address the communication skills needed to provide a
ANSWERS GRADED A++
✔✔Distributed Simulation - ✔✔The concept of simulation on-demand, made widely
available wherever and whenever it is required; DS provides an easily transportable,
self-contained 'set' for creating simulated environments, at a fraction of the cost of
dedicated, static simulation facilities (Kneebone et al, 2010). • A set of simulations
operating in a common environment and distributed to learners; a distributed simulation
may be composed of any of the three modes of simulation: live, virtual, and
constructive, and are seamlessly integrated within a single exercise (Department of
Defense Modeling and Simulation Glossary).
✔✔Durational Simulation - ✔✔• Multiple simulations that build off of one another. This
can include a simulation that focuses on an initial assessment of a simulated or
standardized patient portraying a patient role and the subsequent simulations are the
follow-up visit (e.g., initial visit, one-month visit and six-month visit, etc.). • A Durational
Simulation is the opposite of a Discrete Simulation in that changes occur in the system
between simulations.
✔✔Dryrun - ✔✔A "planning meeting with standardized learners" is used to reveal un-
intentional problems within the scenario. A designated time to explore the possibility of
errors. (Boilat et al, 2012) • A verification period prior to live encounters to ensure a
"safe and therapeutic" environment. (Greswell et al, 2018)
✔✔Educator (Simulation Educator) - ✔✔Person who uses the modality of simulation to
educate learners, utilizing evidence -based strategies. • Person who supports
healthcare professionals who are learning to manage clinical situations and provide
care that is safe, effective, efficient, timely, patient-centered, and equitable. May teach
an individual learner or a group of learners practicing to work as a team (Lindell,
Poindexter, & Hagler, 2016).
✔✔Embedded Participant - ✔✔Definition • An individual who is trained or scripted to
play a role in a simulation encounter in order to guide the scenario, and may be known
or unknown to the participants; guidance may be positive or negative, or a distractor
based on the objectives, level of the participants, and the needs of the scenario. • A role
assigned in a simulation encounter to help guide the scenario. • The embedded
participant's role is part of the situation. However, the underlying purpose of the role
may not be revealed to the participants in the scenario or simulation (INACSL, 2013).
✔✔Environmental Fidelity - ✔✔• The degree to which the simulated environment
(manikin, room, tools, equipment, moulage, and sensory props) replicates reality and
appearance of the real environment.
✔✔Evaluation - ✔✔• Determination of the value, nature, character, or quality of
something or someone (Merriam Webster) • A broad term for appraising data or placing
,a value on data gathered through one or more measurements. It involves rendering a
judgment, including strengths and weaknesses. Evaluation measures quality and
productivity against a standard of performance. Evaluation may be formative,
summative, high stakes, or related to the simulation program or process. (INACSL
Standards Committee, Glossary, 2016c)
✔✔Event - ✔✔• The occurrences that cause variation or changes in the state of a
system (Sokolowski and Banks, 2009); in health care simulation, this term is common
when programming manikins and often refers to learner actions. • An event is described
by the time it occurs and event lists can be created to drive changes in a simulation
✔✔Facilitator (Simulation Facilitator) - ✔✔• An individual who is involved in the
implementation and/or delivery of simulation activities. For example, faculty, educators,
etc. • An individual that helps to bring about an outcome (such as learning, productivity,
or communication) by providing indirect or unobtrusive assistance, guidance, or
supervision. For example: The debriefing facilitator kept the discussion flowing smoothly
✔✔Feedback• - ✔✔• An activity where information is relayed back to a learner;
feedback should be constructive, address specific aspects of the learner's performance,
and be focused on the learning objectives (Society for Simulation in Healthcare). •
Information transferred between participants, facilitator, simulator, or peer with the
intention of improving the understanding of concepts or aspects of performance
(INACSL 2013). Feedback can be delivered by an instructor, a machine, a computer, a
patient (or a simulated person), or by other learners as long as it is part of the learning
process.
✔✔Fiction Contract - ✔✔A concept which implies that an engagement in simulation is a
contract between the instructor and the learner: each has to do his or her part to make
the simulation worthwhile (Rudolph, Dieckmann, et al.). • The degree of engagement
that healthcare trainees are willing to give the simulated event. Also known as the
"suspension of disbelief", it is a literary and theatrical concept that encourages
participants to put aside their disbelief and accept the simulated exercise as being real
for the duration of the scenario.
✔✔Fidelity - ✔✔The degree to which the simulation replicates the real event and/or
workplace; this includes physical, psychological, and environmental elements. • The
ability of the simulation to reproduce the reactions, interactions, and responses of the
real-world counterpart. It is not constrained to a certain type of simulation modality, and
higher levels of fidelity are not required for a simulation to be successful. • The level of
realism associated with a particular simulation activity; fidelity can involve a variety of
dimensions, including (a) physical factors such as environment, equipment, and related
tools; (b) psychological factors such as emotions, beliefs, and self-awareness of
participants; (c) social factors such as participant and instructor motivation and goals;
(d) culture of the group; and (e) degree of openness and trust, as well as participants'
modes of thinking (INACSL, 2013);
, ✔✔Fixation Error - ✔✔A principle of crisis resource management wherein humans fail to
revise a situation assessment in risky and dynamic systems or events (Decker, 2011). •
The persistent failure to revise a diagnosis or plan in the face of readily available
evidence suggesting that a revision is necessary
✔✔Frame(s) - ✔✔• The perspectives through which individuals interpret new
information and experiences for the purpose of decision-making. • Frames are formed
through previous experiences and can be based on knowledge, attitudes, feelings,
goals, rules, and/or perceptions. • The mindset of the internal participant or facilitator;
their knowledge, thoughts, feelings, actions (speech/body language), attitudes
(verbal/non-verbal), and perceptions (adapted from Rudolph, J.W. et al, 2007, 2008).
✔✔Functional Fidelity - ✔✔• The degree in which the equipment used in the simulation
responds to the participant's actions; e.g., a static ventilator would offer low functional
fidelity compared to a working ventilator in a simulation requiring a ventilator alarm.
✔✔Gamification - ✔✔• The application of game design elements (conceptual building
blocks integral to building successful games) to traditionally nongame contexts
(Rutledge et al, 2018). • The application of the characteristics and benefits of games to
real-world processes or problems. "Gamification differs from serious games in terms of
the design intention, with gamification interventions involving the application of game
elements with a utilitarian purpose..." (Gentry et al, 2019).
✔✔Guided Reflection - ✔✔The process encouraged by the instructor during debriefing
that reinforces the critical aspects of the experience and encourages insightful learning,
allowing the participant to link theory with practice and research (INACSL, 2013). • The
facilitated intellectual and affective activities that allow individuals to explore their
experience in order to lead to new understanding and appreciations (adapted from Boud
et al, 1985).
• A mentor-facilitated process that allows the learner to "integrate the understanding
gained into one's experience in order to enable better choices or actions in the future,
as well as enhance one's overall effectiveness" (Rogers, 2001).
✔✔Gynecological / Genitourinary Teaching Associate (GTA, GUTA, MUTA) - ✔✔• A
Genitourinary Teaching Associate (GUTA) is an individual trained to teach the
techniques and protocol for performing the gender-specific physical examination to
learners, using himself or herself as a demonstration and practice model. • A
Gynecological Teaching Associate (GTA) is a female specifically trained to teach,
assess, and provide feedback to learners about accurate pelvic, rectal and/or breast
examination techniques. They also address the communication skills needed to provide
a comfortable exam in a standardized manner, while using their bodies as teaching
tools in a supportive, nonthreatening environment (ASPE). • A Male Urogenital
Teaching Associates (MUTA) is a male specifically trained to teach, assess, and
provide feedback to learners about accurate urogenital and rectal examination
techniques. They also address the communication skills needed to provide a
