CHSOS EXAM — COMPLETE QUESTIONS &
SOLUTIONS (2025/2026)
Introduction
The Certified Healthcare Simulation Operations Specialist (CHSOS) credential, awarded by the
Society for Simulation in Healthcare (SSH), recognizes professionals who operate, maintain, and
support simulation-based education and training programs. The 2025/2026 examination
blueprint stresses six competency domains:
• Healthcare Simulation Technology & Operations
• Simulation Resource Management & Logistics
• Scenario Support, Manikin Use & Troubleshooting
• Instructional Support & Facilitation Readiness
• Program Integration, Quality & Safety
• Professionalism, Teamwork & Communication
The following 115 items (100 scored + 15 unscored) mirror the live examination in format,
rigor, and topic distribution. All content is original, scenario-based, and aligned with current SSH
standards, INACSL guidelines, and technology vendor documentation. Each item includes a
single best answer and concise rationale to reinforce mastery.
Question 1
During pre-brief setup, the specialist notices the manikin’s left carotid pulse is absent while the
right is strong. Which action is most appropriate?
A. Swap the entire manikin with a spare
B. Replace the left carotid solenoid valve per service manual
C. Re-calibrate all pulses via software and retest
D. Document as acceptable asymmetry and proceed
Answer: B. Replace the left carotid solenoid valve per service manual
Rationale: Focal pulse loss indicates component failure, not calibration drift. Replacing the
specific solenoid restores function without unnecessary manikin swap. Software re-calibration
cannot correct hardware failure.
Question 2
A center uses shared VR headsets between sessions. Which disinfection method meets 2025
CDC guidance for non-critical devices?
A. 70 % isopropyl wipes followed by air-dry
B. UV-C cabinet exposure for 1 min
pg. 1
,C. 3 % hydrogen peroxide spray; no rinse
D. Ethylene oxide sterilization after each use
Answer: A. 70 % isopropyl wipes followed by air-dry
Rationale: IPA at 70 % is effective against non-spore organisms and safe for headset plastics. UV-
C requires longer exposure, peroxide can leave residue, and EtO is overkill and impractical.
Question 3
An instructor requests a 30-second delay between CPR compressions and rhythm check to
simulate prolonged pulse palpation. Which feature should the specialist configure?
A. Scenario timeline event marker
B. Manikin physiological latency slider
C. Event logging buffer
D. Instructor override hot-key
Answer: A. Scenario timeline event marker
Rationale: Timeline events allow scripted delays, ensuring consistency across runs. Latency
sliders affect data lag, not pedagogical timing; buffers and hot-keys do not control scenario
pacing.
Question 4
A SimBaby’s chest rise is barely visible at 100 % airway pressure. Airway circuit tests intact.
Next step?
A. Increase compressor output to 6 bar
B. Replace lung bladder
C. Tighten chest skin Velcro
D. Recalibrate CO₂ sensor
Answer: B. Replace lung bladder
Rationale: Loss of compliance in the bladder reduces tidal volume delivery. Compressor
pressure (A) is factory-limited; loose skin (C) would cause asynchronous rise, not low volume;
CO₂ calibration (D) is unrelated.
Question 5
A program wants to track utilization hours per simulator across courses. Which data source is
most reliable?
A. Room scheduling calendar
B. Manikin internal runtime log
C. Instructor sign-out sheet
D. Maintenance ticket timestamps
Answer: B. Manikin internal runtime log
Rationale: Internal logs record actual powered-on minutes, eliminating human error. Calendars
capture bookings, not usage; sign-out sheets are often incomplete; tickets reflect only repair
events.
pg. 2
,Question 6
During setup, the specialist hears audible hissing from the oxygen inlet of a high-fidelity
manikin. Immediate action?
A. Teflon-tape the threaded fitting
B. Shut off gas source and verify washer seal
C. Apply leak-detection solution
D. Reduce regulator flow rate
Answer: B. Shut off gas source and verify washer seal
Rationale: Safety first—stop flow to prevent O₂ enrichment, then inspect washer. Teflon (A) is
prohibited on oxygen fittings; leak solution (C) is secondary; flow reduction (D) does not fix leak
source.
Question 7
Which file format is recommended for 2025-compliant interoperable scenario sharing between
centers using different vendors?
A. .scn (proprietary binary)
B. .xml SSIML 3.0
C. .json vendor-specific
D. .pptx storyboard
Answer: B. .xml SSIML 3.0
Rationale: SSH Simulation Mark-up Language (SSIML) 3.0 is vendor-neutral XML-based. Binary
or vendor JSON lacks interoperability; PowerPoint is for human reading only.
Question 8
A center plans to stream sessions to overflow classrooms. Which network parameter is most
critical for synchronous low-latency video?
A. Jitter < 30 ms
B. Bandwidth ≥ 100 Mbps down
C. Packet loss < 5 %
D. Upload ≥ 1 Gbps
Answer: A. Jitter < 30 ms
Rationale: Jitter directly affects real-time lip-sync; low latency requires consistent timing. High
bandwidth helps but jitter governs synchronicity; 5 % loss is unacceptable; 1 Gbps upload is
overkill.
Question 9
An instructor wants participants to hear real-time heart sounds through wireless headsets. Best
audio routing solution?
pg. 3
, A. Bluetooth 5.2 direct from manikin
B. Low-latency RF transmission (2.4 GHz)
C. Wi-Fi 6E multicast
D. Wired 3.5 mm headphone splitter
Answer: B. Low-latency RF transmission (2.4 GHz)
Rationale: RF offers sub-20 ms latency and avoids Bluetooth pairing drops and Wi-Fi congestion.
Splitters (D) are impractical for mobility.
Question 10
A simulation room’s ambient noise measures 55 dB. Which adjustment best improves audio
fidelity for stethoscope auscultation recordings?
A. Add acoustic ceiling tiles to reach NC-35
B. Increase speaker volume by 10 dB
C. Switch to cardioid microphones
D. Lower HVAC fan speed to 25 %
Answer: A. Add acoustic ceiling tiles to reach NC-35
Rationale: Reducing background to NC-30/35 (≈40 dB) raises signal-to-noise ratio. Boosting
volume (B) amplifies noise; cardioid mics (C) help speech, not low-frequency heart sounds; fan
reduction (D) alone may be insufficient.
Question 11
A specialist needs to store 500 GB of high-resolution video annually for five years with 99.9 %
uptime. Which storage tier is most cost-effective?
A. Local RAID-5 spinning drives
B. Cloud cold-line with lifecycle policy
C. Cloud nearline with frequent access
D. LTO-9 tape library off-site
Answer: B. Cloud cold-line with lifecycle policy
Rationale: Cold-line offers low per-GB cost and high durability for infrequent access, with
automatic lifecycle. RAID-5 lacks off-site redundancy; nearline is pricier; tape requires physical
handling and drives.
Question 12
A manikin’s software crashes whenever SCORM content is launched. Logs show “out of memory”
errors. First troubleshooting step?
A. Increase Java heap size in launcher config
B. Re-install SCORM package
C. Downgrade graphics driver
D. Replace RAM modules
Answer: A. Increase Java heap size in launcher config
Rationale: Memory errors suggest insufficient heap allocation. Re-installing content (B) or
pg. 4
SOLUTIONS (2025/2026)
Introduction
The Certified Healthcare Simulation Operations Specialist (CHSOS) credential, awarded by the
Society for Simulation in Healthcare (SSH), recognizes professionals who operate, maintain, and
support simulation-based education and training programs. The 2025/2026 examination
blueprint stresses six competency domains:
• Healthcare Simulation Technology & Operations
• Simulation Resource Management & Logistics
• Scenario Support, Manikin Use & Troubleshooting
• Instructional Support & Facilitation Readiness
• Program Integration, Quality & Safety
• Professionalism, Teamwork & Communication
The following 115 items (100 scored + 15 unscored) mirror the live examination in format,
rigor, and topic distribution. All content is original, scenario-based, and aligned with current SSH
standards, INACSL guidelines, and technology vendor documentation. Each item includes a
single best answer and concise rationale to reinforce mastery.
Question 1
During pre-brief setup, the specialist notices the manikin’s left carotid pulse is absent while the
right is strong. Which action is most appropriate?
A. Swap the entire manikin with a spare
B. Replace the left carotid solenoid valve per service manual
C. Re-calibrate all pulses via software and retest
D. Document as acceptable asymmetry and proceed
Answer: B. Replace the left carotid solenoid valve per service manual
Rationale: Focal pulse loss indicates component failure, not calibration drift. Replacing the
specific solenoid restores function without unnecessary manikin swap. Software re-calibration
cannot correct hardware failure.
Question 2
A center uses shared VR headsets between sessions. Which disinfection method meets 2025
CDC guidance for non-critical devices?
A. 70 % isopropyl wipes followed by air-dry
B. UV-C cabinet exposure for 1 min
pg. 1
,C. 3 % hydrogen peroxide spray; no rinse
D. Ethylene oxide sterilization after each use
Answer: A. 70 % isopropyl wipes followed by air-dry
Rationale: IPA at 70 % is effective against non-spore organisms and safe for headset plastics. UV-
C requires longer exposure, peroxide can leave residue, and EtO is overkill and impractical.
Question 3
An instructor requests a 30-second delay between CPR compressions and rhythm check to
simulate prolonged pulse palpation. Which feature should the specialist configure?
A. Scenario timeline event marker
B. Manikin physiological latency slider
C. Event logging buffer
D. Instructor override hot-key
Answer: A. Scenario timeline event marker
Rationale: Timeline events allow scripted delays, ensuring consistency across runs. Latency
sliders affect data lag, not pedagogical timing; buffers and hot-keys do not control scenario
pacing.
Question 4
A SimBaby’s chest rise is barely visible at 100 % airway pressure. Airway circuit tests intact.
Next step?
A. Increase compressor output to 6 bar
B. Replace lung bladder
C. Tighten chest skin Velcro
D. Recalibrate CO₂ sensor
Answer: B. Replace lung bladder
Rationale: Loss of compliance in the bladder reduces tidal volume delivery. Compressor
pressure (A) is factory-limited; loose skin (C) would cause asynchronous rise, not low volume;
CO₂ calibration (D) is unrelated.
Question 5
A program wants to track utilization hours per simulator across courses. Which data source is
most reliable?
A. Room scheduling calendar
B. Manikin internal runtime log
C. Instructor sign-out sheet
D. Maintenance ticket timestamps
Answer: B. Manikin internal runtime log
Rationale: Internal logs record actual powered-on minutes, eliminating human error. Calendars
capture bookings, not usage; sign-out sheets are often incomplete; tickets reflect only repair
events.
pg. 2
,Question 6
During setup, the specialist hears audible hissing from the oxygen inlet of a high-fidelity
manikin. Immediate action?
A. Teflon-tape the threaded fitting
B. Shut off gas source and verify washer seal
C. Apply leak-detection solution
D. Reduce regulator flow rate
Answer: B. Shut off gas source and verify washer seal
Rationale: Safety first—stop flow to prevent O₂ enrichment, then inspect washer. Teflon (A) is
prohibited on oxygen fittings; leak solution (C) is secondary; flow reduction (D) does not fix leak
source.
Question 7
Which file format is recommended for 2025-compliant interoperable scenario sharing between
centers using different vendors?
A. .scn (proprietary binary)
B. .xml SSIML 3.0
C. .json vendor-specific
D. .pptx storyboard
Answer: B. .xml SSIML 3.0
Rationale: SSH Simulation Mark-up Language (SSIML) 3.0 is vendor-neutral XML-based. Binary
or vendor JSON lacks interoperability; PowerPoint is for human reading only.
Question 8
A center plans to stream sessions to overflow classrooms. Which network parameter is most
critical for synchronous low-latency video?
A. Jitter < 30 ms
B. Bandwidth ≥ 100 Mbps down
C. Packet loss < 5 %
D. Upload ≥ 1 Gbps
Answer: A. Jitter < 30 ms
Rationale: Jitter directly affects real-time lip-sync; low latency requires consistent timing. High
bandwidth helps but jitter governs synchronicity; 5 % loss is unacceptable; 1 Gbps upload is
overkill.
Question 9
An instructor wants participants to hear real-time heart sounds through wireless headsets. Best
audio routing solution?
pg. 3
, A. Bluetooth 5.2 direct from manikin
B. Low-latency RF transmission (2.4 GHz)
C. Wi-Fi 6E multicast
D. Wired 3.5 mm headphone splitter
Answer: B. Low-latency RF transmission (2.4 GHz)
Rationale: RF offers sub-20 ms latency and avoids Bluetooth pairing drops and Wi-Fi congestion.
Splitters (D) are impractical for mobility.
Question 10
A simulation room’s ambient noise measures 55 dB. Which adjustment best improves audio
fidelity for stethoscope auscultation recordings?
A. Add acoustic ceiling tiles to reach NC-35
B. Increase speaker volume by 10 dB
C. Switch to cardioid microphones
D. Lower HVAC fan speed to 25 %
Answer: A. Add acoustic ceiling tiles to reach NC-35
Rationale: Reducing background to NC-30/35 (≈40 dB) raises signal-to-noise ratio. Boosting
volume (B) amplifies noise; cardioid mics (C) help speech, not low-frequency heart sounds; fan
reduction (D) alone may be insufficient.
Question 11
A specialist needs to store 500 GB of high-resolution video annually for five years with 99.9 %
uptime. Which storage tier is most cost-effective?
A. Local RAID-5 spinning drives
B. Cloud cold-line with lifecycle policy
C. Cloud nearline with frequent access
D. LTO-9 tape library off-site
Answer: B. Cloud cold-line with lifecycle policy
Rationale: Cold-line offers low per-GB cost and high durability for infrequent access, with
automatic lifecycle. RAID-5 lacks off-site redundancy; nearline is pricier; tape requires physical
handling and drives.
Question 12
A manikin’s software crashes whenever SCORM content is launched. Logs show “out of memory”
errors. First troubleshooting step?
A. Increase Java heap size in launcher config
B. Re-install SCORM package
C. Downgrade graphics driver
D. Replace RAM modules
Answer: A. Increase Java heap size in launcher config
Rationale: Memory errors suggest insufficient heap allocation. Re-installing content (B) or
pg. 4
