Booking form

The Clinical Learning and Simulation Program (CLSP) is a Rady Faculty of Health Sciences and Winnipeg Regional Health Authority resource that provides simulation-based education space, equipment and supplies to a vast array of learner groups. The CLSP manages the bookings for the Clinical Learning and Simulation Facility (000 Brodie, 205 Brodie) and the Skills Lab (211 Basic Medical Sciences Building).

Complete this online booking form to request rooms or equipment managed by the Clinical Learning and Simulation Program.

Requests take up to 10 days to process.

Contact information

Please provide details for the person BOOKING the session.
 
Name
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Phone
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Please provide details for the person LEADING the session.
 
Name
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Phone

Session information

Request type
Simulation technician and equipment to off-site/HSC location
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Session name - please include course code if applicable
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Does the session charge registration fees?
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Date, start and end time. Provide alternate options if first choice cannot be accommodated.
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NOTE: List all requested date(s) and time(s). Booking times should align with the actual arrival and departure times of learners. Rooms are typically kept clear 30-60 minutes before and after for setup and teardown. Session time must begin no earlier than 8:00 AM and conclude no later than 4:30 PM. Please justify any requests outside these hours.

Description

Please describe your session's objectives and/or summarize the agenda.
 
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Participants

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Rooms

 Exam room (Brodie lower level, 4-8 chairs plus exam table)
 Number of rooms needed
Hi-fidelity simulation room (Brodie lower level)
 Number of rooms needed
Large multipurpose room (Brodie lower level, up to 20 chairs)
 Number of rooms needed
Skills lab (211 Basic Medical Sciences Building, capacity: 45. Contains 15 two-person tables inside a large wet lab, suitable for suture sessions and task trainers.)
 Number of rooms needed
Central learning area (205 Brodie, up to 12 chairs)
 Number of rooms needed
Small group learning (205 Brodie, 8-12 chairs)
 Number of rooms needed
EXAMPLE
For example A/B, C, D, E/F, G, H (six spaces, two large rooms, four small rooms)
EXAMPLES
For example:
•    2 high fidelity simulation rooms (adult manikin) required; 1 prebrief/debrief room for up to 14 participants.
•    1 high fidelity simulation rooms (pediatric manikin) required; 1 debrief room for up to 8 participants.
•    2 large rooms required; 15 participants per room for skills station, equipment requirements specified below
•    4 physical exam rooms, 5 participants per room; 1 large room
Are quiet signs required?

Biosafety

To comply with EHSO biosafety standards, we must be informed about any sessions involving meat, human tissue, animal tissue, biological substances (such as slides), human blood, and body fluids (including injections, blood drawing, throat swabs, internal exams, etc.). Please provide specific details.

Beds

If beds or tables are required for people (not manikins), indicate your requirements here
Hospital bed (Brodie lower level)
 Number of beds needed
Hi-lo treatment table (Brodie lower level - electric, on wheels) 
 Number of hi-low treatment tables needed
Obs/Gyn examination table (Brodie, lower level)
 Number of obs-gyn exam tables needed
Obs/gyn examination table (205 Brodie) 
 Number of obs-gyn exam tables needed

Equipment and supplies

Please describe your equipment needs. Our equipment catalogue (PDF) offers details on what is available.
Indicate all required supplies
 

Audiovisual services

The following services are available. Select all that apply:
 
Who requires access to the video?

Standardized patients

Will you be booking a Standardized Patient to portray a patient, family member, or health care worker during your session?
 
Please complete the standardized patient booking form.

Additional information

Please supply any additional information about this booking we should know about:
 

Contact us

Clinical Learning and Simulation Program (CLSP)
Brodie Centre, 727 McDermot Avenue
University of Manitoba
Winnipeg, MB R3T 2N2 Canada

clsf@umanitoba.ca
204-272-3070
Hours of operation are Mon-Fri, 8am to 4pm