Waldron College of Health and Human Services
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Clinical Simulation Center
I have access to Confidential Clinical Simulation Center Information and need to be aware of and abide by procedures that apply to simulation information:
Confidential simulation information is defined as anything that I, or those individuals with whom I interact, would expect to remain private including information relating to
- simulation patients;
- standardized patients;
- patient models; and
Confidential information may be used only as needed to perform my specific activity related responsibilities.
As a student, learner, trainee or patient actor, I am required to comply with the Clinical Simulation Center guidelines relating to confidential information. I understand that:
1. I may have access to confidential simulation information.
2. I am responsible for protecting all simulation information.
3. Confidential simulation information may only be used as needed to perform my assigned activities. I may:
a. not share any simulation scenario information with others outside of my clinical simulation group and clinical faculty;
b. not share or disclose specific simulation patient health information;
c. not share student performance with anyone other than those in my clinical simulation group and clinical faculty;
d. not misuse or be careless with simulation information.
4. Violating this Agreement may subject me to loss of simulation privileges.
5. Video recordings/photos may be used for follow-up instruction, orientation to the simulated environment, CSC tours, seminars, and RU simulation center website/RU Facebook page.
By signing below, I acknowledge that I have read and understand the above Agreement and agree to abide by the terms of this Agreement.
Printed Name _________________________________
Revised: May 2014