No./Title: SIM 112 – SP Breaks	Resp. Office: CHIPS Approval Body: CASA	Effective Date: 03/02/2021
Category: Academic	Last Review: 03/02/2021	Next Review: 03/02/2024
Contact: Executive Director, CHIPS	🕿 901 448 9746	🖂 simulate@uthsc.edu
Related Policies:	SIM 107 Sim Physical and Psychological Safety

DEFINITIONS

1. Standardized/Simulated Patient (SP) – A person who has been carefully coached to simulate an actual patient so accurately that the simulation cannot be detected by a skilled clinician. In performing the simulation, the SP presents the gestalt of the patient being simulated; not just the history, but the body language, the physical findings, and the emotional and personality characteristics as well (Barrows 1987).
2. Round – The entire event flow for a single learner. This includes encounter and post-encounter activity.
3. Encounter – This is the time that the SP is in direct contact with the learner. This includes in-person or other technological platforms.
4. Post-Encounter- Any additional documentation, feedback, or debriefing requirements.
5. Buffer – Dedicated time between rounds needed to transition and reset.
6. Break – Protected time where an SP is not actively engaged in a simulation event.

POLICY

1. All events utilizing SPs must include breaks in accordance with simulation standards of best practice, as well as state and federal laws.
2. Appropriate breaks will be provided to mitigate potential adverse effects of role portrayal and prevent physical injury or fatigue.

PROCEDURE

1. All schedules for SP events must be reviewed and approved by the appropriate CHIPS staff.
2. Any subsequent changes once the schedule has been approved cannot be made without prior approval.
3. A five-minute buffer will be set between rounds to provide adequate time for transition and reset.
4. Every fourth round, or 90 minutes, a break will be scheduled according to the criteria below
   1. A break of five minutes if:
      1. Minimal moulage or attached medical equipment AND
      2. No more than 12 rooms are running.
      3. The encounter is on a virtual platform
   2. A break of ten minutes if:
      1. High-levels of moulage or attached medical equipment OR
      2. More than 12 rooms are running at a time.
   3. To ensure a safe work environment, more break time may be required at the discretion of appropriate CHIPS staff. This includes when SPs are subject to high levels of physical, cognitive, and/or psychological stress.
5. Meal breaks will be scheduled for SP events by CHIPS for the following instances:
   1. Any event scheduled lasting more than six hours is required by state law to provide a 30-minute break.
   2. Any event scheduled to run between the hours of 11:00-1:00 is subject to a 30-minute break.
   3. Any event scheduled to run between the hours of 5:00-7:00 is subject to a 30-minute break.
6. If an event is delayed, SP breaks may not be removed, but may be adjusted with prior approval from an appropriate CHIPS Staff member.

APPROVAL HISTORY

Effective: March 2, 2021

Reviewed: March 2, 2021, CASA

Approved: March 6, 2021, Chief Academic Officer