ILC Room & Resource Requests for AY25 (August 26, 2024-August 24, 2025)

ILC Room & Resource Requests for AY25 (August 26, 2024-August 24, 2025)

IMPORTANT: MASKING UPDATE FOR EVENTS NOVEMBER 1, 2024 THROUGH MARCH 31, 2025:

As you may be aware, Santa Clara County has once again implemented universal masking mandates in patient care areas starting on November 1, 2024, through March 31, 2025. Therefore, CISL will implement masking requirements for activities that replicate the clinical environment. Such activities include mannequin-based simulation, standardized patient simulation, and task training. The masking requirement will be in effect until the County lifts the mandate.

Please note: All events or activities involving Standardized Patients (SPs) and Ultrasound models will adhere to the masking guidelines communicated at the time of booking, as this is an established agreement. If the guidelines change between the time of booking and the event, the SPs/models will adhere to whichever guidelines are stricter.

For small-group classroom activities, we leave the decision to mask or not to students, faculty, and staff. We ask that you be sensitive and respectful to the needs of immunocompromised students, faculty, and staff (or close contacts of such) and not ridicule or refuse a request to wear a mask. Please have an N-95, KN-95, or equivalent mask available (in backpacks or pockets) in case a group decides to wear masks for the safety of one or more participants in small-group activities.

Protecting the health and safety of Faculty, Staff, and Students remains a priority. We appreciate your understanding during these times. Please share this information with all faculty involved in teaching your event. You may reach out to deans Gaba or Eller (gaba@stanford.edu or seller62@stanford.edu) if you have any questions.

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Hours of Operation: 7:00am-5:30pm Monday through Friday (including setup and takedown) - Evenings and Weekends by Special Arrangement

PLEASE NOTE:

This is a request form to reserve space in the Immersive Learning Center (ILC). Complete the form below as thoroughly as possible. Please allow three business days for ILC staff to respond to your request and arrange a consultation. All programs must be finalized two weeks prior to the scheduled event date.
New requests made with less than two weeks' notice cannot be accommodated.
The ILC may be reserved for immersive and simulation-based learning activities, including technology-based simulation using mannequins, standardized patient program (SPP), and part task training. Prior to booking a room, the requestor must complete this form so ILC staff can determine the appropriate room(s), resources, and personnel necessary for the activity.
All new courses and those with significant revisions require a consult with the appropriate ILC staff member(s). Our skilled team of educators, trainers, clinicians, and technicians are all here to help match your learning objectives to the available rooms and resources (e.g. ultrasound machine, task trainers, laptops, etc) in the ILC.
After-hours events (weekdays after 9:00 p.m. and weekends) require paid, prearranged after-hours housekeeping. If your after-hours ILC event is approved, please arrange housekeeping by submitting an OFPM Customer-Funded Work Request (medfacilities.stanford.edu) or by calling 650-721-2146 at least one week in advance of your event.

NOTE: If either the Event Coordinator and/or the Faculty/Director have not yet attested to the AY25 ILC Use & Support Agreement, they can do so here. Confirmations will not be released until we have received Agreements from both the Event Coordinator and Faculty/Director.

Course/Activity Details

NOTE: ILC rooms are NOT available to reserve as meeting spaces. If you need to request a meeting space in a School of Medicine classroom, visit the Medscheduler website, and select "Classroom & Outdoor Space Reservations", and choose the appropriate form.

* = required field

Title of event:*

Include number with course name if related to a medical student course (example: INDE 205: EMED or PICU CRM).

Is this a repeat activity (previously held in the ILC) with NO changes from the last session?:*

Yes

If No (not a repeat course), is this a*

Revised activity (e.g. curriculum, rooms, or resources have changed)

New activity

N/A: This is a repeat course

Please provide an outline of the session's activities*

Choose the event type category that best suits this event*

Select

Primary learner population*

If there is more than one learner population, please list primary here and below.

Select or enter value

Secondary learner population

Select or enter value

Number of participants per session*

Program Information

Name and title of requestor*

Requestor e-mail*

Requester phone*

Requesting department or organization*

Name and title of faculty lead*

Faculty e-mail*

Date*

This date MUST be at least two weeks from today. We cannot accommodate requests with less than two weeks' notice.

This form is for AY25 dates only (August 26, 2024-August 24, 2025). If you are requesting for a date before AY25, please use the AY24 Request Form.

Duration of set up time required*

Select or enter value

Preferred start time*

Preferred end time*

Duration of take down time required*

Select or enter value

Additional dates

List additional dates and corresponding start and finish times if you would like to run multiple iterations of the same course.

Alternative dates and times

We will only schedule your course on an alternative date if we are unable to accommodate your first preference. In the event that this occurs, we will contact you before finalizing the reservation.

Preferred room type (e.g., clinic rooms, OR, 3-Bay, task training space, large classroom, etc.)*

To better accommodate your request, it is important that you list below the appropriate room type and all of the resources that you would prefer.

Preferred resources (if known)

See ILC Resources list for details (SUNet ID is required to view).

Will this course be repeated during the academic year?*

Select or enter value

Does your program require a simulationist?*

A simulationist is required if you are reserving the OR and/or 3-Bay.

Select or enter value

PLEASE NOTE: SIMULATIONISTS ARE EXPERT TECHNICIANS WHO ARE AVAILABLE TO SUPPORT FACULTY AND INSTRUCTORS. HOWEVER, THEY ARE NOT CLINICIANS AND CANNOT ASSIST WITH TEACHING OF COURSE MATERIAL TO PARTICIPANTS.

Do you anticipate needing standardized patients or ultrasound models for your program?*

Please note that there is a cost associated with hiring Standardized Patient actors or Ultrasound Models, and the request must be made through a different form. Links can be found at

https://cisl.stanford.edu/standardized-patient-program/faculty.html

Select or enter value

Information for invoicing

Some courses will have costs associated with the use of rooms, resources or supplies. These costs will be identified prior to charging the PTA/Cost Center listed below. Please note that we can only charge one PTA/cost center; we are not able to split costs across multiple accounts.

PTA/Cost Center Approver First and Last name

PTA/Cost Center Approver contact number

PTA/Cost Center approver e-mail

E-mail address of approver for billing of resources/supplies on above PTA.

PTA/Cost Center number

PTA number for billing of resources/supplies

Are you receiving any industry support for this event? This includes financial support as well as donation of equipment.*

If yes, please be aware of the Stanford Industry Interactions Policy (SIIP), which can be found here: http://med.stanford.edu/siip/home.html. We require that you provide proof of compliance with this policy if your program has industry support.

Select or enter value

Comments/Questions

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