- Exam Snapshot: The Numbers You Must Memorize
- Registration, Fees, and Eligibility at a Glance
- The Five Domains, Weighted and Ranked
- Domain-by-Domain Fast Facts
- Question Format and Scoring Mechanics
- Test-Day Logistics: Prometric vs. ProProctor
- Renewal, CPD, and Keeping It Active
- The Week-Before Review Schedule
- Quick-Reference Comparison Table
- FAQ
- The exam has 115 questions (100 scored, 15 unscored pretest) in a two-hour window.
- Passing requires a scaled score of 700; there is no penalty for guessing.
- Simulation Technology Operations is the largest domain at 35% of the exam.
- Fees are $395 for SSH members/supporting-org employees and $495 for nonmembers.
Exam Snapshot: The Numbers You Must Memorize
If you only have five minutes before your exam appointment, these are the numbers that matter. The Certified Healthcare Simulation Operations Specialist (CHSOS) exam is a two-hour, computer-based test made up of 115 four-option multiple-choice questions. Of those, 100 are scored and 15 are unscored pretest items used to evaluate future exam versions - but because you cannot tell which is which, every question deserves your full attention.
The passing standard is a scaled score of 700, and there is no penalty for guessing, so leaving a question blank is always the wrong move. For a deeper breakdown of how that scaled score is calculated and what it actually represents, see our full CHSOS Passing Score 2026 guide.
Registration, Fees, and Eligibility at a Glance
CHSOS is administered by the Society for Simulation in Healthcare (SSH) through its Certification Council, with exam delivery handled by SMT and Prometric. The fee structure is straightforward:
- $395 for SSH members and employees of supporting organizations
- $495 for nonmembers
Eligibility isn't automatic. Applicants must currently work in a healthcare-simulation operations role with focused learner-facing expertise, hold a bachelor's degree (or an equivalent combination of education and experience), document at least two years of healthcare-simulation operations experience, and secure three confidential references or reports. If you're unsure whether your job title or experience qualifies, our detailed CHSOS Requirements 2026 article walks through each qualifying pathway.
For a line-by-line cost comparison - including what happens if you need to retake the exam - check the CHSOS Certification Cost 2026 breakdown.
Key Takeaway
Confirm your two years of operations experience and gather your three references before you pay the $395/$495 application fee - incomplete applications waste both time and money.
The Five Domains, Weighted and Ranked
The current blueprint is the 2024 examination content outline, built from the 2022-2023 practice analysis. Every scored question maps to one of five domains, and the weighting tells you exactly where to invest your study hours.
| Domain | Weight | Rank |
|---|---|---|
| Simulation Technology Operations | 35% | 1st (largest) |
| Healthcare Simulation Practices, Principles, and Procedures | 25% | 2nd |
| Professional Role: Behavior, Capabilities, and Leadership | 15% | Tied 3rd |
| Concepts in Instructional Design as Applied to Simulation | 15% | Tied 3rd |
| Concepts in Healthcare as Applied to Simulation | 10% | 5th (smallest) |
Notice that Simulation Technology Operations alone accounts for roughly a third of the exam. That single domain deserves as much study time as the two smallest domains combined. For a domain-by-domain walkthrough with example topics and task statements, see the CHSOS Exam Domains 2026 complete guide.
Domain-by-Domain Fast Facts
Domain 1: Concepts in Healthcare as Applied to Simulation (10%)
Covers foundational clinical and healthcare-system knowledge that operations specialists need to support realistic scenarios.
- Basic anatomy, physiology, and clinical terminology relevant to scenario setup
- How healthcare workflows and settings translate into simulation design
Domain 2: Simulation Technology Operations (35%)
The largest domain by far - covers the hands-on technical backbone of the job.
- Manikin and task-trainer setup, troubleshooting, and maintenance
- Audiovisual systems, control room software, and networking basics
- Moulage, props, and equipment inventory management
Domain 3: Healthcare Simulation Practices, Principles, and Procedures (25%)
Covers the operational standards and safety practices that keep simulation programs running smoothly.
- Standards of Best Practice application in day-to-day operations
- Scenario execution, safety protocols, and quality assurance
Domain 4: Professional Role: Behavior, Capabilities, and Leadership (15%)
Covers professionalism, teamwork, and leadership expectations for operations specialists.
- Communication with faculty, learners, and interprofessional teams
- Ethical conduct and professional development responsibilities
Domain 5: Concepts in Instructional Design as Applied to Simulation (15%)
Covers how learning objectives and instructional theory shape the operational build of a scenario.
- Supporting debriefing logistics and learner assessment tools
- Aligning technical setup with defined learning outcomes
Want the full task-statement-level breakdown for each of these? The CHSOS Exam Domains 2026 guide expands on every bullet above.
Question Format and Scoring Mechanics
Every question on the CHSOS exam is a standard four-option multiple-choice item - there are no multi-select, drag-and-drop, or essay-format questions. This consistency is good news: you only need to master one question type, not several. Expect scenario-based stems that describe a simulation-center situation (a malfunctioning manikin, a scheduling conflict, a debriefing question) and ask you to select the best operational response.
Because 15 of the 115 questions are unscored pretest items, your actual scored performance is based on 100 questions, but you won't know which 15 don't count - so treat every item as if it matters. The scaled score of 700 needed to pass is not a raw percentage; it accounts for item difficulty across the pool. For candidates who want to understand exactly how difficult the exam feels in practice compared to other certification exams, our How Hard Is the CHSOS Exam? guide breaks down the difficulty factors in detail.
Test-Day Logistics: Prometric vs. ProProctor
You have two options for sitting the exam:
- In-person at a Prometric test center - the traditional route, with proctors on-site and standardized testing conditions.
- Live remote proctoring via ProProctor - take the exam from your own location while a proctor monitors remotely.
Both delivery methods use the same 115-question, two-hour format. If English is not your first language, approved ESL accommodations may add one additional hour to your testing time - worth requesting well in advance if you qualify, since accommodation approval isn't instant. For scheduling windows, blackout periods, and how far in advance to book your seat, see CHSOS Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Renewal, CPD, and Keeping It Active
CHSOS certification is valid for three years from the date you pass. Before it expires, you have two renewal paths:
- Earn 45 Continuing Professional Development (CPD) credits, with required activity represented in every one of the five content domains - you can't concentrate all your CPD hours in one area.
- Retake the exam if you'd rather requalify through testing than accumulate CPD hours.
Because CPD activity must touch every domain, it's worth tracking your professional development against the same five categories you studied for initially - Simulation Technology Operations, Healthcare Simulation Practices, Professional Role, Instructional Design, and Concepts in Healthcare. This keeps your recertification portfolio balanced and audit-ready.
Key Takeaway
Log CPD activity by domain from day one of your certification cycle - waiting until year two or three to plan renewal creates unnecessary scrambling.
The Week-Before Review Schedule
A cheat sheet is only useful if you review it on a schedule that matches the exam's weighting. In the final week before your test date, allocate review time proportionally to each domain's percentage rather than spending equal time on all five.
Simulation Technology Operations (35%)
- Review manikin troubleshooting steps, AV/control-room workflows, and equipment maintenance logs
- Run through moulage and inventory-management scenarios from memory
Healthcare Simulation Practices, Principles, and Procedures (25%)
- Re-read Standards of Best Practice summaries
- Drill scenario-execution and safety-protocol questions
Professional Role & Instructional Design (15% each)
- Review communication, ethics, and leadership scenarios
- Revisit debriefing logistics and learning-objective alignment
Concepts in Healthcare as Applied to Simulation (10%) + Full Review
- Skim clinical terminology basics
- Take a full timed practice run through our CHSOS practice test platform to simulate the two-hour format
This weighted approach mirrors the actual exam blueprint instead of generic study advice - spending equal time on all domains would waste hours on the smaller Domain 1 while underprepping the 35%-weighted Domain 2. For a full multi-week study plan built the same way, see the CHSOS Study Guide 2026.
Quick-Reference Comparison Table
| Fact | Detail |
|---|---|
| Administering body | SSH Certification Council |
| Exam delivery | SMT and Prometric (test center or ProProctor remote) |
| Fee (member/supporting org) | $395 |
| Fee (nonmember) | $495 |
| Total questions | 115 (100 scored + 15 unscored pretest) |
| Time allowed | 2 hours (plus 1 hour for approved ESL accommodation) |
| Passing standard | Scaled score of 700; no guessing penalty |
| Minimum experience | 2 years in healthcare-simulation operations |
| Education requirement | Bachelor's degree or equivalent combination |
| References required | 3 confidential references/reports |
| Certification validity | 3 years |
| Renewal options | 45 CPD credits (all domains) or retake exam |
| Largest domain | Simulation Technology Operations (35%) |
If you're still weighing whether the credential fits your career goals, our Is the CHSOS Certification Worth It? ROI Analysis and CHSOS Salary Guide 2026 look at how the certification connects to hiring and compensation trends in simulation centers, academic medical centers, and healthcare training programs. And for anyone new to the acronym itself, our foundational explainer What Is CHSOS? is a good starting point before diving into this cheat sheet in more depth.
FAQ
The exam has 115 four-option multiple-choice questions - 100 scored and 15 unscored pretest items - administered over two hours. Approved ESL accommodations may add one additional hour.
You need a scaled score of 700. There is no penalty for guessing, so answer every question even if you're unsure.
Simulation Technology Operations, which makes up 35% of the exam - more than double the weight of the smallest domain, Concepts in Healthcare as Applied to Simulation (10%).
$395 for SSH members and employees of supporting organizations, or $495 for nonmembers.
Certification is valid for three years. You can renew by earning 45 Continuing Professional Development credits with activity in every content domain, or by retaking the exam.
Keep this cheat sheet handy as a quick refresher, but pair it with real practice under timed conditions using our CHSOS practice exam simulator so the numbers above translate into exam-day confidence.