- Defining the CHSOS Credential
- Who Administers the Exam and Why It Matters
- What a CHSOS Actually Does on the Job
- Exam Structure, Format, and Scoring
- The Five Content Domains
- Eligibility Requirements
- Registration, Fees, and Testing Options
- Maintaining the Credential
- How to Prepare Around the Blueprint
- Frequently Asked Questions
- CHSOS is administered by SSH's Certification Council, with testing delivered through SMT and Prometric.
- The exam has 115 four-option questions (100 scored, 15 unscored) over two hours.
- Simulation Technology Operations is the largest domain, worth 35% of the exam.
- Passing requires a scaled score of 700, and there's no penalty for guessing.
Defining the CHSOS Credential
CHSOS stands for Certified Healthcare Simulation Operations Specialist. It's a credential built specifically for the technical and operational side of healthcare simulation-the people who run the mannequins, manage the audiovisual systems, maintain equipment, and make sure a simulation scenario executes without a hitch. If you've landed here after searching "what is a CHSOS," you're likely trying to figure out whether this certification applies to your job, what it takes to earn it, and whether it's worth pursuing. This article breaks down the credential itself: who governs it, what the exam covers, how it's structured, and what's required to sit for it.
For a broader look at related terminology, you may also want to check our companion pieces on CHSOS meaning, what CHSOS stands for, and what CHSOS means in the context of simulation-based education.
Who Administers the Exam and Why It Matters
The Society for Simulation in Healthcare (SSH) administers CHSOS through its Certification Council. This matters because SSH is the professional body most closely associated with simulation-based healthcare education, and its certifications carry weight with hospitals, nursing schools, medical schools, and simulation centers that hire specifically for operations roles. Examination services-scheduling, delivery, and score reporting-are handled through SMT and Prometric, which is why candidates can test at physical Prometric test centers or through live remote proctoring using ProProctor.
What a CHSOS Actually Does on the Job
Before diving into the exam mechanics, it helps to understand who this certification is designed for. CHSOS-eligible professionals typically work in learner-facing simulation operations roles: setting up mannequins and task trainers, programming physiological responses, troubleshooting audiovisual and debriefing systems, managing moulage and consumables, and supporting faculty during live scenarios. They are the technical backbone of a simulation center, and increasingly, employers post CHSOS jobs explicitly requiring or preferring the credential for hiring and advancement.
This is distinct from certifications aimed purely at educators or administrators. The CHSOS blueprint assumes hands-on, applied knowledge of equipment, technology, and simulation-day logistics-not just instructional theory.
Exam Structure, Format, and Scoring
The 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 content-candidates won't know which is which, so every question should be treated as if it counts.
- Format: Four-option multiple choice, single best answer
- Length: 115 total questions (100 scored, 15 unscored)
- Time limit: Two hours, with an additional hour available for approved English-as-a-second-language accommodations
- Passing standard: A scaled score of 700
- Guessing policy: No penalty for incorrect answers, so every question should be answered
Because scoring is scaled rather than raw, the exact number of correct answers needed can vary slightly between forms. For a deeper breakdown of how scoring works, see our dedicated guide on the CHSOS passing score.
Key Takeaway
Since there's no guessing penalty, never leave a question blank-select your best guess and move on rather than losing time you need elsewhere on the exam.
The Five Content Domains
The exam is built from the 2024 examination content outline, which itself was derived from a 2022-2023 practice analysis of working simulation operations professionals. That means the domains reflect what people in these roles are actually asked to do, not an abstract academic framework. There are five domains, each weighted differently on the exam.
Domain 1: Concepts in Healthcare as Applied to Simulation (10%)
Covers foundational clinical and healthcare-system knowledge needed to make simulation scenarios realistic and safe.
- Basic clinical terminology and healthcare workflows
- Patient safety principles as they translate into scenario design
Domain 2: Simulation Technology Operations (35%)
The single largest domain, focused on the equipment and systems operations specialists manage directly.
- Mannequin and task trainer setup, programming, and troubleshooting
- Audiovisual systems, recording, and debriefing platforms
- Equipment maintenance, inventory, and technical problem-solving under time pressure
Domain 3: Healthcare Simulation Practices, Principles, and Procedures (25%)
The second-largest domain, covering the operational standards and best practices that keep simulation programs consistent and safe.
- Standards of best practice in simulation delivery
- Scenario setup, moulage, and environment preparation
Domain 4: Professional Role: Behavior, Capabilities, and Leadership (15%)
Focuses on professionalism, communication, and leadership expectations within a simulation team.
- Interprofessional collaboration and communication
- Ethical conduct and confidentiality in simulation settings
Domain 5: Concepts in Instructional Design as Applied to Simulation (15%)
Covers how operations specialists support the instructional side of simulation, even without being lead educators.
- Understanding learning objectives and how technology supports them
- Basic instructional design principles as they intersect with operations
Because Simulation Technology Operations and Healthcare Simulation Practices together make up 60% of the exam, candidates should weight their preparation accordingly. Our full CHSOS Exam Domains Guide walks through each domain in far greater depth, including subtopics and sample question styles.
Eligibility Requirements
CHSOS isn't open to everyone in healthcare education-it's specifically scoped to operations professionals. To sit for the exam, applicants must meet several criteria:
- 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
- Arrange three confidential references or reports from colleagues or supervisors
These requirements confirm that CHSOS is a mid-career credential, not an entry-level certificate. If you're unsure whether your background qualifies, our detailed CHSOS Requirements guide walks through documentation, acceptable experience types, and how the reference process works.
Registration, Fees, and Testing Options
The exam fee is $395 for SSH members and employees of supporting organizations, or $495 for nonmembers. This fee covers the application review and the computer-based exam delivered through SMT/Prometric infrastructure.
| Candidate Type | Exam Fee |
|---|---|
| SSH member / supporting organization employee | $395 |
| Nonmember | $495 |
Candidates have two testing venue options: an in-person Prometric test center, or live remote proctoring through ProProctor from a private location. Approved ESL accommodations can add an extra hour to the standard two-hour time limit. For a full cost breakdown, including what happens if you need to retake the exam, see our CHSOS Certification Cost breakdown. You can also review current testing windows in our CHSOS Exam Dates guide before you register.
Maintaining the Credential
CHSOS certification is valid for three years. To renew, certificants must either:
- Earn 45 Continuing Professional Development (CPD) credits, with activity documented in every content domain, or
- Retake and pass the exam
The requirement to show CPD activity across all five domains-not just the ones most relevant to your daily job-means operations specialists need to keep some exposure to instructional design and professional leadership content even if their day-to-day work leans heavily toward technology operations.
How to Prepare Around the Blueprint
Because the exam blueprint weights Simulation Technology Operations at 35% and Healthcare Simulation Practices, Principles, and Procedures at 25%, an effective preparation plan should allocate more review time to those two domains than to the others-without ignoring the smaller ones, since all 100 scored questions count toward the 700 scaled-score passing standard.
Simulation Technology Operations
- Review mannequin programming, AV systems, and troubleshooting scenarios
- Practice equipment maintenance and inventory management concepts
Healthcare Simulation Practices and Procedures
- Study best-practice standards for scenario setup and moulage
- Review safety and consistency protocols across simulation environments
Professional Role and Instructional Design
- Cover leadership, communication, and ethical conduct topics
- Connect instructional design basics to your operations work
Full Review and Practice Testing
- Take timed practice exams under two-hour conditions
- Revisit weak domains identified through practice scoring
This kind of domain-weighted scheduling is more useful than generic study techniques because it directly mirrors how the exam is built. For a more comprehensive walkthrough of preparation strategy, our CHSOS Study Guide covers pacing, resource selection, and how to structure practice sessions around each domain's weight. If you're still assessing how demanding the exam actually is relative to your background, How Hard Is the CHSOS Exam? offers an honest difficulty assessment. You can also start running full-length practice questions right now on our CHSOS practice test platform to see where your knowledge gaps actually are.
Frequently Asked Questions
No. CHSOS is specifically focused on simulation operations roles-equipment, technology, and logistics-rather than instructional design or educator-focused credentials. See our overview at CHSOS Certification for how it compares to related credentials.
The exam contains 115 four-option multiple-choice questions (100 scored, 15 unscored pretest items) with a two-hour time limit. Approved ESL accommodations can add one extra hour.
You need a scaled score of 700. There's no penalty for guessing, so answering every question is advantageous. More detail is available in our CHSOS Passing Score guide.
Yes. Candidates can test at a Prometric test center or through live remote proctoring using ProProctor, giving flexibility depending on location and preference.
Certification is valid for three years. Renewal requires earning 45 Continuing Professional Development credits, with activity across every content domain, or retaking the exam.
Understanding what a CHSOS is starts with recognizing it as a role-specific, evidence-based credential built directly from a practice analysis of working simulation operations professionals. If you're weighing whether to pursue it, our guides on whether CHSOS certification is worth it, CHSOS salary data, and CHSOS pass rate information can help round out the picture before you commit to the application process.