- CHSOS is administered by the Society for Simulation in Healthcare's Certification Council.
- The exam has 115 four-option questions (100 scored) with a 700 scaled passing score.
- Simulation Technology Operations is the largest domain, worth 35% of the exam.
- Fees are $395 for SSH members/supporting organization staff, $495 for nonmembers.
What CHSOS Actually Is
CHSOS stands for Certified Healthcare Simulation Operations Specialist. It is a credential built specifically for the people behind the scenes of healthcare simulation programs - the specialists who set up manikins, run audiovisual systems, program scenarios, and keep the technical and logistical machinery of a simulation center running smoothly. Unlike credentials aimed at educators who design curriculum, CHSOS focuses on the operational and technical expertise required to execute simulation-based learning safely and reliably.
If you're still getting oriented to the basics, our companion pieces on CHSOS Meaning and What Does CHSOS Stand For? cover the terminology in more depth. This article focuses on the mechanics: who runs the program, what the exam covers, and what you need to qualify.
Who Administers It and Where You Take It
The Society for Simulation in Healthcare (SSH) administers CHSOS through its Certification Council. Testing logistics are handled through SMT and Prometric, giving candidates two ways to sit the exam: in person at a Prometric test center, or remotely via live remote proctoring through ProProctor. Candidates approved for English-as-a-second-language accommodations may receive up to one additional hour to complete the exam.
This dual-delivery model matters practically. If you live far from a Prometric center, remote proctoring removes travel as a barrier, but you'll need a private, quiet space and a compliant testing setup. For a full rundown of registration windows and scheduling logistics, see CHSOS Exam Dates 2026.
Eligibility Requirements Before You Apply
CHSOS is not an entry-level credential. SSH requires candidates to meet several criteria before they can sit the exam:
- Current work in a healthcare-simulation operations role with focused, learner-facing expertise
- A bachelor's degree, or an equivalent combination of education and experience
- At least two years of documented healthcare-simulation operations experience
- Three confidential references or reports supporting the application
The reference requirement often surprises first-time applicants - it's not just a form to fill out but a set of confidential attestations that take time to collect, so start that process early. For a line-by-line breakdown of documentation and how "equivalent experience" is evaluated, read CHSOS Requirements 2026.
Key Takeaway
Because references are confidential and must come from people who can speak to your operations experience, request them at least a month before you plan to submit your application.
Exam Format, Fees, 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 - you won't know which is which, so every question deserves full attention.
Passing requires a scaled score of 700. There is no penalty for guessing, which means leaving a question blank is strictly worse than making an educated guess. For the exact mechanics of how the scaled score is calculated and what it means relative to raw correct answers, see CHSOS Passing Score 2026.
| Exam Detail | Specification |
|---|---|
| Total Questions | 115 (100 scored, 15 unscored pretest) |
| Question Format | Four-option multiple choice |
| Time Allotted | 2 hours (+1 hour for approved ESL accommodations) |
| Passing Score | 700 (scaled) |
| Guessing Penalty | None |
| Fee (SSH member) | $395 |
| Fee (Nonmember) | $495 |
Because the fee difference between member and nonmember pricing is $100, many candidates evaluate SSH membership before registering. For a complete cost picture including retake and renewal expenses, check CHSOS Certification Cost 2026.
The Five Content Domains
The current blueprint is the 2024 examination content outline, developed from a 2022-2023 practice analysis of what operations specialists actually do on the job. Every scored question maps to one of five domains, and the weighting tells you exactly where to invest your preparation time.
Domain 1: Concepts in Healthcare as Applied to Simulation (10%)
Covers foundational clinical and healthcare-system knowledge that operations specialists need to build and support realistic scenarios.
- Basic clinical terminology and workflows relevant to scenario accuracy
Domain 2: Simulation Technology Operations (35%)
The largest domain by far, covering manikin operation, audiovisual and recording systems, moulage, task trainers, and troubleshooting technical failures during live sessions.
- Manikin programming and hardware maintenance
- AV capture, debriefing systems, and control-room operations
Domain 3: Healthcare Simulation Practices, Principles, and Procedures (25%)
The second-largest domain, focused on the standards, protocols, and procedural knowledge that keep simulation activities safe, consistent, and effective.
- Scenario setup, safety protocols, and standardized operating procedures
Domain 4: Professional Role: Behavior, Capabilities, and Leadership (15%)
Covers professionalism, ethical conduct, communication with learners and faculty, and leadership within the simulation team structure.
- Interprofessional collaboration and role boundaries
Domain 5: Concepts in Instructional Design as Applied to Simulation (15%)
Tests understanding of how simulation scenarios connect to learning objectives, even though CHSOS candidates are not primarily designing curriculum.
- Alignment between operational execution and instructional intent
Together, Domains 2 and 3 account for 60% of the exam, meaning technology operations and simulation practices should dominate your review time. For a deeper walkthrough of each domain with sample topic lists, see CHSOS Exam Domains 2026: Complete Guide to All 5 Content Areas.
Who Hires CHSOS-Certified Professionals
CHSOS-certified specialists typically work inside academic health science centers, nursing and medical school simulation labs, hospital-based simulation programs, and standalone simulation training centers. Titles vary - simulation operations specialist, simulation technician, simulation lab coordinator - but the underlying function is consistent: keeping the technical and logistical infrastructure of simulated learning environments functional and learner-ready.
Because the credential validates hands-on technical competence rather than instructional authorship, employers often treat it as a differentiator when hiring for roles that involve manikin programming, AV systems, or lab operations management. If you're weighing whether the credential translates into better job prospects or pay, CHSOS Salary Guide 2026: Complete Earnings Analysis and Is the CHSOS Certification Worth It? Complete ROI Analysis 2026 both address that question directly. For current openings that specifically reference the credential, browse CHSOS Jobs.
Certification Validity and Renewal
Once earned, CHSOS is valid for three years. Renewal happens in one of two ways: earning 45 Continuing Professional Development (CPD) credits - with required activity represented across every content domain - or retaking the exam entirely.
The domain-spread requirement for CPD credits is easy to overlook. It's not enough to accumulate 45 credits from a single conference track; you need documented activity touching Domains 1 through 5, which encourages certified specialists to stay broadly current rather than narrowly specialized.
Building a Domain-Aware Study Plan
Generic study techniques - timed review blocks, active recall, spaced repetition - work fine for CHSOS prep, but only when they're mapped to the actual weighting of the blueprint. Spending equal time on all five domains ignores the fact that Domain 2 alone is worth more than Domains 1, 4, and 5 combined.
Simulation Technology Operations (Domain 2)
- Review manikin systems, AV/control-room workflows, and troubleshooting scenarios first since this domain carries 35% of exam weight
Simulation Practices, Principles, and Procedures (Domain 3)
- Study safety protocols, scenario setup standards, and operating procedures - the second-heaviest domain at 25%
Professional Role and Instructional Design (Domains 4 & 5)
- Cover leadership, professionalism, and how instructional objectives shape operational execution
Healthcare Concepts (Domain 1) and Full Review
- Finish the lightest-weighted domain, then run full-length practice sets under timed, guess-friendly conditions
For a complete week-by-week plan with resource recommendations, our CHSOS Study Guide 2026: How to Pass on Your First Attempt expands on this structure in detail. And if you want an honest assessment of how challenging the exam is relative to other certifications before you commit to a timeline, How Hard Is the CHSOS Exam? Complete Difficulty Guide 2026 walks through that comparison.
Because there's no guessing penalty, practicing under realistic time pressure with a full 115-question set matters more than memorizing isolated facts. You can run timed practice sessions that mirror the real exam structure on our practice test platform, which is built specifically around the current CHSOS blueprint.
Key Takeaway
Allocate study time roughly in proportion to domain weight - Domain 2 and Domain 3 together should absorb well over half of your preparation hours.
For candidates who want a condensed reference to keep nearby during final review, the CHSOS Cheat Sheet 2026: One-Page Review of Must-Know Facts distills the highest-yield facts from all five domains into a single page. And if you're curious how your preparation compares against how other candidates actually perform, CHSOS Pass Rate 2026: What the Data Shows looks at the available outcome data.
Frequently Asked Questions
No. CHSOS focuses specifically on operations and technical execution roles, while other SSH credentials target educators and program facilitators. The domain structure and exam blueprint are built around operations competencies rather than instructional design authorship.
The exam contains 115 four-option multiple-choice questions - 100 scored and 15 unscored pretest items - administered over a two-hour testing window, with an additional hour available for approved ESL accommodations.
You need a scaled score of 700. There is no penalty for guessing, so answering every question - even with an educated guess - is always better than leaving it blank.
Yes. Candidates can test at a Prometric test center or through live remote proctoring via ProProctor, giving flexibility for those without convenient access to a physical test site.
Certification is valid for three years. Renewal requires earning 45 Continuing Professional Development credits with activity represented in every content domain, or retaking the exam.
For a broader look at the credential's full scope, requirements, and career context, our overview article on CHSOS Certification and the related What Is CHSOS Certification? piece both provide additional detail. You can also explore practice questions organized by domain weighting on the main CHSOS practice test site to see exactly where your preparation stands before exam day.