If you teach with simulation, you've probably seen the letters after a colleague's name: CHSE, sometimes CHSE-A or CHSOS. These are certifications from the Society for Simulation in Healthcare (SSH), and they give simulation educators and operations staff a way to show that their practice has been measured against a published standard.
No one needs a certificate to run a good scenario. But if simulation is becoming a real part of your job, or you're moving into a simulation role, it helps to know what each credential asks of you and what it gives back.
The four SSH certifications at a glance
| Credential |
Intended for |
Degree |
Simulation experience |
Assessment |
| CHSE |
People in a simulation educator role |
Bachelor's or equivalent |
2 years |
115-question, 2-hour exam |
| CHSE-A |
Leaders in simulation education; must hold a current CHSE |
Master's or equivalent |
5 years |
Structured portfolio, peer reviewed |
| CHSOS |
People in a simulation operations specialist role |
Bachelor's or equivalent |
2 years in an operations role |
115-question, 2-hour exam |
| CHSOS-A |
Leaders in simulation operations; must hold a current CHSOS |
Bachelor's or equivalent |
5 years in an operations role |
Structured portfolio |
Each is valid for three years, and SSH requires every eligibility criterion to be met before you apply.
CHSE: Certified Healthcare Simulation Educator
SSH describes the CHSE as intended for people "who perform healthcare simulation in the educator role," whatever the modality, setting, learner population or profession. For most nursing faculty who facilitate and debrief scenarios, this is the starting point.
Eligibility. You need a bachelor's degree or an equivalent combination of education and experience (candidates without a bachelor's can petition SSH for equivalency), plus two years of continued use of simulation in healthcare education, research or administration. You also need an educational role in simulation with learners. The CHSE eligibility page has the exact wording.
The application. You apply online and list three professional references, who each complete a confidential report on your performance, so ask them early.
The exam. It has 115 questions and a two-hour limit. You can test with remote proctoring through Prometric or at a testing site. Results are pass or fail, and a scaled score of 700 is needed to pass. Candidates who don't pass receive their scaled score and a breakdown by domain. You can take the exam once every 90 days, up to four times in a calendar year.
Fees. As of November 2026, SSH lists the first-time CHSE application, which includes the first exam attempt, at $395 for members of SSH and supporting organizations and $495 for everyone else. Check the CHSE application page for current fees before you budget.
CHSE-A: the advanced educator credential
SSH calls the CHSE-A "a portfolio-based certification for leaders in healthcare simulation." There's no exam. Instead, you submit a structured portfolio that trained peer reviewers compare against SSH's published Standards and Suggested Evidence. Two reviewers evaluate each portfolio, and a third is brought in if they can't agree.
To apply, you must hold a current CHSE, have a master's degree or equivalent, and document five years of continued simulation use in healthcare education, research or administration. The portfolio includes narrative responses showing your performance in the domains SSH assesses, an exemplar activity, a simulation-specific CV and two references. SSH reviews CHSE-A applications twice a year, with deadlines of March 1 and September 1. A first CHSE-A takes on the expiration date of your current CHSE.
CHSOS and CHSOS-A: the operations track
The CHSOS is for people "who perform healthcare simulation in the operations specialist role." In a nursing program, that's often the person who runs the technology and the lab rather than the debrief.
Eligibility mirrors the CHSE: a bachelor's degree or an accepted petition for equivalency, plus two years of continued simulation use in a healthcare operations role. The exam is also 115 questions in two hours, the application asks for three professional references, and SSH lists the same first-time fee as for the CHSE.
The CHSOS-A is the portfolio-based advanced credential for operations leaders. It requires a current CHSOS, a bachelor's degree or equivalent, and five years of experience in a healthcare simulation operations role.
Keeping it current: the three-year cycle
For the CHSE and CHSOS, you have two ways to stay certified:
- Renewal, which SSH recommends. Submit evidence of continued professional development before your certification expires. SSH accepts education- or simulation-focused activities, such as conferences, webinars and other education events.
- Recertification. Pass the exam again within the year before your certification expires.
As of November 2026, SSH lists renewal at $350 for members and $450 for others, and recertification by exam at $395 and $495.
How certification connects to the INACSL standards
The INACSL Healthcare Simulation Standards of Best Practice set out ten standards for simulation-based education, from Professional Development and Simulation Design to Facilitation and The Debriefing Process. INACSL released the fourth edition, with several standards revised, in 2025.
The Professional Development standard opens with: "Initial and ongoing professional development supports the simulationist across their career." The standards don't award credentials, but certification is one structured way to show both halves of that sentence: the exam or portfolio checks your foundation, and renewal asks for continued development every three years.
The Debriefing Process standard says every simulation-based educational activity must include a planned debriefing process, and the Facilitation standard ties the facilitation method to the learners' needs. Certification doesn't replace practice and peer feedback on those skills, but studying for it pushes you to name the frameworks behind what you already do.
At the program level, INACSL's Standards Endorsement recognizes programs that show excellence in four cornerstone standards: Prebriefing, Facilitation, Professional Integrity and Debriefing.
How certification connects to SSH accreditation
If your program holds or is pursuing SSH accreditation, certification shows up in the evidence. SSH's Teaching/Education accreditation standards ask programs to show they have people with expertise in designing simulation activities. The companion guidance lists "Certification in Healthcare Simulation (CHSE and CHSOS)" as one example of how that competency can be shown, alongside formal academic coursework in simulation. It's an example, not a requirement.
The same standards ask programs to have a process that assures the ongoing development and competence of simulation educators at least once a year. Educator evaluations should draw on at least two sources, such as self-evaluation, peer review, learner evaluation or the DASH rater tool. Certified or not, that's a useful template for consistent faculty practice.
Is it worth it?
Reasons it often is:
- Career moves. If you're moving from classroom or clinical teaching into a simulation educator, coordinator or director role, the credential gives a hiring committee an external, standardized signal of your simulation expertise.
- Credibility you can verify. SSH lists currently certified CHSEs on its website and will provide formal verification or a letter to your supervisor on request.
- A shared language for your faculty. When educators prepare against the same blueprint and standards, it's easier to agree on what a good prebrief, facilitation or debrief looks like from one course to the next.
Who might not need it yet:
- You've used simulation for less than two years. You aren't eligible yet. Spend the time building experience and keeping records you'll need later.
- Simulation is an occasional part of your teaching, and a simulation center team runs the scenarios and debriefs.
- Your program's bigger gap is consistency. Training every facilitator in one debriefing model may do more for students this year than one person's credential.
- Your budget is tight right now. Membership in SSH or a supporting organization lowers the fees, so compare costs before paying the non-member rate.
Practical steps to prepare
- Document your eligibility. List your simulation work by year, role and learner group, so the two-year (or five-year) requirement is easy to show.
- Work from the blueprint. SSH's own advice is to download the exam blueprint and turn each item into a question. The ones you can't answer easily get the most study time. Every exam question maps to at least one blueprint element.
- Choose extras on purpose. SSH offers an optional practice exam, review courses and a Blueprint Reference Manual. SSH notes the manual hasn't been updated to the 2024 blueprint, so check the CHSE preparation page before you buy.
- Re-read the INACSL standards, especially Facilitation, The Debriefing Process and Professional Development.
- Start a professional development log the day you pass, so renewal means uploading what you've already recorded.
Build the standards into every scenario
Whether or not you sit for the exam, the habits it rewards are the ones students notice: clear objectives, a prebrief that prepares them, a scenario that responds to their decisions and a debrief built on a model.
MapMySim drafts complete nursing simulation scenarios with objectives, prebrief, patient states, documents and a debrief written in your school's model. Every scenario is a draft for faculty review. Your first scenario is free.
For help choosing that model, see Which debriefing model should you use for nursing simulation?