school for change agents certification application form

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Gain a certificate as a health and care change agent. Get certificated! Take some actions to demonstrate your learning from the School for Change Agents and become a “Certificated Change Agent.” If you complete the learning process to a satisfactory level you will: be recognised as a “certificated change agent” by the School for Change Agents from the Horizons Group be awarded a virtual badge that you can use on your email signature, personal website, LinkedIn profile etc. receive a certificate Can I apply for CPD credits for attending the School? Yes, if you are based in the United Kingdom. The certificate that you will receive, if you choose to go through the process, will be sent along with a document that contains details about the modules, including the topics they covered and the length of time for each module. You will then be able to use this information and certificate in your own personal CPD portfolio that you submit to your Royal College or professional association. What do I need to do to be awarded the certificate? You need to demonstrate that you have used the learning from the School for Change Agents within a change action in your working environment. You need to complete the enclosed form and return it to the School ([email protected]) by 1700 (GMT) on Monday 1 May 2017.

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Page 1: School for Change Agents Certification Application Form

Gain a certificate as a health and care change agent. Get certificated!Take some actions to demonstrate your learning from the School for Change Agents and become a “Certificated Change Agent.”

If you complete the learning process to a satisfactory level you will:

be recognised as a “certificated change agent” by the School for Change Agents from the Horizons Group

be awarded a virtual badge that you can use on your email signature, personal website, LinkedIn profile etc.

receive a certificate

Can I apply for CPD credits for attending the School?Yes, if you are based in the United Kingdom.

The certificate that you will receive, if you choose to go through the process, will be sent along with a document that contains details about the modules, including the topics they covered and the length of time for each module. You will then be able to use this information and certificate in your own personal CPD portfolio that you submit to your Royal College or professional association.

What do I need to do to be awarded the certificate?You need to demonstrate that you have used the learning from the School for Change Agents within a change action in your working environment.

You need to complete the enclosed form and return it to the School ([email protected]) by 1700 (GMT) on Monday 1 May 2017.

Questions and AnswersIf you have any question about filling in this form please visit the Certification page on the School website http://theedge.nhsiq.nhs.uk/school.

Page 2: School for Change Agents Certification Application Form

Name:

Postal address:

Email address:

Question 1: What was the change action you set out to address? (100 words max)

Question 2: What action or actions did you take personally to bring about the change? (100 words max)

Question 3: How did you involve others in creating the change action e.g. stakeholders? (100 words max)

Page 3: School for Change Agents Certification Application Form

Question 4: Did you encounter any resistance whilst creating and/or undertaking the change, how did you respond to this resistance? (250 words max)

Question 5: How did what you learned from the School help you to implement the change action? For example what models / frameworks from the School did you make use of if any? (250 words max)

Question 6: What is different or what do you expect to be different as a result of the change action? Please tell us what impact the change will have. (400 words max)

Page 4: School for Change Agents Certification Application Form

Question 7: What learning from the School has helped you to develop as a Change Agent? (250 words max)

Please tick to confirm you have done the following:

o I have watched the live web seminars for all five of the modules or have watched the recordings of the live sessions

o I have applied what I have learnt from the School to a ‘real’ changeo I have completed the evaluation process for the School for Change Agents

What we’ll be looking forAs we read through your application, we will be looking for evidence of your learning from the School. We are interested in knowing how you have put your new learning into practice and what difference your changes have made to you, the people you work with and/or the people you care for.

Please return your completed submission to School ([email protected] ) by 1700 (GMT) on Monday 1 May 2017.