Application for Recognition of Teaching Contributions 2023 1General Information2Role3Teaching4Teaching Qualifications/Training5Letter of Support6Personal Data If your application was successful in 2022 you do not need to reapply this year. You are instead asked to contact FacultySec@medschl.cam.ac.uk with 'teaching recognition' in the subject line, confirming whether your contribution has remained the same or has changed. We will then liaise individually with those whose contribution has changed. This change in process has been agreed for this year due to ongoing pandemic. If you would like to apply for recognition of teaching time, but have not applied previously or your application last year was unsuccessful, you must submit an application this year, for recognition of teaching time over the next twelve months from 1 April 2023. Application is made via online form and you are required to complete all sections of the form. Recognition is for the forthcoming year. For example, individuals approved for recognition in Lent Term 2023 would be recognised for the contributions they will make in the period l April 2023 to 31 March 2024. Anonymised statistical data on teaching qualifications/training gathered through this exercise will also be used to return information on Staff Development Key Performance Indicators as part of the data the Trust provides every year to the Clinical School as part of the School's annual quality assurance process. The statistical data will be used to answer questions such as 'What percentage of key teaching staff have undertaken an accredited educational qualification?' and 'What percentage of key teaching staff have discussed undergraduate education as part of their annual appraisal?'General InformationCan you confirm that you are a new applicant, i.e. that you do not currently have teaching recognised through the teaching recognition process?*If you are not a new applicant and currently have teaching recognised through this process, please see the note above regarding how to apply for continuation of this recognition. Yes Name* Prefix MrMrsMissMsDrProf.Rev. First Last Telephone*Email* Enter Email Confirm Email Use of Virtual Learning Environment (VLE)*Please note how regularly you use the Clinical School VLE (MedEd) to support your teaching commitments:Please selectNeverOccasionallyFrequentlyDid your last NHS appraisal include discussion of your undergraduate teaching activities?*YesNo RoleAre you a Specialty or Theme Lead?*Please selectYesNoFor which specialty or theme are you the Specialty Lead? Main Post / Specialty* Teaching Specialty* TeachingPlease indicate which of the following apply to your teaching, including the approximate number of hours per week or weeks per year for each.Lectures and SeminarsThis is dedicated teaching time in students' timetables (not teaching on ward rounds)Hrs/WeekWeeks/YearWard TeachingHrs/WeekWeeks/YearStudent Selected Components (SSCs)Hrs/WeekWeeks/YearClinical Communication Skills teachingHrs/WeekWeeks/YearProfessionalism teachingHrs/WeekWeeks/YearEthics and Law teachingHrs/WeekWeeks/YearTeaching pre-clinical studentsHrs/WeekWeeks/YearOther teaching/student support activities(for example, teaching for 'longitudinal themes' not listed above, pastoral care/mentorship, college activities, other activities). Please give brief description:Description of activityHrs/WeekWeeks/Year Total number of hoursIf you have not specified the number of hours per week and/or weeks per year above, please give an approximate total number of hours over a 42-week period. Your Teaching Contributions (description)Please give a brief description of your undergraduate teaching role over and above that which would normally be expected with a teaching hospital, and therefore beyond what would be encompassed within the standard 0.5 SPS allocation. Supervising SSC students may form part of this additional activity if it happens with regularity, as may regular small group teaching (e.g., for professionalism, radiology or in other areas). Teaching Qualifications/Training1. Do you have an educational component within your Personal Development Plan?Please selectYesNo2. Have you undertaken, or are you currently undertaking, the CUH Train the Trainers course?Please selectYesNo3. Have you undertaken, or are you currently undertaking, the CUH Essential Training for Eductional and Clinical Supervisors course?Please selectYesNo4. Have you undertaken, or are you currently undertaking, the Integrated Foundations of Medical Edcucation (IFME) course?Please selectYesNo5. Have you undertaken, or are you currently undertaking, a Postgraduate Certificate or Postgraduate Diploma in Medical Education?Please selectYesNo6. Have you undertaken, or are you currently undertaking, a masters in Medical Education?Please selectYesNo7. If you selected 'Yes' to Questions 3, 4, 5, 6 or 7 above, please give the date of completion (or expected completion) and qualification name (where relevant)8. Have you completed within the last five years (or are you currently attending) any other courses for teachers or examiners?Please selectYesNo9. If you selected 'Yes' to Question 8 above, please give names and dates of the courses attended10. Are you a member of the Higher Education Academy (HEA)?Please selectYesNo11. Are you a member of the Association of Medical Education (ASME)?Please selectYesNo12. Are you a member of the Academy of Medical Educators (AoME)?Please selectYesNo Letter of SupportPlease arrange for the template letter of support to be signed by your Specialty Lead.*Note: If you are the Specialty Lead, please arrange for the template letter of support to be signed by a member of the Deanery Team. If your form is complete except for the Letter of Support, click on 'Save and Continue Later' and you will receive, via email, a copy of your application so far. You can then forward that to your Specialty Lead (or a member of the Deanery Team, if appropriate) as background to your request for the letter of support.Max. file size: 8 MB. Personal DataHow we use your personal data General information on how the University handles personal data is available at https://www.information-compliance.admin.cam.ac.uk/data-protection/general-data. For further information on how data is handled with regard to the Recognition of Teaching Contributions process, please see Members of the public who are teachers, facilitators, or actors/simulated patients. Personal information relating to unsuccessful applicants for recognition of teaching contributions will be retained for twelve months and then destroyed.Untitled First Choice Second Choice Third Choice Untitled Δ