Call for AHA Team Training Faculty Please read the Call for AHA Faculty before submitting your proposal. It is suggested you draft your proposal in a separate Word document before submitting. Please note that once you begin, you must complete your proposal in the same session. You will not be able to save and return at a later time. After you have successfully submitted your proposal, you will be taken to a confirmation page. If you have any difficulties or questions, please contact TeamTraining@aha.org. Question Title * 1. Contact information for the submitting applicant: Name Credentials (degrees, certifications, etc.) Position Title Organization Name City/Town State/Province Zip/Postal Code Country Email Address Phone Question Title * 2. Please list other members of the core faculty team and include their name, credentials and position title. Question Title * 3. Please provide resumes or CVs for each member of the core team. Combine into one file. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please provide resumes or CVs for each member of the core team. Combine into one file. Question Title * 4. Upload a letter of support from your organization's leadership (preferred but not required). This letter should come from your direct supervisor or higher and should discuss how the organization will support your team's participation in serving as Faculty for AHA Team Training. PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Upload a letter of support from your organization's leadership (preferred but not required). This letter should come from your direct supervisor or higher and should discuss how the organization will support your team's participation in serving as Faculty for AHA Team Training. The following are questions regarding your team's facilitation of TeamSTEPPS courses and other logistics. Question Title * 5. Does your team have any travel limitations? Yes No Other (please specify) Question Title * 6. How much time is needed for your team to make travel arrangements? 1 month or less 2-3 months 3-6 months 6 months or more Question Title * 7. Who manages the course logistics on behalf of the team? Question Title * 8. Please describe the team’s experience teaching TeamSTEPPS courses. What course type/length has the team taught (e.g., 4-hour courses, 2-day Master Trainer courses, etc.)? Please describe how the modules or sections of the course are distributed among team members. Do team members typically have assigned roles? Question Title * 9. Where did each member of the core team attend their first TeamSTEPPS Master Trainer Course and when? Question Title * 10. What is your team's philosophy on providing and facilitating a TeamSTEPPS course? Question Title * 11. Please provide a detailed 2-day Master Training Course agenda including high-level descriptions of activities, facilitated discussions, etc. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Please provide a detailed 2-day Master Training Course agenda including high-level descriptions of activities, facilitated discussions, etc. Question Title * 12. Applicants who submit a video of a module or portion of the course taught by the core team will be highly favored. Please upload your video to a file sharing site and enter the URL below in order to share. The following are questions regarding your organization's experience implementing TeamSTEPPS. Question Title * 13. What are the clinical and/or non-clinical areas or units that are engaged in TeamSTEPPS implementation at your organization? Question Title * 14. Please describe challenges and successes of your TeamSTEPPS implementation and include data if available. Question Title * 15. If there is anything else you would like us to know about your team or organization, please enter it below. Done
