CW KT Design Collaborative Survey/Intake Form

It can take up to 17 years for new knowledge to be adopted into practice. Knowledge translation (KT) involves dynamic and iterative strategies addressing barriers to change, mobilizing knowledge into practice to improve care. The CW KT Design Collaborative is a cohort-based learning curriculum that provides participants with the opportunity to:
● Bring a gap between knowledge and practice from their workplace that they wish to address as their change/knowledge translation (KT) initiative.
● Apply evidence-informed KT principles and tools to create effective strategies for change.
● Learn together and build on their toolkits for supporting change.

The aim is to build capacity to translate knowledge into care and support change. The learning program is delivered by Learning & Development over six 55-minute virtual learning sessions scheduled flexibly to meet the availability and progress of cohort members over eight months (Oct/24 - May/25) with mentorship and support between sessions. No prior experience in KT is necessary to participate.
Participants are asked to discuss their project and complete a Leadership Sponsorship Form with their leaders. Consider choosing projects addressing areas of priority aligned with your roles and responsibilities.
It should take less than 10 minutes to complete this survey/intake. Your responses will help us to better tailor the program for you.

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* 1. Participant Profile (help us to get to know you)

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* 2. Learning considerations (help us understand how we can support you to get the most out of the KT Design Collaborative)

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* 3. Describe two (2) objectives or learning goals that you would like to achieve by the end of KT Design Collaborative, to consider the experience a personal success.

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* 4. Please indicate the day(s) you would prefer to attend Virtual interactive KT Design Collaborative Learning Bursts (Learning Bursts will be scheduled approximately every 4 weeks from Oct/24 - May /25)

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* 5. Please indicate the times(s) you would prefer to attend Virtual interactive KT Design Collaborative Learning Bursts (55 minutes learning bursts will be scheduled approximately every 4 weeks from Oct/24 - May /25)

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* 6. How would you rate your confidence level in creating a KT/Change Plan

0 Not confident at all 10 Extremely confident
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i We adjusted the number you entered based on the slider’s scale.

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* 7. Help us learn more about your KT project!
In the KT Design Collaborative, we encourage you to bring a project or challenge from your work, so you can apply your learning and create a KT/change plan that you can put into action afterwards. In the first learning burst, there will be more opportunity to refine this together.

Please tell us a little more about the problem or project you hope to undertake as part of the KT Design Collaborative.

What is the knowledge translation problem are you trying to address?

What gap between knowledge and practice or change that you want to make (e.g. implement a practice, procedure, guideline, policy)?


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* 8. Why is the change important now?

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* 9. What constraints are you working with? (Please explain the 'non-negotiable' aspects of the project such as deadlines, limitations, deliverables, etc.)

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* 10. What supports do you have to complete this project? (What assets can you use to design and implement your KT plan?  This could include leadership sponsorship, champions/allies, resources (e.g. some dedicated time), your knowledge and experience, etc.)

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* 11. Knowledge and Experience in KT and other related areas
*No prior experience is necessary to participate in the KT Design Collaborative

To assist us in preparing to work alongside you in designing your KT plan, please tell us, in a few dot points, a little more about the training, knowledge and/or experiences you have in using knowledge translation, education, quality improvement or championing change.
e.g. have you attended a KT webinar, did you learn about KT in school, do you have training & experience as an educator or quality leader? 

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* 12. Thank you for completing this pre-program survey.

Please discuss your planned project with your Leader and obtain their sponsorship on the Leadership Sponsor Form.

Feel free to use the space below to share anything else that you would like to with the KT Design Collaborative organizers. You can also email us directly:
Kim Miller (Senior Leader, L&D): kimberly.miller@cw.bc.ca
Tarndeep Singh (Coordinator, L&D): tarndeep.singh1@phsa.ca

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