Nomination Form for National MI Training Course

LeicesterUniversity

Please complete all fields legibly (including the learning agreement overleaf), any incomplete or illegible forms may result in your application being delayed or refused. You must complete and send a form to you regional MI service even if you have verbally informed your regional service or the course organisers of your intended application.

Applicantdetails

MI Region:
First Name:
Surname:
Name of Hospital/Trust or Centre:
Full postal address:
Contact telephone number:
Contact email address:
National MI Training Course dates applied for (see UKMi website for next course dates)

Background Information(this information will assist in assessing if the course is appropriate for you)

Question / Yes / No
Are you an MI technician?
IF YES: In addition to this nomination form please complete the AMITTS application form which can be found on the UKMi website and forward to the AMITTS Scheme Director.
The course fee will be different to the NMITC fee.
Are you an MI pharmacist?
Are you an Information Scientist?
If you have not ticked YES to any of the above, please state your job title
What is your current AfC Band?
Is your post permanent, rotational or fixed term?
Approximately what percentage of your time is spent on MI duties alone?
On average, how many enquiries does your centre complete each month? Of these, what percentage do you complete / Centre enquiries/month:
% enquiries:
If you do NOT spend 100% of your time in MI, please state what else is in your employed role
How long have you been employed in your current post?
Do you have any previous MI experience?
If you have ticked yes to previous MI experience, please give details

Additional Information

If your nomination is successful, the following information will be useful for the venue (please indicate your response):

Question / Yes / No
Will you require the venue to provide you with accommodation for the course duration? / Note: Reduced fee available to non-residential applicants which is exclusive of accommodation and breakfast
Do you have any special dietary requirements? (please note that the venue can cater for vegetarian)
Do you plan to bring your own laptop (or device) for use in the IT based sessions? (The venue provides free Wi-Fi.)
Will you require car parking at the venue for the duration of the course?
Will you be staying for the optional lunch on day 3?

Please read and sign the learning agreement that follows.

By doing so, you agree that if your nomination is successful, you will ensure that full payment (as advertised) is raised when requested. In addition, if for any reason after being accepted onto the course you are then unable to attend; full payment must still be made.

Learning Agreement for National MI Training Course

UKMi will provide a 3-day residential coursedesigned to equip attendees with the knowledge and skills needed to work effectively in Medicines Information.

By the end of the course attendees should be able to:

Discuss UKMi strategy and MI’s role in the current NHS.
Develop and demonstrate the skills needed to search literature databases effectively, in particular Medline, Embase and Cochrane (NICE Evidence platform used – skills are transferable).
Assist in identifying and dealing with legal and ethical problems that may be encountered in MI.
Discuss UKMi standards and peer review an enquiry and provide feedback.
Develop networking skills and practice sharing through sessions such as enquiry sharing.
Discuss how you could develop and promote your MI service further (including identifying how service evaluation or research could be used and developed in this context).
Discuss the factors to consider when providing written answers to MI enquiries.
Discuss how new medicines are introduced into practice.
Identify key components of clinical trial design and apply these to a critical appraisal of the literature
Discuss the value of using the Advanced Pharmacy Framework and GPhC CPD entries to develop their professional practice, and that of their staff (latter is required of all registered pharmacists and pharmacy technicians in GB)

By signing this agreement, the applicant agrees to:

  • Complete any pre-course work for the residential course.
  • Participate in the 3-day residential course and all associated workshops and lectures.
  • Complete the residential course feedback form.
  • Ensure payment is received in full when requested.

Applicant (Full Name):Applicant (Signature):

Date:

Line Manager’s name and signature:Date:

On behalf of UKMi Executive:Trevor Beswick

Chairperson for the UKMi Workforce Development group

Applicants must return a completed nomination form and a signed learning agreement to their Regional MI Centre to be considered for a place on the National MI Training Course.

______

FOR REGIONAL MI CENTRE USE ONLY

Priority status for course attendance: …………………

(Indicate High/Medium/Low for all nominations)

Regional MI Centre to send all completed form(s) to:

Sandra Wharton,

London (Northwick Park Hospital) MI;

Fax: 020 8869 2764; Email: t least 3 months before the announced course dates.

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UpdatedDecember 2015 on behalf of the UKMi Workforce Development Group