2020 CIHR-ICRH/CCCS Distinguished Lecturer Award in Critical Care Sciences
Nomination Form
Submission deadline is 4:00 PM MST on May 14, 2020.
Please send the completed form by email to Dr. Helen Coe at [email protected]
Sponsor's Information Name:
Position:
Institution:
Phone Number:
Email address:
Nominee’s Information Name:
Position:
Institution:
Address:
City:
Province/State:
Postal Code/Zip:
Phone Number:
Email address:
Website:
Is the nominee available to attend the 2020 Canadian Critical Care Forum in Toronto October 4-7, 2020 (Yes / No )
Nomination Package:
1. Biography of Nominee: Please append the nominee’s full CCV in a separate attachment.
2. Letter of Support: No more then two (2) letters of support (at a maximum of two (2) pages each) should be submitted. One letter of support must be provided by the nominee’s institution. The second letter must come from outside the
nominee’s institution (preferably an international collaborator).
3. Please provide a short justification (max 250 words) for your selection:
Nominations will be assessed against the evaluation criteria listed below. Please ensure you provide the appropriate detailed information in order for the review committee to assess the candidates accordingly.
Note: Nominations will be assessed against the following evaluation criteria:
1. Impact of nominee’s research on and advancement of critical care sciences both in Canada and internationally (e.g. tool or a guideline) over the last ten years;
2. Relevance/application/impact of the nominee’s research to a clinical setting (i.e.
“research to practice to policy”);
3. Demonstrated strength and reputation of the nominee in the field of critical care sciences in Canada and internationally; and
4.
Impact of the nominee’s mentorship and training environment on the development of young scientists and other highly qualified personnel in Canada and internationally.Note: The nominee must NOT have received an ICRH partnered DL Award in the past.
Nominations for highly competitive candidates not selected will be carried forward for consideration up to three (3) consecutive years from the original nomination year.
