Nominate Please note: You may save drafts of this form for a maximum of 30 days from today. Your draft will be accessible by a unique link. Section 1 – Nomination TypeNomination Type *Self nominationNomination of another individualNomination by a business / organizationSection 2 – Nominee InformationPlease provide contact information for the Nominee.Name *Title / Position *Organization / Institution *Street Address *City *Province *AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code *Email Address *Confirm Email Address *Phone *Website (if applicable)Section 3 – Nominator Information(Complete only if nominating someone else.)NameTitle / PositionOrganization / InstitutionRelationship to NomineeEmail AddressConfirm Email AddressPhoneSection 4 – Research OverviewTitle of Research Program, Project or Initiative *Type of Research (as per tri-council research pillars) *BiomedicalClinicalHealth services and systemsHumanitiesInterdisciplinaryPopulation and public healthSocial sciencesTechnology developmentOtherResearch Partners Visual Code Funding Sources – CurrentVisual Code Funding Sources – Previous (last 5 years)Visual Code Proposed Award CitationProvide a brief LAY LANGUAGE summary of the nominee’s work and impact in no more than 70 words. This summary should succinctly highlight the research and impact for which the nominee deserves to be recognized. This text may be used as the award citation should the nominee be successful. Word limit: 70 words0 / 70Visual Code Section 5 – Innovativeness and uniqueness of the research (20%)Provide a clear and lay accessible summary of the research project. Please use the following bolded text as headings: Target population — type(s) of physical disability Unmet need, limitation or gap — the unmet need, limitation or gap in current knowledge, methods or practice targeted by this research Objectives Innovation — novel concepts, frameworks, technologies, solutions or methodology Uniqueness — what fundamentally distinguishes this research from existing/previous worksInnovativeness and uniqueness of the research *Word limit: 750 words0 / 750Visual Code Section 6 – Meaningful engagement of people with disabilities (15%)Describe how the research involved people with physical disabilities. Examples: Accessibility in research design and methods Co-authorship of publications Co-design with disability communities Co-development of accessible research outputs Co-presenting research findings Inclusion of team members (e.g., staff and students) with lived experience of disability Participatory research methods Priority setting Meaningful engagement of people with disabilities *Word limit: 500 words0 / 500Visual Code Section 7 – Magnitude and scope of impact to date (40%)Describe the magnitude and scope of impact of this research on people with physical disabilities. Impact may be realized at the individual level (e.g., improvements in individual participation, quality of life, health outcomes, independence); system level (e.g., adoption of healthcare systems, reduction in disparities in access to care, streamlined transitions); and societal level (e.g., economic benefits, policy change, more equitable employment/educational opportunities, increased public accessibility). Evidence of impact may include: Quantitative data — such as: Accessibility improvements (e.g., compliance scores) Cost reduction or efficiency gains Disability representation statistics in the workforce Number of people impacted Scale of implementation (e.g., adoption metrics) Standardized clinical outcomes Qualitative evidence — such as: Changes in awareness, attitudes or culture Clinician and practitioner perspectives Implementation experience Patient and caregiver narratives User/stakeholder feedback and/or testimonials and Independent validation — such as: Adoption in independent clinical guidelines Commercial uptake by external entities Expert commentary by reputable media Policy uptake by governments Replication by independent research groups Uptake by external organizations or services Magnitude and scope of impact to date *Word limit: 1,000 words0 / 1000Visual Code Supporting MaterialsPlease attach supporting materials as a single PDF file (e.g., independent impact evaluation reports, technology adoption data, policy citations, regulatory approvals, media coverage, up to three letters of support).Upload file *Choose FileNo file chosenDelete uploaded fileSection 8 – Potential for sustained impact (25%)Describe how the research has potential for sustained, long-term and widespread impact beyond the life of a single project or funding period. Considerations for sustained impact may include: How the work will continue to be used in real world settings (e.g., practice, services, policy, technology, programs) Who is expected to adopt or sustain the work, and why this is feasible The potential for the research to be scaled, adapted or replicated across settings, regions or populations How the work aligns with or contributes to systems level change (e.g., healthcare, education, policy, accessibility standards) Partnerships, stakeholder engagement or infrastructure that supports long-term uptake How impact can be maintained, updated or evaluated over time Potential for sustained impact *Word limit: 625 words0 / 625Visual Code Section 9 – DeclarationI certify that the information provided in this nomination is accurate and that the research described represents current or recently completed work. I further acknowledge that all decisions of the Selection Board shall be final and binding. The Selection Board will not engage in any correspondence, discussion or appeals regarding its decisions. In the event of a tie, the Co-Chairs shall have the sole and final authority to determine the outcome. Incomplete submissions will not be considered.By submitting this form, I confirm that I have read and understood the above provisions and agree to be bound by them.SubmitSave as Draft
