Letter of Agreement to Get Access to SIC Training

Letter of Agreement to access to SIC materials for delivering training

Please use this form if you would like to facilitate training for a SIC clinician workshop or a SIC Train the Trainer workshop

Have you attended the SIC Train the Trainer facilitator training workshop?*
- Yes
- No
If you have not yet attended facilitator training, please email our office to request to be put on a waiting list for the next Train the Trainer Workshop.
If you are wanting access to the resources for facilitators, please fill in the corresponding letter of agreement fields out below, selecting your province of delivery and either option one or option 2 for clinician workshop in order to fill out the online Letter of Agreement via this form and obtain access to the relevant materials.
Have you delivered a SIC clinician workshop while being supervised by a SIC Master Trainer?*
- Yes
- No
If you wish to deliver a SIC Clinician Workshop, please identify the Master Trainer who will co-facilitate with you below. If you do not have a Master Trainer to co-facilitate with you please contact the office: sstuerle@bc.cpc.ca to get connected with a master trainer in your area.
Name of Master Trainer you will be co-facilitating with (if applicable)*
Have you delivered a SIC Train the Trainer facilitator training workshop, while being supervised by a SIC Master Trainer?*
- Yes
- No
Please fill in the corresponding letter of agreement fields out below, selecting your province of delivery and the train the trainer option, in order to fill out the online Letter of Agreement via this form and obtain access to the relevant materials.
If you wish to begin the process to deliver the train the trainer workshop, please send a request to the office to become a Master Trainer – the office will forward their request to the Medical and Clinical Leads. Otherwise, for facilitator materials, please see the form below.
Your Name
First Last
Organization Name
Email
Training will be held*
How would you like to deliver the Clinician Training for the Serious Illness Conversation in BC?*

Option 1: Facilitated Clinician Workshop (In person or virtual)
For Clinicians trained as SIC Facilitators, educational materials and resources for a 3.0 hour CME accredited Clinician Workshop are available. Guidelines for a break-down of the 3.0 hour workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, Clinician Evaluation Form, and the SIC Clinician Workshop Accreditation Certificate are all included.

Option 2: Online Module and in Person or Virtual Session
For Clinicians trained as SIC Facilitators, a 2 part CME accredited session is available that includes access to a 1.5 hour online module and educational materials for a 1.5 hour facilitated skills development session. Guidelines on how to register learners for the Learning Hub Moodle Course: Serious Illness Care: More, Earlier, Better Conversations, a break-down of the 1.5 hour in person skills development workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, Clinician Evaluation Form, and the SIC Clinician Workshop Accreditation Certificate are all included.

Option 3 & 4: SICG in the Time of COVID-19 (Outpatient and Inpatient workshop materials)
For Clinicians trained as SIC Facilitators, education materials and resources for a 1.5 hour CME accredited workshop. Guidelines for a break-down of the workshop, slide deck, facilitator's instruction sheet for role play, SICG COVID version, cases, clinician observer form, clinician evaluation form and workshop accreditation certificate are all included.

Option 5: Train the Trainer Workshop in Person or Virtual session
For Facilitators who have completed our training process to become SIC Master Trainers, a full day CME accredited workshop is available for Health Care Professionals who wish to train facilitators in their communities to hold clinician workshops. Educational Materials include a Core Slide Deck, Facilitator’s Companion Guide that includes all resource materials required to run a full day Train the Trainer Workshop, a Workshop Suggested Schedule, an Evaluation Form or Survey Link, and Accredited Certificates for both participants and newly trained Master Trainers.

Option 6: Train the Trainer Workshop – Online Module and in Person or Virtual Session
For Facilitators who have completed our training process and become SIC Master Trainers, a full day 2 part CME accredited workshop is available that includes access to a 1.5 hour on line module and educational materials for a 6.5 hour facilitated skills development workshop for Health Care Professionals who wish to train Facilitators in their communities to hold clinician workshops. Educational Materials include: Core Slide Deck, Facilitator’s Companion Guide that includes access to the 1 ½ hour Learning Hub Moodle Course: Serious Illness Care: More, Earlier, Better Conversations for persons within and outside BC and all educational materials required for a 6.5 hour facilitated skills development session, a Workshop Suggested Schedule, an Evaluation Form or Survey Link (virtual or in person), and Accredited Certificates for both participants and newly trained Master Trainers.

Option 7: Pediatric SIC Clinician Workshop
For Clinicians trained as SIC Facilitators, educational materials and resources for a 3.0 hour CME accredited Pediatric Clinician Workshop are available. Guidelines for a break-down of the 3.0 hour workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, Clinician Evaluation Form, and the SIC Clinician Workshop Accreditation Certificate are all included.

Option 8: Facilitated Undergraduate Clinician Workshop (In person or virtual)
For Clinicians/Faculty trained as SIC Facilitators, educational materials and resources for a 3.0 hour Undergraduate Clinician Workshop are available. As this workshop is for undergraduates only, no CME credits are provided. Guidelines for a break-down of the 3.0 hour workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, Pre Workshop Survey, Workshop Evaluation Form and Post Workshop Survey are all included.

Option 9: Undergraduate Online Module + In Person/Virtual Training
For Clinicians/Faculty trained as SIC Facilitators, a 2-part session is available that includes access to a 1.5 hour online module and educational materials for a 1.5 hour facilitated skills development session. As this workshop is for undergraduates only, no CME credits are provided. Guidelines on how to register learners for the Learning Hub Moodle Course: Serious Illness Care: More, Earlier, Better Conversations, a break-down of the 1.5 hour in person skill development workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, and Pre-Workshop Survey, Post-Workshop Survey, and Follow-Up Survey are all included.
[Out of Province] How would you like to deliver Training for the Serious Illness Conversation?*
How would you like to deliver the Clinician Training for the Serious Illness Conversation?

There are multiple options available for providing the Serious Illness Conversation Workshop education described below. Please select the training option you would like to access:

Option 1: Facilitated Clinician Workshop (In person or virtual)
Educational materials and resources for a 3.0 hour Clinician Workshop that includes guidelines for a break-down of the 3.0 hour workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form and Clinician Evaluation Form or Survey Link.

Option 2: Online Module and In Person or Virtual Session
A 2 part session is available that includes access to a 1.5 hour online module and educational materials for a 1.5 hour facilitated skills development session. Guidelines on how to register learners for the Learning Hub Moodle Course: Serious Illness Care: More, Earlier, Better Conversations, a break-down of the 1.5 hour in person skills development workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form and Clinician Evaluation Form or Survey Link are all included.

Option 3 & 4: SICG in the Time of COVID-19 (Outpatient and Inpatient workshop materials)
For Clinicians trained as SIC Facilitators, education materials and resources for a 1.5 hour CME accredited workshop. Guidelines for a break-down of the workshop, slide deck, facilitator's instruction sheet for role play, SICG COVID version, cases, clinician observer form, clinician evaluation form and workshop accreditation certificate are all included.

Option 5: Train the Trainer Workshop – in Person or Virtual session
For Facilitators who have completed our training process to become SIC Master Trainers, a full day CME accredited workshop is available for Health Care Professionals who wish to train facilitators in their communities to hold clinician workshops. Educational Materials include a Core Slide Deck, Facilitator’s Companion Guide that includes all resource materials required to run a full day Train the Trainer Workshop, a Workshop Suggested Schedule, an Evaluation Form or Survey Link, and Accredited Certificates for both participants and newly trained Master Trainers.

Option 6: Train the Trainer Workshop – Online Module and in Person or Virtual Session
For Facilitators who have completed our training process and become SIC Master Trainers, a full day 2 part CME accredited workshop is available that includes access to a 1.5 hour on line module and educational materials for a 6.5 hour facilitated skills development workshop for Health Care Professionals who wish to train Facilitators in their communities to hold clinician workshops. Educational Materials include: Core Slide Deck, Facilitator’s Companion Guide that includes access to the 1 ½ hour Learning Hub Moodle Course: Serious Illness Care: More, Earlier, Better Conversations for persons within and outside BC and all educational materials required for a 6.5 hour facilitated skills development session, a Workshop Suggested Schedule, an Evaluation Form or Survey Link (virtual or in person), and Accredited Certificates for both participants and newly trained Master Trainers.

Option 7: Pediatric SIC Clinician Workshop
For Clinicians trained as SIC Facilitators, educational materials and resources for a 3.0 hour CME accredited Pediatric Clinician Workshop are are available. Guidelines for a break-down of the 3.0 hour workshops, Core slide deck, Instruction Sheet for Role Play, Cases, Clinician Observer Form and Clinician Evaluation Form are all included

Option 8: Facilitated Undergraduate Clinician Workshop (In person or virtual)
For Clinicians/Faculty trained as SIC Facilitators, educational materials and resources for a 3.0 hour Undergraduate Clinician Workshop are available. As this workshop is for undergraduates only, no CME credits are provided. Guidelines for a break-down of the 3.0 hour workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, Pre Workshop Survey, Workshop Evaluation Form and Post Workshop Survey are all included.

Option 9: Undergraduate Online Module + In Person/Virtual Training
For Clinicians/Faculty trained as SIC Facilitators, a 2-part session is available that includes access to a 1.5 hour online module and educational materials for a 1.5 hour facilitated skills development session. As this workshop is for undergraduates only, no CME credits are provided. Guidelines on how to register learners for the Learning Hub Moodle Course: Serious Illness Care: More, Earlier, Better Conversations, a break-down of the 1.5 hour in person skill development workshop, Core slide deck, Facilitator’s Instruction Sheet for Role Play, Cases, Clinician Observer Form, and Pre-Workshop Survey, Post-Workshop Survey, and Follow-Up Survey are all included.
Planned date of workshop
Letter of Agreement for Clinician Workshop
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School, into care within your program/site. Our goal is to improve the lives of British Columbians by increasing meaningful conversations about their values and priorities and to align care to what matters to patients.

You will receive the following to support your Clinician Workshop
1. Core slide deck
2. Evaluation Form Template
3. Serious Illness Conversation Guide (version 3)
4. Reference Guide for Interprofessional Clinicians
5. Patient Pre-Visit Letter
6. Family Communication Guide
7. 3 Cases for Role Play
8. Observer Form for Role Play
9. Flyer Template for Clinician Workshop that includes UBC Accreditation logo
10. Speaker letter template which must be sent to all speakers
11. Disclosure form which must be completed by all speakers and returned to you – if there are conflicts you must disclose them as per UBC Guidelines which can be found at https://ubccpd.ca/accreditation/disclosures
12. UBC Certificates to be signed by organizing physician for physician CME credits
For Clinicians within British Columbia (Option 1)*
To offer UBC CME credit, you must agree to abide by the UBC CME rules as outlined in the guidelines provided, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.

By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to BCCPC and BCCPC will compile the results and send you a report OR compile my evaluations myself in a template we send you, and forward to us
- I agree to provide BCCPC with the total number of workshop participants and their professional designation.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. If you do not have a Master Facilitator within your program the BCCPC will provide one.
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Facilitator if requested.
- For CME credits I agree to abide by the UBC CME rules as above, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.
- I do not agree (please indicate reason below)
Letter of Agreement for SICG in the Time of COVID-19 (Outpatient & Inpatient workshop materials)
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School, into care within your program/site. Our goal is to improve the lives of British Columbians by increasing meaningful conversations about their values and priorities and to align care to what matters to patients.

You will receive access to the following to support your Workshop
1. Core slide deck
2. Evaluation Form Template
3. COVID-19 Serious Illness Conversation Guide
4. Cases for Role Play
5. Observer Form for Role Play
6. Poster Template for Workshop
7. Tip Sheet for Zoom
8. Speaker letter template which must be sent to all speakers
9. Disclosure form which must be completed by all speakers and returned to you – if there are conflicts you must disclose them as per UBC Guidelines which can be found at https://ubccpd.ca/accreditation/disclosures
10. UBC Certificates to be signed by organizing physician for physician CME credits
11. Self-Reflection tool to be given to workshop participants
For Clinicians within British Columbia (Option 3 & 4)*
To offer UBC CME credit, you must agree to abide by the UBC CME rules as outlined in the guidelines provided, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.

By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to BCCPC and BCCPC will compile the results and send you a report OR compile my evaluations myself in a template we send you, and forward to us
- I agree to provide BCCPC with the total number of workshop participants and their professional designation.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. If you do not have a Master Facilitator within your program the BCCPC will provide one.
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Trainer if requested.
- For CME credits I agree to abide by the UBC CME rules as above, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.
- I agree to ensure participants have completed the online module prior to attending the in person workshop.
- I do not agree (please indicate reason below)
Letter of Agreement for Online Training Module and In Person Session
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School, into care within your program/site. Our goal is to improve the lives of British Columbians by increasing meaningful conversations about their values and priorities and to align care to what matters to patients.

A two part Serious Illness Conversation Workshop has been developed in order to provide accessible learning opportunities to all British Columbians. In order for participants to receive CME credits or Certificates of Attendance they must complete both parts of the course. The online module is a pre-requisite for the face to face workshop.

Part One: The Introduction to the Serious Illness Conversation is a 1.5 hour online module

Please note: Participants should be asked to show proof of completion by the organizers prior to attending the face to face workshop

Part Two: A 1.5 hour face to face workshop focusing on skills development on how to use the guide in practice through role play.

You will receive access to the following to support your 2 Part Serious Illness Conversation Learning Opportunity
1. Registration to the Learning Hub’s Online Module: Serious Illness Care: More, Earlier, Better Conversations
2. Core slide deck to set up the Role Play for Part Two
3. Evaluation Form Template
4. Serious Illness Conversation Guide (version 3)
5. Reference Guide for Interprofessional Clinicians
6. Patient Pre-Visit Letter
7. Family Communication Guide
8. 3 Cases for Role Play
9. Observer Form for Role Play
10. Flyer Template for Clinician Workshop that includes UBC Accreditation logo
11. Speaker letter template which must be sent to all speakers
12. Disclosure form which must be completed by all speakers and returned to you – if there are conflicts you must disclose them as per UBC Guidelines which can be found at https://ubccpd.ca/accreditation/disclosures
13. UBC Certificates to be signed by organizing physician for physician CME credits
For Clinicians within British Columbia (Option 2)*
To offer UBC CME credit, you must agree to abide by the UBC CME rules as outlined in the guidelines provided, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.

By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to BCCPC and BCCPC will compile the results and send you a report OR compile my evaluations myself in a template we send you, and forward to us
- I agree to provide BCCPC with the total number of workshop participants and their professional designation.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. If you do not have a Master Facilitator within your program the BCCPC will provide one.
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Trainer if requested.
- For CME credits I agree to abide by the UBC CME rules as above, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.
- I agree to ensure participants have completed the online module prior to attending the in person workshop.
- I do not agree (please indicate reason below)
Letter of Agreement for Train the Trainer Workshop
The Serious Illness Conversation initiative supports health-care providers to conduct Train the Trainer workshops on how to facilitate Serious Illness Conversation Clinician Workshops through mentorship and the provision of Continuing Medical Education (CME) accredited workshop materials. The structure of the day outlined in the Workshop Agenda includes building the case for a Systematic Approach, Teaching Methods, How to use the Serious Illness Conversation Guide in Practice and How to Facilitate Clinician Workshops on the use of the guide.

The following Educational Materials are for use in the Full Day Train the Trainer Workshop

1. Guidelines for use of the Train the Trainer Workshop Materials to meet UBC accreditation standards prior to leading a Train the Trainer Workshop in your community
2. SIC Core Slides for Train the Trainer Workshop– the Guidelines above outline the terms and conditions of the adaptation of the slide deck to address the needs of your specific audience.
3. Reference List for Presentation
4. Facilitator’s Companion Guide – The guide includes an introduction to role play for both clinicians and facilitators, cases, observer forms, facilitator observer forms, facilitator observer forms.
5. Evaluation Form or Survey Link

In addition, if you wish to give UBC CME credits you will receive

6. Speaker letter template which must be sent to all speakers
7. Disclosure form which must be completed by all speakers and returned to you – if there are conflicts you must disclose them as per UBC Guidelines which can be found at https://ubccpd.ca/accreditation/disclosures
8. UBC Certificates for participants to be signed by organizing physician for physician CME credits
9. UBC Certificates for Master Trainers to be signed by SIC Medical Lead
For Clinicians within British Columbia (Options 5 & 6)*
For Clinicians within British Columbia* To offer UBC CME credit, you must agree to abide by the UBC CME rules as outlined in the guidelines provided, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.

By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to BCCPC and BCCPC will compile the results and send you a report OR compile my evaluations myself in a template we send you, and forward to us
- I agree to provide BCCPC with the total number of workshop participants and their professional designation.
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Trainer if requested
- For UBC CME credits I agree to abide by the UBC CME rules as above, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to the BCCPC.
- I agree to have a Master Trainer present for the first time a newly trained facilitator facilitates a Train the Trainer event. (If you do not have a Master Trainer in your program the BCCPC will provide one)
- I do not agree (please indicate reason below)
Letter of Agreement for Pediatric Clinician Workshop within BC
We are pleased to hear of your interest in furthering the implementation of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School, into care within your program/site. Our goal is to improve the lives of British Columbians by increasing meaningful conversations about their values and priorities and to align care to what matters to patients.

You will receive the following to support your Pediatric Clinician Workshop
1. Core slide deck
2. Evaluation Form Template
3. Serious Illness Conversation Guide Pediatric (version 5)
4. Reference Guide for Interprofessional Clinicians in the Pediatric Setting
5. Pre-Visit Letter Adapted for NICU
6. Pre-Visit Letter Adapted for Pediatric
7. Cases for Role Play
8. Instructions for Role Play
9. Speaker letter template which must be sent to all speakers
10. Disclosure form which must be completed by all speakers and returned to you – if there are conflicts you must disclose them as per UBC Guidelines which can be found at https://ubccpd.ca/accreditation/disclosures
11. UBC Certificates to be signed by organizing physician for physician CME credits
For Clinicians within British Columbia (Option 7)*
To offer UBC CME credit, you must agree to abide by the UBC CME rules as outlined in the guidelines provided, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to Canuck Place.

By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to Canuck Place, Canuck Place will compile the results and send you an annual report OR compile my evaluations myself in a template Canuck Place sends you, and forward to Canuck Place annually.
- I agree to provide Canuck Place with the total number of workshop participants, their professional designations, the health region the workshop took place in and the healthcare setting (hospital, community, etc.).
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Trainer if requested
- I agree to have a Master Pediatric Facilitator present for the first time a newly trained facilitator facilitates a Pediatric workshop.
- For CME credits I agree to abide by the UBC CME rules as above, including sending Speaker letters to all speakers and collecting Disclosure forms from all speakers to be forwarded to Canuck Place.
- I do not agree (please indicate reason below)
Letter of Agreement - Out of Province - Option 1
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation in (your organization) of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School. Our goal, at the BC Centre for Palliative Care, is to improve the lives of people facing a serious illness by increasing meaningful conversations about their values and priorities and to align their care to what matters most to them.

Educational tools have been developed in order to provide learning materials to health care professionals. For Continuing Medical Education credits in your province applications will need to be made to your own University. This workshop is accredited in British Columbia through the University of British Columbia. Our additional educational materials, noted below, are adapted by the BCCPC from the work of Ariadne Labs and we acknowledge their generosity in sharing content which is held under the Creative Commons license. The Creative Commons License allows you to:
1. 1. Reproduce and share the Licensed Materials
2. 2. Modify the Licensed Materials, and/or
3. 3. Re-name the Licensed Materials.
In British Columbia we have have modified some of the materials and ask that you include the following wording to the adapted material as per below:

This material has been modified by (ie: the Serious Illness Conversation Nurse Working Group (Canada) or the working group/person who has done the modification). The original content can be found at https://portal.ariadnelabs.org and is licensed by Ariadne Labs undere the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

For all other materials we ask that you include an acknowledgement to the BC Centre for Palliative Care and to Ariadne Labs as noted on the materials. The following materials will be made available to you:
1. 1. Core slide deck for a Clinician Workshop
2. 2. Evaluation Form Template
3. 3. Serious Illness Conversation Guide (version 3)
4. 4. Reference Guide for Interprofessional Clinicians
5. 5. Patient Pre-Visit Letter
6. 6. Family Communication Guide
7. 7. 4 Cases for Role Play
8. 8. Observing Clinician Form for Role Play
We ask that you agree to the following:
- I agree to adhere to requirements of the Creative Commons License as noted above for already adapted material and for any new adaptations I may make.
- I agree to acknowledge the BC Centre for Palliative Care and Ariadne Labs on all materials that are shared as noted above.
- I agree to inform the BC Centre for Palliative Care of any changes I make to the materials provided.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. (If you do not have a Master Facilitator within your program contact BCCPC.)
Letter of Agreement - Out of Province - Option 2
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation (in your organization) of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School. Our goal, at the BC Centre for Palliative Care, is to improve the lives of people facing a serious illness by increasing meaningful conversations about their values and priorities and to align their care to what matters most to them.

To support this goal the BCCPC has developed a two part educational session that includes an online module and a face to face clinician workshop. The online module: Serious Illness Care: More, Earlier, Better Conversations has been developed in collaboration with Open School British Columbia and is available through the Learning Hub to provide accessible learning opportunities to health care professionals. For access to the online module we ask that you contact the BC Centre for Palliative Care office@bc-cpc.ca. For further use of the online module or modifications we ask that you contact one of the course facilitators: Dr Gillian Fyles gfyles@bc-cpc.ca or Elizabeth Beddard-Huber ebeddard-huber@bc-cpc.ca.

Our additional educational materials for the face to face clinician workshop, noted below, are adapted by the BCCPC from the work of Ariadne Labs and we acknowledge their generosity in sharing content which is held under the Creative Commons license. The Creative Commons License allows you to:
1. 1. Reproduce and share the Licensed Materials
2. 2. Modify the Licensed Materials, and/or
3. 3. Re-name the Licensed Materials.
In British Columbia we have modified some of the materials and ask that you include the following wording to the adapted material as per the example below:

This material has been modified by (ie: the Serious Illness Conversation Nurse Working Group (Canada) or the working group/person who has done the modification). The original content can be found at https://portal.ariadnelabs.org and is licensed by Ariadne Labs undere the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

For all other materials we ask that you include an acknowledgement to the BC Centre for Palliative Care and to Ariadne Labs as noted on the materials. Please note for Continuing Medical Education credits in your province applications will need to be made to your own University. This workshop is accredited in British Columbia through the University of British Columbia.
1. 1. Core slide deck for a Clinician Workshop
2. 2. Evaluation Form Template
3. 3. Serious Illness Conversation Guide (version 3)
4. 4. Reference Guide for Interprofessional Clinicians
5. 5. Patient Pre-Visit Letter
6. 6. Family Communication Guide
7. 7. 4 Cases for Role Play
8. 8. Observing Clinician Form for Role Play
We ask that you agree to the following:
- I agree to adhere to requirements of the Creative Commons License as noted above for already adapted material and for any new adaptations I may make.
- I agree to acknowledge the BC Centre for Palliative Care (BCCPC) and Ariadne Labs on all materials that are shared as noted above.
- I agree to inform the BCCPC of any changes I make to the materials provided.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. (If you do not have a Master Facilitator within your program contact BCCPC.)
Letter of Agreement - Out of Province - Option 3 & 4
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation (in your organization) of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School. Our goal, at the BC Centre for Palliative Care, is to improve the lives of people facing a serious illness by increasing meaningful conversations about their values and priorities and to align their care to what matters most to them.

To support this goal the BCCPC has developed a two part educational session that includes an online module and a face to face clinician workshop. The online module: Serious Illness Care: More, Earlier, Better Conversations has been developed in collaboration with Open School British Columbia and is available through the Learning Hub to provide accessible learning opportunities to health care professionals. For access to the online module we ask that you contact the BC Centre for Palliative Care office@bc-cpc.ca. For further use of the online module or modifications we ask that you contact one of the course facilitators: Dr Gillian Fyles gfyles@bc-cpc.ca or Elizabeth Beddard-Huber ebeddard-huber@bc-cpc.ca.

Our additional educational materials for the face to face clinician workshop, noted below, are adapted by the BCCPC from the work of Ariadne Labs and we acknowledge their generosity in sharing content which is held under the Creative Commons license. The Creative Commons License allows you to:
1. 1. Reproduce and share the Licensed Materials
2. 2. Modify the Licensed Materials, and/or
3. 3. Re-name the Licensed Materials.
In British Columbia we have modified some of the materials and ask that you include the following wording to the adapted material as per the example below:

This material has been modified by (ie: the Serious Illness Conversation Nurse Working Group (Canada) or the working group/person who has done the modification). The original content can be found at https://portal.ariadnelabs.org and is licensed by Ariadne Labs undere the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

For all other materials we ask that you include an acknowledgement to the BC Centre for Palliative Care and to Ariadne Labs as noted on the materials. Please note for Continuing Medical Education credits in your province applications will need to be made to your own University. This workshop is accredited in British Columbia through the University of British Columbia.
1. Core slide deck
2. Evaluation Form Template
3. COVID-19 Serious Illness Conversation Guide
4. Cases for Role Play
5. Observer Form for Role Play
6. Poster Template for Workshop
7. Tip Sheet for Zoom
We ask that you agree to the following:
- I agree to adhere to requirements of the Creative Commons License as noted above for already adapted material and for any new adaptations I may make.
- I agree to acknowledge the BC Centre for Palliative Care (BCCPC) and Ariadne Labs on all materials that are shared as noted above.
- I agree to inform the BCCPC of any changes I make to the materials provided.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. (If you do not have a Master Facilitator within your program contact BCCPC.)
Letter of Agreement - Out of Province - Train the Trainer (Options 5 & 6)
The Serious Illness Conversation initiative supports health-care providers to conduct Train the Trainer workshops on how to facilitate Serious Illness Conversation Clinician Workshops through mentorship and workshop materials. The structure of the day outlined in the Workshop Agenda includes building the case for a Systematic Approach, Teaching Methods, How to use the Serious Illness Conversation Guide in Practice and How to Facilitate Clinician Workshops on the use of the guide.

Our educational materials for the Train the Trainer workshop, noted below, are adapted by the BCCPC from the work of Ariadne Labs and we acknowledge their generosity in sharing content which is held under the Creative Commons license. The Creative Commons License allows you to:
1. 1. Reproduce and share the Licensed Materials
2. 2. Modify the Licensed Materials, and/or
3. 3. Re-name the Licensed Materials.
In British Columbia we have modified some of the materials and ask that you include the following wording to the adapted material as per the example below:

This material has been modified by (ie: the Serious Illness Conversation Nurse Working Group (Canada) or the working group/person who has done the modification). The original content can be found at https://portal.ariadnelabs.org and is licensed by Ariadne Labs undere the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

For all other materials we ask that you include an acknowledgement to the BC Centre for Palliative Care and to Ariadne Labs as noted on the materials.

The following Educational Materials are for use in the Full Day Train the Trainer Workshop. Please note for Continuing Medical Education credits in your province applications will need to be made to your own University. This workshop is accredited in British Columbia through the University of British Columbia.
1. 1. Guidelines for use of the Train the Trainer Workshop Materials
2. 2. SIC Core Slides for Train the Trainer Workshop– the Guidelines above outline the terms and conditions of the adaptation of the slide deck to address the needs of your specific audience.
3. 3. Reference List for Presentation
4. 4. Facilitator’s Companion Guide – The guide includes an introduction to role play for both clinicians and facilitators, cases, observer forms, facilitator observer forms, facilitator observer forms.
5. 5. Evaluation Form or Survey Link
By ticking the box we understand that you agree:
- I agree to adhere to requirements of the Creative Commons License as noted above for already adapted material and for any new adaptations I may make.
- I agree to acknowledge the BC Centre for Palliative Care (BCCPC) and Ariadne Labs on all materials that are shared as noted above.
- I agree to inform the BCCPC of any changes I make to the materials provided.
- I agree to have a Master Trainer present for the first time a newly trained facilitator facilitates a Train the Trainer event.
Letter of Agreement - Out of Province - Pediatric SIC Clinician Workshop (Option 7)
We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation in (your organization) of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School. Our goal is to improve the lives of people facing a serious illness by increasing meaningful conversations about their values and priorities and to align their care to what matters most to them.

Educational tools have been developed in order to provide learning materials to health care professionals. For Continuing Medical Education credits in your province applications will need to be made to your own University. This workshop is accredited in British Columbia through the University of British Columbia. Our additional educational materials, noted below, are adapted from the work of Ariadne Labs and we acknowledge their generosity in sharing content which is held under the Creative Commons license. The Creative Commons License allows you to:
1. 1. Reproduce and share the Licensed Materials
2. 2. Modify the Licensed Materials, and/or
3. 3. Re-name the Licensed Materials.
In British Columbia we have have modified some of the materials and ask that you include the following wording to the adapted material as per below:

This material has been modified by (ie: the Serious Illness Conversation Nurse Working Group (Canada) or the working group/person who has done the modification). The original content can be found at https://portal.ariadnelabs.org and is licensed by Ariadne Labs undere the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

For all other materials we ask that you include an acknowledgement to the BC Centre for Palliative Care, Canuck Place and to Ariadne Labs as noted on the materials. The following materials will be made available to you:
1. 1. Core slide deck
2. 2. Evaluation Form Template
3. 3. Serious Illness Conversation Guide Pediatric (version 5)
4. 4. Reference Guide for Interprofessional Clinicians in the Pediatric Setting
5. 5. Pre-Visit Letter Adapted for NICU
6. 6. Pre-Visit Letter Adapted for Pediatric
7. 7. Cases for Role Play
8. 8. Instructions for Role Play
- I agree to either send my completed evaluation forms to Canuck Place, Canuck Place will compile the results and send you an annual report OR compile my evaluations myself in a template Canuck Place sends you, and forward to Canuck Place annually.
- I agree to provide Canuck Place with the total number of workshop participants, their professional designations, the health region the workshop took place in and the healthcare setting (hospital, community, etc.).
- I agree to have a Master Trainer present for the first time a newly trained facilitator facilitates a Train the Trainer event.
- I do not agree (please indicate reason below):
Letter of Agreement - (Option 8)
Letter of Agreement for Undergraduate Workshop

We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School, within your program/site. Our goal is to improve the lives of British Columbians by increasing meaningful conversations about their values and priorities and to align care to what matters to patients.

You will have access to the following to support your Undergraduate Workshop:
By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to BCCPC and BCCPC will compile the results and send you a report OR compile my evaluations myself in a template we send you, and forward to us
- I agree to provide BCCPC with the total number of workshop participants and their professional designation.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. If you do not have a Master Facilitator within your program the BCCPC will provide one.
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Facilitator if requested.
- I do not agree (please indicate reason below):
Letter of Agreement - (Option 9)
Letter of Agreement for Undergraduate Online Module + In Person/Virtual Training

We at the BC Centre for Palliative Care (BCCPC) are pleased to hear of your interest in furthering the implementation of the Serious Illness Conversation Guide, developed and tested by Ariadne Labs, Harvard Medical School, within your program/site. Our goal is to improve the lives of British Columbians by increasing meaningful conversations about their values and priorities and to align care to what matters to patients.

You will have access to the following to support your Undergraduate Workshop:
By ticking the box we understand that you agree:
- I agree to either send my completed evaluation forms to BCCPC and BCCPC will compile the results and send you a report OR compile my evaluations myself in a template we send you, and forward to us
- I agree to provide BCCPC with the total number of workshop participants and their professional designation.
- I agree to have a Master Facilitator present for the first time a newly trained facilitator facilitates a workshop. If you do not have a Master Facilitator within your program the BCCPC will provide one.
- I understand the BCCPC is not responsible for workshop costs other than providing a workshop Master Facilitator if requested.
- I do not agree (please indicate reason below):
Reason if I do not agree to the above agreement:
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Letter of Agreement to Get Access to SIC Training

Letter of Agreement to access to SIC materials for delivering training

Letter of Agreement for Clinician Workshop

Letter of Agreement for SICG in the Time of COVID-19 (Outpatient & Inpatient workshop materials)

Letter of Agreement for Online Training Module and In Person Session

Letter of Agreement for Train the Trainer Workshop

Letter of Agreement for Pediatric Clinician Workshop within BC

Letter of Agreement for Undergraduate Workshop

Letter of Agreement for Undergraduate Online Module + In Person/Virtual Training

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