Welcome to the NMQSLA 2024 Scholar Nomination Questionnaire!

Thank you all for your interest in the Navy Medicine Quality and Safety Leadership Academy (NMQSLA)! The questionnaire below is comprised of four sections requesting various pieces of information pertinent to your attendance and potential acceptance to the program. If at any time you have questions about the questions below, please do not hesitate to reach out to the NMQSLA Support Team at usn.ncr.bumedfchva.mbx.qualityand-safetyleadershipacademy@health.mil.

*Please follow this link to complete the questionnaire on DoD SharePoint: https://esportal.med.navy.mil/bumed/rh/m5/NavyMedicineHighReliabilityNetwork/Lists/NMQSLA%202024%20Scholar%20SelfNomination%20Form/NewForm.aspx?Source=https%3A%2F%2Fesportal%2Emed%2Enavy%2Emil%2Fbumed%2Frh%2Fm5%2FNavyMedicineHighReliabilityNetwork%2FLists%2FNMQSLA%25202024%2520Scholar%2520SelfNomination%2520Form%2Foverview%2Easpx


Statement of Interest


Participant Availability and Commitment

5. Two NMQSLA Cohorts are being planned to occur throughout CY 2024. Both Cohorts will feature a hybrid Kick-Off (approximately one week) and subsequent Virtual Classrooms (~20 to 25 hours over the course of three months).

From the following options, please indicate which of the Cohort options you would be able to attend*. Final Scholars will only be selected for one Cohort. If you cannot attend one of the Cohort options due to a prior scheduling commitment, please specify your schedule conflict for that timeframe.

*DISCLAIMER: Please note that travel funding to attend NMQSLA will be determined once Scholars have been selected, and may be required to be Command-funded. Additionally, the dates listed are NOT final and are subject to change. Additional guidance on travel booking and Kick-Off logistics will be provided to confirmed Scholars. Any additional concerns pertaining to the in-person Kick-Off may be referred to the NMQSLA Support Team Mailbox.
6. Please indicate if you are anticipating a permanent change of station (PCS) during the NMQSLA timeframe; if so, please note your anticipated Command and Title.
7. I have informed my Chain of Command leadership of my application and intent to participate in NMQSLA, and confirm their support for my participation.
8. If selected, I commit to attending 100% of the week-long in-person Kick-Off and at least 80% of the Virtual Classroom sessions (~20-25hrs over the course of three months) following the program Kick-Off.

Program Awareness

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