Note to Template Users

1
Note to Template Users

• Save this template as a PowerPoint
• On each slide, highlight the prompt text (in
  parentheses) type over to replace it with the
  narrative about your experience.
• Please insert the type of information requested
  on each slide. If you have additional content to
  add, use insert new slide as needed.
• To update the blue bar to the right
• Click on View, Master, Slide Master
• Highlight (insert Name and District here) and
  type in your name and district
• Click on Close Master View
• DELETE slides 1 and 2 once you have completed
  filling in this template!

2
Impact Statement Overview

• The successful activities and ideas captured
  through the Impact Statement will be communicated
  as an example to other leaders struggling with
  similar challenges that you face. This document
  can be used to codify your change efforts and to
  communicate your work with other Educational
  Leadership professionals.
• Process for submission
• Complete this self-directed Impact Statement
  template
• Submit this to Ann Duffy at ann.duffy_at_galeaders.or
  g
• Ann will check your Impact Statement for quality
  and accuracy before sending it out to other
  leaders as an example
• If you have questions about the format or the
  procedure for filling out this template, please
  contact Becky Cocos at becky.cocos_at_galeaders.org
  or Ann Duffy at ann.duffy_at_galeaders.org.

3
Rising Stars CollaborativeImpact Statement

• (Name)
• (District)
• (School Name)
• (Position/Tenure at time you led the effort)
• (Current Position may or may not be applicable)
• (Telephone Number)
• (Email)

4
We faced this challenge

• Background (insert background information
  what caused / led up to / indicated the presence
  of the challenge you faced)
• Goal (list the main goal focused on during the
  effort)
• Challenge (insert a description of the
  challenge)
• What we implemented (concisely describe what
  you implemented)

5
Our analysis that helped us define the problem

• Data analyzed (identify which data was analyzed
  to further define the problem)
• Causes identified (list the probable root causes
  that you identified)

The result of this analysis told us these systems
had to change

• (list the systems that were impacted by this
  challenge e.g. Curriculum, Assessment,
  Instruction, Professional Learning, Technology
  Integration, People)

6
We took these actions and performed this work

• (describe the tasks, sub-tasks, steps you
  performed in pursuit of your goalyou may also
  wish to describe which parties were responsible
  for which actions)

7
We experienced these changes as a result

• (what changes did you experience as a result of
  your efforts? Consider these arenas and more
• team or organizational culture
• the Collaborative
• a partner
• a cohort
• a district
• an instructor

8
We gained these results
(Insert charts, graphs, or tables here)
9
These other factors influenced our results

• (did other systems, programs, or processes,
  beyond the one you focused on, also impact your
  goal)

10
We learned these lessons

• Lessons Learned (what lessons did you learn?
  Did all your actions have the expected results?
  Or did other things happen that skewed your
  results positive or negative?)
• Meaning to you as a professional (how has this
  change / improvement / experience been meaningful
  to you as a professional?)
• Next steps (what are your next steps in this
  improvement effort? Or in another effort that
  will be your follow up to this one?)
• What if anything would you have done differently
  to improve your results? (Include steps that you
  would add or steps you would modify or not do.)

11
My Summary

• Problem Identified (Include a brief statement of
  the problem you were faced with)
• Work Done (State concisely the actions you
  actually performed)
• Changes Experienced (Identify the changes that
  occurred)
• Result Realized (Explain the impact or result of
  the work done)