Consent form
Prior to conducting my study in each term, I was careful to inform students about my project and the sort of data I was collecting, as well as the used to which I planned to put the information. I asked students to sign the consent form below. Participation in the study was voluntary; therefore, students had the option or not of completing the Measure of Epistemological Reflection, the Jackson Personality Inventory, and the surveys I administered. Students could also refuse to allow me to use their work in this project. As you peruse the data from the study, you will notice that not all students completed the standardized instruments and surveys. In the four terms I have been conducting this study, only 4 students have refused to participate. However, I have had several students who signed a consent form fail to complete all the instruments. This was largely due to their busy schedules and the fact that participation was entirely voluntary and failure to complete these instruments did not in any penalize them in the course.
Since human subjects were used in the research, I had to submitted this form and a detailed description of my project to the Institutional Review Board at Georgia College & State University.
CONSENT FORM
I, (please print your name) agree to be a participant in the research titled "The Cognitive and Intellectual Development of Students in Interdisciplinary Courses," which is being conducted by Dr. Deborah Vess, who can be contacted at 445-4441. I understand that this participation is entirely voluntary; I can withdraw my consent at any time and have the results of the participation returned to me, removed from the experimental records, or destroyed. The following points have been explained to me:
1) The purpose of this study is to document the impact of interdisciplinary courses on the cognitive and intellectual development of students at GC&SU. It will also attempt to determine whether there are differences in the impact of broad vs. Narrow interdisciplinary courses, and what the obstacles to learning and interdisciplinary integration are for students.
2) I understand that the procedures to be used are as follows: I will be asked to take standardized pre-and post-tests which will be given a code name to protect my anonymity and sent to outside raters. These pre- and post-tests will not affect my course grade, and will be used for research and publication purposes only. I will also submit required course work, which may be analyzed by the investigator, given a code to protect my anonymity, and used in publications concerning this research project. I may be interviewed by the investigator or her assistant to describe my reasoning about difficulties or conceptual challenges faced during the course. I will be asked to sign this form giving consent to participate in this study.
3) You may find that many questions are invasive or personal. If you become uncomfortable answering any questions, you may cease participation at any time. No discomforts or distresses will be faced during this research.
4) No physical, psychological, social, or legal risks exist in this study.
5) The results of this participation will be anonymous and will not be released in any individually identifiable form without my prior consent unless required by law.
6) The investigator will answer any further questions about the research (see above phone number).
7) In addition to the above, further information, including a full explanation of the purpose of this research, will be provided at the completion of the experiment.
Signature of Investigator
Date
Signature of Participant
Date
****************************************************************************** Research at Georgia College & State University which involves human participants is carried out under the oversight of the Institutional Review Board. Questions or problems regarding these activities should be addressed to Dr. Kenneth Jones, Dean of the Graduate School & Research Services, Campus Box 73, Georgia College & State University, Milledgeville, Georgia 31061. [912-445-1228]
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