Lab report
1
Research Proposal Consent Form
Conducting a research study of any type requires that the researcher obtain informed consent from each subject. MTSU has a website where you can find the basic information for obtaining consent, including the form required by MTSU’s Institutional Review Board ( http://www.mtsu.edu/irb/ ).
The next page shows a modified form that we use for this class. The yellow highlight is what I typed for a previous project. You must delete all the highlighted information and then add your own information based on your specific study. Include your consent form in your proposal as appendix A.
Appendix B may be a demographic form you create if your proposal includes collecting basic subject information such as gender, age, race, etc. Appendices C, D, E, etc., will be copies of your surveys, if you are using surveys. If you are not doing survey research, then they will be copies of your data recording sheet or other materials that you may be presenting to your subjects, such as a copy of the instructions you will be giving the subjects.
Remember, you must treat all groups the same, except for the IV, so your instructions must be written out and read to subjects to ensure you say the same thing each and every time. And these instructions must then be included in your proposal.
Principal Investigator: __________________
Study Title: ____________________________________________________________
Institution: Middle Tennessee State University
Name of participant: _________________________________________________________ Age: ___________
The following information is provided to inform you about the research project and your participation in it. Please read this form carefully and feel free to ask any questions you may have about this study and the information given below. You will be given an opportunity to ask questions, and your questions will be answered. Also, you will be given a copy of this consent form.
Your participation in this research study is voluntary. You are also free to withdraw from this study at any time. In the event new information becomes available that may affect the risks or benefits associated with this research study or your willingness to participate in it, you will be notified so that you can make an informed decision whether or not to continue your participation in this study.
For additional information about giving consent or your rights as a participant in this study, please feel free to contact the MTSU Office of Compliance at (615) 494-8918.
1. Purpose of the study:
You are being asked to participate in a research study because the researcher is a student learning to conduct research and needs help with this class assigned research project. The project is designed to teach the student the basics of designing research, collecting and analyzing data, and writing results. The data will be use for no other purpose.
2. Description of procedures to be followed and approximate duration of the study:
Participants are asked to fill out a short form of questions regarding a few personal items (for example age and sex) and then to fill out a short sensation-seeking scale. This scale measures one's attitude toward risky activities such as riding motorcyles.
3. Expected costs:
There are no costs to the participants other than their time.
4. Description of the discomforts, inconveniences, and/or risks that can be reasonably expected as a result of participation in this study:
There are no discomforts, inconveniences, or risks expected as a result of your participation. You may find some of the survey items, silly, irrelevant, or meaningless to you.
5. Compensation in case of study-related injury:
There is no compensation. No injury is expected as a result of filling out the survey forms.
6. Anticipated benefits from this study:
a) The potential benefits to science and humankind that may result from this study are the experience and knowledge gained by the student-researcher as an inherent part of her/his education.
b) The potential benefits to you from this study are the good feeling and knowledge that you are helping a college student complete assignments required for her/his graduation and future success.
7. What happens if you choose to withdraw from study participation: Nothing. You may withdraw at any time for any reason with no recrimination.
8. Contact Information. If you should have any questions about this research study or possibly injury, please feel free to contact Donald F. Kendrick, Professor of Psychology (615 898 2706).
9. Confidentiality. All efforts, within reason, will be made to keep the personal information in your research record private but total privacy cannot be promised. Your information may be shared with MTSU or the government, such as the Middle Tennessee State University Institutional Review Board, Federal Government Office for Human Research Protections, but only if you or someone else is in danger or if we are required to do so by law.
10. STATEMENT BY PERSON AGREEING TO PARTICIPATE IN THIS STUDY
FORMCHECKBOX I have read this informed consent document and the material contained in it has been explained to me verbally. I understand each part of the document, all my questions have been answered, and I freely and voluntarily choose to participate in this study.
Date Signature of patient/volunteer
Consent obtained by:
Date Signature
Printed Name and Title