Honoring the Whole Student Workbook Survey

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Research Participant Information and Consent Form
1. EXPLANATION OF THE RESEARCH and WHAT YOU WILL DO:
You are being asked to participate in a research study about how learning in informal higher education spaces as it relates to the Honoring the Whole Student: Developing Space for Native American Students in STEM by Supporting Complex Identities Workbook.
Workbook users will be asked to complete an online survey.
You must be at least 18 years old to participate in this research.

2. YOUR RIGHTS TO PARTICIPATE, SAY NO, OR WITHDRAW:
Participation in this research project is completely voluntary. You have the right to say no. You may change your mind at any time and withdraw. You may choose not to answer specific questions or to stop participating at any time. Whether you choose to participate or not will not impact your ability to use the workbook.

3. COSTS AND COMPENSATION FOR BEING IN THE STUDY:
There will be no costs or compensation for participating in this study.

4. CONTACT INFORMATION FOR QUESTIONS AND CONCERNS:

If you have concerns or questions about this study, such as scientific issues, how to do any part of it, or to report an injury, please contact the researcher (Christie Poitra, Ph.D., Michigan State University Native American Institute, 446 W. Circle Dr. RM 412, East Lansing, MI. 48824; poitrach@msu.edu; (517) 353-6632).

If you have questions or concerns about your role and rights as a research participant, would like to obtain information or offer input, or would like to register a complaint about this study, you may contact, anonymously if you wish, the Michigan State University’s Human Research Protection Program at 517-355-2180, Fax 517-432-4503, or e-mail irb@msu.edu or regular mail at 4000 Collins Rd, Suite 136, Lansing, MI 48910.

5. DOCUMENTATION OF INFORMED CONSENT:
By completing this online survey, you indicate your voluntary agreement to participate in this study. If you do not wish to participate in the study, you do not need to complete this survey.

What is your current role? *

Graduate student

Staff

Researcher

Fix-term faculty (e.g., Clinical Faculty, Non-Tenure Track Faculty)

Tenure-track Faculty (e.g., Assistant Professor)

Tenured Faculty (e.g., Associate, Full or Emeritus Professor)

Other:

What is your gender identity? *

Non-binary or gender fluid

Female

Male

Other:

What is your age? *

18-34 years old

35-44 years old

45-54 years old

55 and older

What is your ethnicity? *

Biracial or Multiracial

Native American, Indigenous or American Indian

Black or African American

Hispanic or Latino

Asian/Pacific Islander

White

What is the state in which you work? *

If you work for a university, how would you describe your institution? *

2-year institution

4-year institution

Not applicable

How would you rate this workbook? *

Not Helpful

Very Helpful

What made you want to use this workbook?

What is one thing you want to remember from the workbook?

After using this workbook, what is one question you have?

What are some specific ways that you plan to use this workbook to improve your practice?

How did you hear about this workbook? *

Recommended by a colleague

Found it online

Recommended by an organization

Other:

Please email Dr. Christie Poitra (poitrach@msu.edu) for a letter from the Michigan State University Native American Institute that highlights your professional learning supporting diversity, equity, and inclusion using the Honoring the Whole Student Workbook.

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