INFORMED CONSENT AGREEMENT
University of Central Arkansas
Informed Consent Agreement
ATOM Scholars: Supplemental Instruction, Mentorship Circle, Professional Development - Supplemental Instruction
You are being asked to participate in a research study. Before you give your consent to volunteer, it is important you read the following information and ask as many questions as necessary to be sure you understand what you will be asked to do.
Investigators
Dr. Marsha Massey, Department of Chemistry and Biochemistry at the University of Central Arkansas
Dr. Faith Yarberry, Department of Chemistry and Biochemistry at the University of Central Arkansas
Dr. Kristin Dooley, Department of Chemistry and Biochemistry at the University of Central Arkansas
Dr. Patrick Desrochers, Department of Chemistry at the University of Central Arkansas
Dr. Michelle Buchanan, Department of Teaching and Learning at the University of Central Arkansas
Dr. Darshon Anderson, Department of Psychology & Counseling at the University of Central Arkansas
Dr. Makenzie Long, Department of Chemistry and Biochemistry, Creighton University
Giovana Stanford, Undergraduate Research Student - Department of Chemistry, University of Central Arkansas
Purpose of the Research
This research study will evaluate the effectiveness of Supplemental Instruction as a tool to improve student success in chemistry courses at the University of Central Arkansas. Data from this research will impact Supplemental Instruction offerings in future chemistry classes.
Procedures
You will be asked to complete a 30-minute survey that includes questions related to high school experience, demographic information, academic perceptions of oneself, and chemistry.
You may also be asked to complete an end-of-semester survey that will take 10-minutes. Participation in the initial survey does not create expectation of participation in the end of semester survey.
Potential Risks or Discomforts
There are no foreseeable risks to you by participating in this study. The only foreseeable impact may be discomfort with sharing your experience. If survey questions, though unexpected, bring up emotions, we encourage you to contact UCA’s Counseling Center in the Student Health Services Building in Suite 327 or to call at (501) 450-3138 if you experience stress or discomfort.
Potential Benefits of the Research
Participant: It is anticipated that participants may observe improved performance in these chemistry courses as well as promoting students self-efficacy.
Long Term: The research should inform best practices and strategies to improve learning for students taking College Chemistry I through Organic Chemistry II in the Department of Chemistry at UCA and practices to reduce the achievement gaps among different populations thereby promoting ones self-efficacy. If correlations between improved student self-efficacy for underrepresented populations in our department is observed, this could impact the broader science community by informing scientists worldwide of an effective model for peer mentoring or supplemental instruction.
Confidentiality and Data Storage
Your privacy is important to us. The researchers will ask that you to provide your student ID number as a method to collate survey responses to institutional information including academic records. Completion of the survey will serve as consent to match your survey responses with institutional records. Your survey data and Institutional Records will be tracked for all College Chemistry I, College Chemistry II, Organic Chemistry I, Organic Chemistry II courses taken by you.
Once all of the data has been collated, your student ID will be deleted from the file. The researchers will be reporting only aggregate data that is completely unidentifiable.
Survey responses will be stored digitally and password locked at the University of Central Arkansas for a period of ten years. Only the researchers will have access to the raw data. Survey data collated with institutional records will be stored on computers in Dr. Faith Yarberry's office and laboratory. The doors will be locked at all times when the faculty member is not present. All computers containing your survey responses collated to your institutional records will be password locked and will require Dr. Faith Yarberry to log in. When reporting and sharing the data with others, the data will be combined from all participants, and individual identifying information will be removed.
Participation and Withdrawal
Your participation in this research study is voluntary. You may refuse to participate without penalty. If you decide to participate, you are free to stop at any time without penalty by just stopping and/or telling the investigator.
You may not withdraw from the study after data collection has been completed since your name will not be clearly linked to any of the data.
Questions about the Research
If you have any questions about the research, please ask them now. If you have questions later, you may contact Dr. Marsha D. Massey at
marsham@uca.edu, Dr. Faith Yarberry at
fyarberry@uca.edu, Dr. Makenzie Long at
mlong14@uca.edu, or Dr. Patrick Desrochers at
patrickd@uca.edu This research project has been reviewed and approved by the Institutional Review Board for the Protection of Human Subjects at the University of Central Arkansas. If you believe there is any infringement upon your rights as a research subject, you may contact the Research Compliance Coordinator at (501) 450-3451.
Email is being collected for your certificate.
