Research Participant Consent Form
Purdue University
College of Engineering
Purpose of Research
We seek to assess the effectiveness of the SURF program. Specifically, we seek to i) understand SURF students’ motivations for participating in this program, ii) identify learning (or other) student-derived benefits from participating in the program, iii) identify the strength of the SURF program, and iv) identify areas of the program that might be improved. We also seek to analyze these results as a function of student demographics (e.g. student gender, ethnicity, work experience, etc.).
Specific Procedures to be Used
Each SURF participant will be requested to complete a pre- and post- assessment of the program. During the pre-assessment, students will be asked to provide demographic information and to self-evaluate their current abilities and reasons for participating in the program. Each student will be given an assigned survey number to be used for both the pre- and post- assessments.
Duration of Participation
Students will be asked to participate in an online pre- and post- assessment. Participation will end after the post-assessment survey has been completed.
Risks to the Individual
We do not foresee any risks associated with this assessment that would be more than encountered in everyday life.
Benefits to the Individual or Others
By participating in the project, you may help i) identify learning (or other) student-derived benefits from participating in the SURF program at Purdue, ii) identify the strengths of the SURF program, and iii) identify areas of the SURF program that might be improved for future participants.
Extra Costs to Participate
There is no cost to you to participate in this survey.
Confidentiality
All data will be stored in secure data files. After analysis has been completed, the data will be returned to the SURF program administrators.
Voluntary Nature of Participation
I do not have to participate in this research assessment. If I agree to participate, I can withdraw my participation at any time without penalty.
Contact Information:
If I have any questions about this research assessment, I can contact the College of Engineering at 765-494-2122. If I have concerns about the treatment of research participants, I can contact the Institutional Review Board (IRB) at Purdue University, 610 Purdue Mall, Hovde Hall Room 307, West Lafayette, IN 47907-2040. The IRB’s phone number is (765) 494-5942. The email address is irb@purdue.edu.
I UNDERSTAND THAT BY CHECKING THE ‘Yes, I understand and agree to the terms above’ BOX BELOW, I AM INDICATING THAT I HAVE HAD THE OPPORTUNITY TO READ THIS CONSENT FORM, ASK QUESTIONS ABOUT THE RESEARCH PROJECT AND AM PREPARED TO PARTICIPATE IN THIS PROJECT.
