1
Appendix A:
High School IRB Documents
Summer MTSU Research Teams Evaluation Forms
For High School Teachers and Students
Table of Contents
- Informed Assent Form for Students under 18 Years of Age
- Informed Consent Form for Parental/Guardian Permission
- Pre-Summer MTSU Research Team Evaluation Form for High School Teachers
- Post-Summer MTSU Research Team Evaluation Form for High School Teachers
- Response Form for High School Teachers
- Pre-Summer MTSU Research Team Evaluation Form for High School Students
- Post-Summer MTSU Research Team Evaluation Form for High School Students
- Response Form for High School Students
Informed Assent Form
Minimal Risk-Students under 18 Years of Age
The College of Basic and Applied Sciences at MiddleTennesseeStateUniversity is sponsoring a project aimed atSTEPing up Undergraduate Research at MTSU (STEPMT). STEPMT is a five year project with a goal of improving retention and graduation rates in Science, Technology, Engineering, and Mathematics (STEM) disciplines. To help do this, the project is building a research community that will include MTSU STEM faculty, MTSU STEM undergraduate and graduate students, and area high school teachers and students.
Congratulations on being selected to participate in a STEPMTSummer Research Team. To help the project leaders determine which factors are helping retention levels, you will be asked to participate in some evaluation activities which will include responding to survey questions both at the beginning and the end of the summer program.
We will want to know your opinions and thoughts about the research community activities and experiences you encountered. You may choose to not answer any survey question and/or you may withdraw from participation in the evaluation activities at any time. However, if you choose not to participate in the evaluation activities then any compensation, including opportunities for participation in this summer research team will be offered to someone else who is willing to participate in the evaluation activity.
Your responses to the survey questions will be kept confidential by the project team and project evaluators. Your responses will be coded with a unique number so that your name will not appear on the questions/responses. Your individual responses and the code sheet will only be viewed by investigators involved in the STEPMT project. Data will be reported for the group, but individuals’ identities will not be reported.
Feel free to contact the dean of the College of Basic and Applied Sciences, Dr. Thomas Cheatham, at 898-2613 if you have any questions or concerns.
I have read and understand the above information and I voluntarily consent to participate in the STEPMTSummer Research Team. Furthermore, I will participate in the evaluation of this project by responding honestly to the survey questions.
______
Student Signature Date
Informed Consent Form
Minimal Risk- Parental/Guardian Permission
The College of Basic and Applied Sciences at MiddleTennesseeStateUniversity is sponsoring a project aimed at STEPing up Undergraduate Research at MTSU (STEPMT). STEPMT is a five year project with a goal of improving retention and graduation rates in Science, Technology, Engineering, and Mathematics (STEM) disciplines. To help do this, the project is building a research community that will include MTSU STEM faculty, MTSU STEM undergraduate and graduate students, and area high school teachers and students.
Congratulations on your child being selected to participate in a STEPMT Summer Research Team. To help the project leaders determine which factors are helping retention levels, you will be asked to participate in some evaluation activities which will include responding to survey questions both at the beginning and the end of the summer program.
The STEPMT investigators would like all participants to have a positive, productive, and memorable experience during their participation. To help us monitor this, with your permission, your child will be interviewed and asked to respond to their experiences. Your child’s responses will be coded with a unique number and his or her name will be kept confidential. Please contactthe dean of the College of Basic and Applied Sciences,Dr. Thomas Cheatham, at 898-2613 if you would like to review the questions or if you have any concerns.
Your child will be asked to participate in research activities that are developed by the STEPMT program which will be evaluated by your child. Your child’s assent is requested along with your permission for him/her to participate in this program. You are free to withdraw your permission at any time during the project for any reason. Your child may choose to not answer any survey question and/or may withdraw from participation in the evaluation activities at any time. However, if he/she chooses not to participate in the evaluation activities then any compensation, including opportunities for participation in this summer research team will be offered to someone else who is participating in the evaluation activity.
I have read and understand the above information and I voluntarily give permission for my child to participate in the STEPMT program and its corresponding evaluation surveys.
______
Parent or Guardian Signature Date
______
Child’s Name
Pre-Summer MTSU Research Team Evaluation Form
High School Teachers
______(Date)
Dear ______:
Congratulations on being accepted as a member of the ______(name of project) research project team for the summer of ______. (year)
We are very pleased that you are going to participate in the CBAS STEPMT Summer MTSU Research Team. During this project you will be working with MTSU students and faculty as well as other local area high school teachers and students to gain a better understanding of Science, Technology, Engineering, or Mathematics (STEM) and reshape STEM curriculum. Our goal is to provide a course that is as exciting as it is educational.
As one component of assessing the effectiveness of this project, we need you to send an email toMr. Brad Rudnik at y ______(due date) stating what you expect to achieve from your work on this project. Please include the name of the high school in which you currently teach and the names of the students from that high school that are participating with you. This document, as well as any other documents you submit to STEPMT, will be kept confidential. They will only be used by the STEPMTadministrators and any information will be reported without the use of your name or other identifying information. By submitting this email, you are giving your consent of your participation in the project as well as to the evaluation process at the end.
When the email with your expectations is received, Mr. Rudnik will forward to you any additional information you may need for this project.
Thank you again for your participation in the STEPMT project. At the completion of the project, you will be asked to complete a short questionnaire about the work and to submit an executive summary of your activities and results. The real goal for your work is to enhance your knowledge about a STEM discipline while shaping and molding the curriculum that will be used in future classrooms. Please let us know how STEPMT can help.
Sincerely,
Dr. Thomas Cheatham, Dean
STEPMT Principle Investigator
Post-Summer MTSU Research Team Evaluation
High School Teachers
______(Date)
Dear ______:
Thank you so much for participating in a STEPMTSummer MTSUResearch Team. We hope you have found your experience to be exciting, educational and enlightening.
Now that you have completed a STEPMTSummer MTSUResearch Team project, your thoughts and opinions are needed to help the STEPMT investigators evaluate the effectiveness of the project. Please complete the attachedform and send it as an email attachment to Mr. Brad Rudnik at The form asks you to describe how long you worked on the project, what you achieved during your work, and how those achievements compare to your original expectations. The form also asks what worked well and solicits suggestions to improve the summer research experience in the future. Thank you in advance for your honesty and cooperation in this evaluation process. Your responses will be kept confidential. They will only be viewed by the STEPMTadministrators and any information that is reported will not include your name or other identifying information.
This final evaluation must be received before your final compensation can be disbursed.
Sincerely,
Dr. Thomas Cheatham, Dean
STEPMTPrinciple Investigator
Response Form for Post-Summer MTSU Research Team Evaluation
High School Teachers
Name:______
Project Title: ______
Research Mentor (MTSU Faculty):______
Thank you again for your participation and honesty in these responses.
What is the name of the research project you worked on?
Who was the project leader?
How many hours did you put into the project? ______
Was this an appropriate amount of time? ______If the answer is no, please explain.
State what you achieved from your work on this project.
How do those achievements compare to your original expectations of the project?
On a scale of 1-4 (1 being not effective and 4 being very effective) rate the effectiveness of the experience in teaching you about the role of research in the science/math disciplines.
Comment on the strengths and weaknesses of the research experience.
How could the summer research program be improved?
Thank you again for your honesty and participation. If you have any questions, please contact Dr. Thomas Cheatham
Dean and STEPMT Principal Investigator
College of Basic and Applied Sciences
MiddleTennesseeStateUniversity
615-898-2613,
Pre-Summer MTSU Research Team Evaluation Form
High School Students
______(Date)
Dear ______:
Congratulations on being accepted as a member of the ______(name of project) research project team for the summer of ______. (year)
We are very pleased that you are going to participate in the CBAS STEPMT Summer MTSU Research Team. During this project you will be working with MTSU students and faculty as well as local area high school teachers to gain a better understanding of Science, Technology, Engineering, or Mathematics (STEM. Our goal is to provide you with a course that is as exciting as it is educational.
As one component of assessing the effectiveness of this project, we need you to send an email to Mr. Brad Rudnik at y ______(due date) stating what you expect to learn from your work on this project. This document, as well as any other documents you submit to STEPMT, will be kept confidential. They will only be used by the STEPMTadministrators and any information will be reported without the use of your name or other identifying information. By submitting this email, you are giving your consent of your participation in the project as well as to the evaluation process at the end. Before attending any classes, the consent form signed by your parent or guardian must be turned in to a STEPMT faculty member.
When the email with your expectations is received, Mr. Rudnik will forward to you any additional information you may need for this project.
Thank you again for your participation in the STEPMT project. At the completion of the project, you will be asked to complete a short questionnaire about the work and to submit an executive summary of your activities and results. The real goal for your work is to enhance your knowledge about a STEM discipline while shaping and molding the curriculum that will be used in future classrooms. Please let us know how STEPMT can help.
Sincerely,
Dr. Thomas Cheatham, Dean
STEPMT Principle Investigator
Post-Summer MTSU Research Team Evaluation
High School Students
______(Date)
Dear ______:
Thank you so much for participating in a STEPMTSummer MTSUResearch Team. We hope you have found your experience to be both exciting and educational.
Now that you have completed a STEPMTSummer MTSUResearch Team, your thoughts and opinions are needed to help the STEPMT investigators evaluate the effectiveness of the project. Please complete the attached document and send it as an email attachment Mr. Brad Rudnik at . The form asks you to describe how long you worked on the project, what you achieved during your work, and how those achievements compare to your original expectations. The form also asks what worked well and solicits suggestions to improve the summer research experience in the future. Thank you in advance for your honesty and cooperation in this evaluation process. Your responses will be kept confidential. They will only be viewed by the STEPMT administrators and any information that is reported will not include your name or other identifying information.
This final evaluation must be received before your final compensation can be distributed.
Sincerely,
Dr. Thomas Cheatham, Dean
STEPMTPrinciple Investigator
Response Form for Post-Summer MTSU Research Team Evaluation
High School Students
Name:______
Project Title:______
Research Mentor (MTSU Faculty):______
Thank you again for your participation and honesty in these responses.
What is the name of the research project you worked on?
Who was the project leader?
How many hours did you put into the project? ______
Was this an appropriate amount of time? ______If the answer is no, please explain.
State what you achieved from your work on this project.
How do those achievements compare to your original expectations of the project?
On a scale of 1-4 (1 being not effective and 4 being very effective) rate the effectiveness of the experience in teaching you about the role of research in the science/math disciplines.
Comment on the strengths and weaknesses of the research experience.
How could the summer research program be improved?
Has your experience in the Summer Research Team had any effect on your choice of college major?
Thank you again for your honesty and participation. If you have any questions, please contact Dr. Thomas Cheatham
Dean and STEPMT Principal Investigator
College of Basic and Applied Sciences
MiddleTennesseeStateUniversity
615-898-2613,