Federal Law Enforcement Training Center

Consent for Voluntary Participation in Research Study

  1. Project name: An Evaluation of Incorporating Simulated Line of Travel Training into the Instruction of FLETC Emergency Vehicle Operations
  1. Purpose of Research: To determine if there are difference in learning the principles of emergency vehicle operations (line of travel) between traditional in-car training and a blended approach using driving simulation and in-car training.
  1. General Plan of the Research: In addition to comparing a traditional vs blended emergency vehicle operations training, all students will be asked to complete a demographic background questionnaire and a Cognitive Assessment of Emergency Vehicle Operations (CAEVO). Upon acceptance into the research, subjects will be randomly assigned to one of two groups. One group of subjects will participate in a traditional emergency vehicle operations class using lecture and in-vehicle training. Another group of subjects will participate in blended class using lecture, driving simulation and in-vehicle training. Upon conclusion, all subjects will then participate in a practical examination (PE). Final PE scores will be compared to determine if there is a difference between the two groups.
  1. Estimated Duration of the Research: Participants will attend two sessions. First session, lasting approximately 4 hours. Second session, lasting 7-8 hours.
  1. Estimated Total Number of Subjects: One Hundred participants.
  1. The subject is encouraged to ask any questions at any time about the study and its procedures, or his/her rights as a subject.

7.Should the subject have any questions or to report any study-related problems, the subject should contact the Principal Investigator, Dr. Rick Giovengo, at the address, phone number, or email as follows: FLETC, Applied Training Research Branch, 1131 Chapel Crossing Road, Glynco, GA, 31524, 912-267-2391, .

If further information is desired or if there are study related problems, the issues should be addressed to the Chair of the Research Review Board, Dr. William Norris, FLETC, Chief, Applied Research Branch, 1131 Chapel Crossing Road, Glynco, GA, 31524, 912-267-2255, .

8.Subject participation is voluntary. Anyone who agrees to participate in the research may change his/her mind at any time. Subjects may refuse to answer any questions and/or withdraw from the study at any time.

9.Exclusion Criteria: Given the requirement for legal informed consent, no participant under the age of 18 will be allowed to volunteer. A participant may also be excluded from the study if they do not hold a valid driver’s license, have a medical reason which precludes them from driving a standard police vehicle, if they are on medication that would alter their ability to drive, if they are pregnant or if they fail to pass the background checks required for entrance to the training center

The subject’s participation may otherwise be terminated by the investigator without regard to the subject’s consent for 1) failure to successfully pass a background check, 2) failure to follow safety protocols, 3) failure to utilize safety equipment provided, 4) not attending all classes, and/or 5) arriving late to a class.

10.FLETC will not provide any compensation or certificate of completion for participation in the study.

11.Though FLETC will not be offering any compensation or certification of completion, subjects will be provided formal instruction in emergency vehicle operations. Participation will assist FLETC to understand the differences, if any, between instructional methods. By understanding these differences, if any, FLETC may be able to optimize instruction and enhance training effectiveness.

12.The information in the study records will be kept confidential. Data will be stored securely and will be made available only to persons conducting the study unless the subject specifically gives permission, in writing, to do otherwise. No reference will be made in oral or written reports which would link the subject to the study.

13.The greatest risk is a participant could be killed or injured in a vehicle crash; however, the more probable risks are motion sickness, simulator adaptive syndrome, and minor injuries from body movement inside the vehicle. All appropriate safety protocols will be followed and appropriate safety equipment will be utilized. Vehicles are equipped with modern safety equipment (seatbelts, airbags, safety glass, anti-lock brakes etc.) andissued helmets by FLETC as an extra precaution.

14.The investigator and instructors will do everything possible to prevent or reduce discomfort and risk, but it is not possible to predict everything that might occur. In the unlikely event of physical injury resulting from the subject’s participation in the research, emergency medical treatment will be provided at no cost to the subject. If a participant thinks something unusual or unexpected is occurring, has unexpected discomfort, or in the event of a research-related injury, he/she should immediately notify the Instructor in charge of the class and the Principal Investigator, Dr. Rick Giovengo at 912-267-2391. Treatment of injuries will be referred to the FLETC Health Unit.

_____ (Initials) I herby certify, that to the best of my knowledge, I am not prohibited from driving a vehicle, can meet the physical requirements (see attached) and hold a valid driver’s license.

_____ (Initials) I herby certify, that to the best of my knowledge, I am not pregnant.

_____ (Initials) I herby certify, that to the best of my knowledge, I am not taking any medication, either off the shelf or prescribed that will interfere with my ability to safely operate a vehicle (see attached for a list of medications).

I have read the above description of the research. Anything I did not understand was explained to me and I had all my questions answered to my satisfaction.

By signing below, I affirm that I am at least 18 years of age or older.

Printed Name: ______

Signature of Subject: ______Date: ______

I hereby certify that the information I provided above is true and correct to the best of my knowledge and belief, and understand that I may be prosecuted under 18 U.S.C. § 1001 should I be found to have knowingly and willfully provided false, including misleading, information.

PHYSICAL REQUIREMENTS

  1. Drive and/or remain seated in an automobile for four (4) hours.
  1. Meet all of the following physical attributes, and possess a valid State driver's license
  2. Full range of motion in limbs and trunk
  3. Average manual dexterity and hand-eye coordination
  4. Average strength for age and build.
  5. Acceptable eyesight and hearing.
  6. Normal vocal ability.
  1. Turn head from side to side and pivot body at trunk while raising right and left arm to shoulder level while seated.
  1. Enter and exit an automobile unassisted.
  1. Quickly manipulate the steering wheel, brake and accelerator pedals of a motor vehicle at slow, moderate, and high speeds.
  2. Execute car removal techniques from vehicles.
  1. Ability to wear safety helmet correctly; having weight of approximately 1 pound.
  1. Sustain repeated shock loads to, and torsion strains of, the limbs and trunk. Additionally, the student should not have suffered recent back or neck problems or undergone recent surgery.

Drug Participatory Checklist

(These drugs may adversely impact your ability to safely operate a vehicle.)

ANTIHISTAMINES

(Some antihistamines cause drowsiness (e.g. Benadryl, Phenergan, Atarax, Tylenol P.M.). If your medication makes you drowsy, please DO NOT volunteer for this study.

Actifed Plus / Btomfed / Efidac 24 / Sine-Aid / Trina!in Repetabs
Allegra / Clairtin / Eldane / Sine-Off / Tylenol Allergy
Anilhisl / Clairtin D / Extandryl / Sinulin / Tylenol Flu
Antlzol / Contac / Pericalin / Sinulab / Tylenol PM
Atarax / Dimetane / Phendry / Sudifed / Tylenol-Allergy
Benadryl / Dimetapp / Phenegran VC / Symprex / Tylenol-Severe Allergy
Benadryl DF / Driroral / Prometh PLN / Tavisl-D / Vistaril
Benadryl-Allergy / Drixora / Prometh VCPL / Thera-Flu-Sinus / Zyrtec

HYPNOTICS

(If you are taking a “hypnotic” medication during the day time, please DO NOT volunteer for this study)

Ambien / Buspirone HCL / Halden / Temazepam
Bevitamel / Doriden / Placidyl / Zebeta
Buspar / Etchlorvynol / Restoril / Ziae

OPIOID ANALESICS

If you are regularly taking one of the following or something similar, please DO NOT volunteer for this study.

Astramorph PF / Kadian / MSIR / Percolone / Tylox
Codine Sulfate / lemine / Narcan / RMS / Ultiva
Darvocet / Lortab / Norco Tablets / Roxana! / Ultran
Dilaudid / Morph SUL / Oramorph / Roxicodone / Vicodin
Duramorph / Morphine / Oxyir / Roxiprin Ful / Wygesic
Fiorieet / Morphine Sulfate Percocet / Talwin / Zydone
Infumorph / MS Contin / Percodan / Tylenon with Godine

Drug Participatory Checklist (continued)

(These drugs may adversely impact your ability to safely operate a handgun.)

BENZODIAZEPINES

(If you are regularly taking one of the following or something similar, please DO NOT volunteer for this study.)

Alprazolam / Doral / Librium / Serax / Tranxene SO
Clorazepate Dipotassim / Equanil / limbilrol / ProSom / Tranxene T
Dalmane / Flurazepam / Meprobamate / Quazepam / Valium
Diaz.epam / Halcion / Miltown / Restori! / Xanax

MUSCLE RELAXERS

If you are regularly taking one of the following or something similar, please DO NOT volunteer for this study.

Flexeril / Robaxin

In the event of an emergency, is there someone you would like us to contact?

In case of emergency, please contact:

Emergency Contact:

Name:______

Relationship______

Phone:______

Address:______

______

______

Email:______

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May we contact you in the future to inquire if you have any interest in participating in potential future studies? Answering “yes” now in no way obligates your participation in such studies.

YESNO

Follow-up Contact Information

Phone:______

Address:______

______

______

Email:______

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