PSCH 353 Consent Form - PSCH 353 PDF

Preview

Summary

PSCH 353...

Description

Human Subject UIC Informed Consent Statement Project Title: Memory Recall Dear Participant: You are being asked to participate in a research study through the Department of Psychology at University of Illinois at Chicago by Dr. Leslie Cameron. The researchers Maseena Ghias, Mirian Zamora , Abdalla Mohammed, and Maha Haroonm, are required to receive your informed consent before you participate in this project. Your participation in research is voluntary. If you choose not to participate, there are no penalties or loss of benefits or services to which you are otherwise entitled. You may withdraw or be withdrawn from the study at any time without penalty and without loss of benefits. A basic description of the project is written below. Please read the explanation below and discuss it with the researchers. We encourage you to ask questions to help you understand the project at any time during the experiment. After any questions you may have are answered and you decide to participate in the research, please sign on the last page of this form in the presence of the person who explained the project to you. An electronic copy of this form will be given to you to keep 1. PROJECT PURPOSE: The goal of this project is to explore people’s ability to accurately recall words, letters, and digits with a distinguishing feature.

2. EXPLANATION OF PROCEDURES: If you agree to participate and sign this form, you will be presented with a screen filled with either words, letters, or numbers. Your task is to accurately recall as many words, letters, or numbers you can remember. The experiment will take approximately 15 minutes to complete. You will receive an email with a Google form; you will be separated into four groups of four or five, each group will be monitored by a researcher. You will be asked to look at the big screen. On each trial, a sequence of either words, letters, or numbers will appear for five seconds. After the full sequence has been presented, you will be asked to write down what you recalled, in any

order. This will be repeated for each trial. At the end of the experiments, you will be asked to submit the Google form.

3. BENEFITS: There are no direct benefits to you. However, your participation will help in the completion of this study and in our understanding of the process of recollection

4.RISKS: The most likely risk from participating in this study is getting a head-ache or tiredness from staring at the screen. Remember that you can stop at any time.

5. CONSENT: o I have read and understood the above information about Eye Spy with my Little Eye, Red, and have been given an opportunity to ask questions. I agree to participate in this project.

o I affirm that I am 18 years of age or older, and I have been given an electronic copy of this consent document, on request.

_______________________________________ Signature of Participant

_______________________________________ Printed Name of Participant

Date: ____________________

_______________________________________ Signature of Research Representative

_______________________________________ Printed Name of Research Representative

Principal Investigator: Dr. Leslie Cameron Department of Psychology University of Illinois at Chicago [email protected]

Student Researchers: Maseena Ghias – [email protected] Mirian Zamora - [email protected] Abdalla Mohammed - [email protected] Maha Haroon- [email protected]

Date: ____________________...