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Sample Lab Study Consent Form

The purpose of this research study is to examine how performing multiple tasks simultaneously affects performance. Participants will be asked to track a moving object on a computer screen using a mouse or joystick while also responding whenever another event occurs by pressing a button. They will also be asked to perform a secondary task like counting backwards or repeating words while doing the primary tasks. Participation will take approximately 60 minutes. There are no anticipated risks to participating. At the end, participants will be debriefed and compensated $10 for their time. All information provided will be kept confidential.

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52 views

Sample Lab Study Consent Form

The purpose of this research study is to examine how performing multiple tasks simultaneously affects performance. Participants will be asked to track a moving object on a computer screen using a mouse or joystick while also responding whenever another event occurs by pressing a button. They will also be asked to perform a secondary task like counting backwards or repeating words while doing the primary tasks. Participation will take approximately 60 minutes. There are no anticipated risks to participating. At the end, participants will be debriefed and compensated $10 for their time. All information provided will be kept confidential.

Uploaded by

Andrew Encarnacion
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Sample Consent Form for Lab Studies

Please consider this information carefully before deciding whether to participate in this research.

Purpose of the research: To examine how performing multiple tasks affects performance.

What you will do in this research: You will view a moving object on a computer display and you will
do your best to track that object using either a mouse or a joystick. You will also respond by pressing a
button whenever another event occurs on the computer display. While you are performing this task, you
will be asked to also perform a second task such as counting backwards or repeating words that are read
to you.

Time required: Participation will take approximately 60 minutes to complete.

Risks There are no anticipated risks associated with participating in this study. The effects of
participating should be comparable to those you would experience from viewing a computer monitor for
60 minutes and using a mouse or keyboard.

Benefits: At the end of the study, we will provide a thorough explanation of the study and of our
hypotheses. We will describe the potential implications of the results of the study both if our hypotheses
are supported and if they are disconfirmed. If you wish, you can send an email message to [investigator’s
name (email address)] and we will send you a copy of any manuscripts based on the research (or
summaries of our results).

Compensation: You will receive $10 [and/or one hour study pool credit] for participating in this study.

Confidentiality: Your participation in this study will remain confidential, and your identity will not be
stored with your data. Your responses will be assigned a code number, and the list connecting your name
with this number will be kept in a locked room and will be destroyed once all the data have been collected
and analyzed. [Researchers with a different plan regarding confidentiality should modify this section of
the consent form to describe what they are actually promising to do to protect confidentiality.]

Participation and withdrawal: Your participation in this study is completely voluntary, and you may
withdraw at any time without penalty. You will receive payment based on the proportion of the study you
completed. You may withdraw by informing the researcher that you no longer wish to participate (no
questions will be asked).

To Contact the Researcher: If you have questions about this research, please contact [investigator’s
name, title, address, phone number, and email address]. You may also contact the faculty member
supervising this work: [adviser’s name, title, address, phone number, and email address]

Whom to contact about your rights in this research, for questions, concerns, suggestions, or complaints that are not
being addressed by the researcher, or research-related harm: Jane Calhoun, Harvard University Committee on the
Use of Human Subjects in Research, 1414 Massachusetts Avenue, Room 234, Cambridge, MA 02138. Phone:
617-495-5459. E-mail: [email protected]

Agreement:
The nature and purpose of this research have been sufficiently explained and I agree to participate in this
study. I understand that I am free to withdraw at any time without incurring any penalty.

Signature: _____________________________________ Date: __________________

Name (print): ________________________________________________


(1/26/10 version)

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