Creative Climate in Education: Least Creative Educational Experience
Research Study
Institutional Review Board
Sponsored Programs Office, Bishop Hall 17
1300 Elmwood Avenue, Buffalo, NY 14222
Federalwide Assurance ID#: 00007126
Informed Consent
NAME AND TITLE OF RESEARCHERS:

DR. CYNDI BURNETT, ASSOCIATE PROFESSOR
Department/Room Number: Creative Studies/Chase 245
Telephone Number: 716-878-6223
Email: argonac@buffalostate.edu

MS. KARINA LOERA BARCENAS
Telephone Number: 716-507-5000
Email: kaloba@gmail.com


STUDY LOCATION(S):
ONLINE, IN THE CLASSROOM, AND IN PERSON AT CREATIVITY EXPERT EXCHANGE CONFERENCE

PURPOSE OF STUDY
The purpose of this research study is to understand what makes up the creative environment of a classroom.

SUBJECTS

Inclusion Requirements
You are eligible to participate in this study if you are at least 18 years of age or older.

PROCEDURES
You will be asked a series of demographic questions followed by a questionnaire based on your experiences in creative and uncreative classroom environments.

RISKS AND DISCOMFORTS
This risks for this study are minimal and no greater than those encountered in everyday life.

BENEFITS
You will not directly benefit from participation in this study.

CONFIDENTIALITY

Data Storage
Your research records will be stored in the following manner:

All data stored electronically will be stored on a secure network server, or on portable devices, such as a laptop with encryption (special software) and password protection. Any hard copies will be shredded and disposed. The questionnaire will be confidential, which means no one, except the research team, can identify you from the study data. Subject identification will be converted into a number that is only accessible to the research team. Names will never be used.

All data will be retained for at least three years in compliance with federal regulations.

IF YOU HAVE QUESTIONS
If you have any comments, concerns, or questions regarding the conduct of this research, please contact the researcher at the top of this form. If you are unable to contact the researcher or have general questions about your rights as a participant, please contact Gina Game, IRB Administrator, Sponsored Programs Office/SUNY Buffalo State at gameg@buffalostate.edu.

VOLUNTARY PARTICIPATION STATEMENT
Participation in this study is voluntary. You may refuse to answer any questions or discontinue your involvement at any time without penalty or loss of benefits to which you might otherwise be entitled. Your decision will not affect your future relationship with Buffalo State.
By entering your NAME and DATE in the space below, we have your permission to take part in this research. *
Your answer
I am part of a creative studies course, and doing this for extra credit. *
Required
If you responded "Yes" to the previous question, write your professor's name. If you responded "No" skip this question.
Your answer
After you complete this questionnaire...
If you complete the following questionnaire we will send you an electronic copy of the book Weaving Creativity into Every Strand of Your Curriculum by Dr. Cyndi Burnett and Julia Figliotti as a thank you gift. Please go on to the next page.
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