Q-bit Student Consent Form (Sample)
You are invited to participate in a research study about the effectiveness of Q-bits in supporting student learning in different classes where quantitative skills and reasoning are important. The study is being carried in collaboration by several partner institutions: Amherst College, Bryn Mawr College, Carleton College, Haverford College, Pomona College, Vassar College, Swarthmore College, Washington & Lee University and Williams College.

You were selected as a possible participant in this study because your professor or course instructor is using one or more Q-bits in a course you are currently taking. We ask that you read this form and ask any questions you may have before agreeing to be in the study.

What are Q-bits?
Q-bits are online modules that can be used by students for just-in-time review and skill-building across disciplines. Each Q-bit focuses on a different quantitative topic or skill, and consist of an initial knowledge check, short videos to review specific quantitative skills, structured application problems to give you practice applying the quantitative skill in disciplinary contexts, and a final knowledge check.
Procedures of the Research Study
By opting in to give your consent, you agree to allow the research team to include data about you and your use of Q-bits this term in our analysis. Any data will be anonymized such that your name, student ID number, or any other personal identifier will be unknown to the researchers. All results of the study will be reported in aggregate such that the activity of any individual student will not be known.

Data may include:

1) responses entered by you into Q-bit modules as part of your interaction with the course materials.
2) your scores on other course assignments or exams in the course(s) where Q-bits are used.
3) limited demographic data provided to the study as authorized by your institution, such as your year in school, legal sex, race/ethnicity, financial aid status, and previous scores on assessments such as math SAT/ACT or other math placement exams. All such data will be handled confidentially (see below).

Risks, inconveniences, and benefits of being in the study
There are no foreseeable risks associated with this study.

The benefits associated with participating in the research study will go to subsequent students at our participating colleges who may participate in similar quantitative skills supports programs. The insights gained from this study will help us in refining Q-bits and developing approaches.

Compensation
There is no compensation for participating in this study.
Confidentiality
The faculty member or instructor who is using Q-bits in your course will not know whether you have consented or declined to participate in the research study. Q-bits will be used by some or all students in similar ways throughout a given course, regardless of any individual student's confidential decision to participate (or not) in this research study.

We will keep all facts about you private. We will keep your records private to the extent allowed by law. We will use a study code rather than your name or ID on study records. Your name and other facts that might point to you will not appear when we present this study or publish the results.

Voluntary Nature of the Study
Your decision whether or not to participate will not affect your current or future relations with YOUR COLLEGE or any institution participating in this study. If you decide to participate, you are free not to answer any questions or to withdraw at any time without affecting those relationships.
Questions
You may ask questions below and a member of the research team will be in contact with you.

If you have questions or concerns regarding this study and would like to talk to someone other than the researchers, contact the Institutional Review Board at [[SCHOOL SPECIFIC INFORMATION]]

Do you have any questions? If so, ask them using the field below:
Your answer
Statement of Consent
Filling in the questions below and submitting this form will serve to indicate your consent.
I have read the above information. I have asked questions and received answer. I consent to allow my course and demographic data to be used as part of this study.
Please write your first and last name below. This will serve as your digital signature.
Your answer
Please choose today's date:
MM
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YYYY
Please indicate if you are 18 years of age or older.
Please Submit Your Response
A copy of your response will be sent to the research team. Your response will not be known by your instructor.


THIS FORM IS A SAMPLE ONLY. NO DATA IS BEING COLLECTED AT THIS TIME.

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