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Sample Research Paper Showing Hypothesis Statement - DOC

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Sample Research Paper Showing Hypothesis Statement document sample

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									 Psychology 242                        Psychology 242, Dr. McKirnan
  Introduction                     Research paper overview and instructions
  to Research



                        Paper assignment requirements

Your teaching assistant (TA) will have primary responsibility for teaching you how to
   approach this paper, clarifying your thoughts, assisting with statistics, etc. This will
   happen during discussion group. Your TA will also read and grade your paper.
Thus, attend and use the discussion group time to develop this paper.
You are wise to submit a draft of the paper to your TA in time to get feedback before
   submitting a final copy: students who go through a rough draft routinely score
   many more points!


The paper
The body of your research paper must be a maximum of 12 pages, including a separate title
page and abstract (thus, 10 pp of actual paper text). References, tables or figures, and
appendices are outside the 12 page limit. The content of your Appendix is given above. The
paper must be typed in 12 point font, double spaced, on 8 ½ by 11 in. paper, using
American Psychological Association (APA) style. See your book for examples and
discussion.

The current APA guidelines for research reports and writing are given here. Instructions for
research citations, headers, and your informed consent document are given here.
Frequently asked questions about the paper are given here. Do not include plastic or
cardboard binders, folders, or other paraphernalia; submit paper only.

Relevant research
The paper will be the description of an actual or hypothetical experiment. Do not base your
paper on a correlational or measurement study. I provide data during Week 12 as part of
your statistics (t-test) assignment: Most students base their paper on those data. You can
also collect real data, or make up data that fits a specific experiment you have in mind.

However you structure your data, you will specify two variables, appropriate measures, and
a number of research participants, and plug in a data set. You must append all your
hypothetical measures (experimental observation sheets, interviews, etc), your "raw" data,
and statistical calculations to the paper.

If you have real data available -- either through another project, or that you can collect
during the course -- you may use that, but must discuss it with me or your TA before you
collect it.

Extra credit on the paper
You can get up to 5 points of extra credit on your paper by performing a correlation or a chi
square as well as a t-test on your data. If you make up or collect data that both compares
two groups and has (an)other variable(s) correlating with your outcome measure, you can
discuss those correlations as part of your theory and results. Work with me or your TA on
this if you like.



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                  Psychology 242, Dr. McKirnan                                            p. 2 of 17
                    Research paper overview



References in scientific journals
All papers must have at least two references to scientific journals, used and formatted in
APA style. Your TA will spend time on this during discussion group. Copy the Abstract page
from the printed journals (not web pages) and append to the paper. Instructions for
research citations are given here.

General UIC reference materials are at: http://www.uic.edu/depts/lib/ . For electronic
journals available at UIC go here. The UIC electronic journals are very comprehensive, and
most have full text articles.

To search by topic, title, or author for full text articles from American Psychological
Association and many other sources, go to the UIC OVID search engine at
http://gateway.ut.ovid.com/gw1/ovidweb.cgi

      “Start OVID” on the entry screen,
      Check “PsychINFO” to search for psychology articles.
      Check “MEDLINE” to search medical and public health journals.
      Search using key words by topic or author; a reference that has a full article available
       will have a link to “Ovid Full Text”.


      American Psychological Association journals: http://www.apa.org/journals/
      Society for behavioral medicine: http://socbehmed.org/sbm/sbm.htm
      The New England Journal of Medicine: http://www.nejm.org/content/index.asp
      The UIC Institutional Review Board: http://www.uic.edu/depts/ovcr/oprr/
      Examples of surveys are in “Health and Psychosocial Instruments” under OVID.
      A good Psychology web site that allows you to search by topic for references,
       discussions and links is at http://www.psywww.com/. This is a nice site to begin
       getting material about your topic.

Late papers
You will lose 20% of the available points each day the paper is late. This works out to about
a full letter grade for each two days the paper is late.

Plagiarism
Plagiarism in any form is a serious offense. Even minor plagiarism will cost you points. If
we determine that you have plagiarized a major part of your paper you will receive a „0‟ on
the paper. In serious cases you will also fail the entire class, and I will file official judicial
charges against you with the Dean of Students, who will place a notice about the incident in
your permanent record.

Plagiarism includes copying the words of a fellow student or any other author in your
papers, copying even short phrases from written work that you are using as a reference
(even if you cite it properly), handing in work that you have handed in for another class, or
handing in papers you've gotten from the internet or from other students. Read the web
section on reference citations carefully and follow it. We will be using a paper-checking
service in Blackboard to check for plagiarism.

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                   Psychology 242, Dr. McKirnan                                          p. 3 of 17
                     Research paper overview



Comments on your paper
If you want your TA to provide comments on your paper submit it with a return envelope (no
stamp necessary). TAs will provide comments only on papers that are submitted with a
return envelope.

                               Overall Paper Structure:
This section describes the structure and grading criteria for your research paper. Each bold
heading must show up in your paper, with appropriate discussion (we are using more
headers than in a typical American Psychological Association [APA] paper). Include
Italicized headings as appropriate to your study. These sections will be discussed during
lectures and discussion groups. Examples of research papers (with APA headings) are in
Appendix B of the text. Examples of final course papers are here and here (do not just
copy these).Papers are scored out of 100, and = 30% of the final grade.
These criteria are general; your teaching assistant will also assess each area based on
issues s/he raised with you personally or during discussion groups.

   Introduction                       10 points.

      Statement of the phenomenon you are interested in.
      General, "big picture" description of a research question.
      At least two APA-style references to published articles in scientific journals.

   Theory                               10 points.

      Causal statement of how the psychological processes that underlie your
       phenomenon relate to each other; addresses “why” or “how” the phenomenon works.
      Describe how the theory is important to understanding (or changing) the
       phenomenon.

   Hypothesis                          10 points

      A prediction or empirical question that clearly follows from or tests the theory. Must
       represent a clear prediction about operationalizable variables that reflect the
       hypothetical constructs underlying the phenomenon.
      Must be testable and/or logically falsifiable.

   Methods                             25 points

   Participants:

      Who are your research participants? What type of sample is this (e.g., random,
       convenience, targeted, etc.)
      Here / how did you recruit them?
      If there are serious sampling limitations mention them here and explain why your
       approach was still justified.




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                  Psychology 242, Dr. McKirnan                                      p. 4 of 17
                    Research paper overview


   Procedures:

      What was the overall design?
      Was this a true experiment or a quasi-experimental study?
      What were the overall study procedures?
      What, step-by-step, did you do with each participant?
      How did you obtain informed consent? What ethical issues may there be (e.g.,
       stressful conditions, deception or placebo groups…), and how did you deal with
       them?

   Measures:

 How did you construct your Independent Variable?

      Was it a quasi-independent variable?
         o     Based on an existing group membership (people how got therapy v. those
              who did not, Republicans v. Democrats, etc…)?
         o Based on a measurement (people above or below some score on a scale,
              e.g., high v. low stress…)?
      Was it a true independent variable, i.e. that you manipulated or controlled?
         o Was it presented directly, such as a drug dose?
                     What was the dose?
                   How do you know it was the correct dose?
         o Was it presented indirectly, such as instructional conditions designed to induce
              stress v. relaxation?
                   How do you know you actually induced the condition you meant to?
                      What was your manipulation check?

 How did you operationally define your Dependent Variable?

      Specifically, where did your numbers come from – what kind of measures did you
       use, how did you go from, e.g., a bunch of survey questions to an actual score, etc.
      Were the measures known to be reliable and valid? How?

   Results                             15 points

   Data

      Use the data from your Week 12 assignment, or develop your own data sheets
       showing all the observations for each participant.
      Provide basic descriptive data: Ms, Standard Deviations.
      Perform your statistics, showing all calculations. You must show every step involved
       in deriving your t score.
      Provide key statistical assumptions: your alpha level, p value.
      Graph your data to show the statistical effects you are testing.

   Interpreting results

      How did you determine if your results were statistically significant?
      Describe your results in relation to your hypothesis:

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                  Psychology 242, Dr. McKirnan    p. 5 of 17
                    Research paper overview


      Was the hypothesis supported?
      Why is it important if it was / was not?




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                  Psychology 242, Dr. McKirnan                                      p. 6 of 17
                    Research paper overview



   Discussion                        10 points

       What are the implications of your results for the hypothesis – was it supported? Was
        an alternate hypothesis supported?
       What are the implications for the initial theory or empirical question you asked?
       What are the limitations on your findings?
       What were your sampling limitations?
       Limitations from the way you operationalized or measured your variables?
       Limitations from the overall design or larger research approach?

   Conclusion                         10 points

       What do we now know about phenomenon or "big picture"?
       How has psychological theory been (or not been…) advanced?
       What basic descriptive or other data do we now have about the phenomenon that we
        did not have before?
       What other research follows from this?


Writing style     10 points
    APA format, including at least two references to scientific papers.
    The entire paper must be in your own words unless you are explicitly quoting another
      source.
    Grammar, spelling, layout, paragraph structure, sentence structure, overall clarity.



PAPER SECTIONS

A) In the text

  The first page is the title page. Include your name, the title of your paper, the date,
   "Psychology 242, Research Methods", and your TA name.
  The second page is your abstract. It is a summary of your paper, 100-120 words long.
   This is the only part of the actual paper that should be single-spaced; everything else is
   double spaced.
  The body of the paper starts on page 3 and continues through your reference section.

B) Appendices

Attach appendices after the reference section. They do not count against your page limit.
Label each appendix separately.

   1. Your measures (survey, questionnaire, interview, etc). This must be typed.
   2. Your informed consent statement (see template below).
   3. Your raw data; this need not be typed.
   4. Statistical computations. This does not have to be typed, but it must be orderly
      enough for us to read and follow.
   5. Copies of the abstracts of the articles you used as references. Do not turn in the
      whole articles.

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                  Psychology 242, Dr. McKirnan                                       p. 7 of 17
                    Research paper overview



The informed consent statement
Any research involving data directly collected from people must have an informed consent
statement. For your studies this does not need to be very long. It should contain each of the
sections given in the informed consent file below (see also, week 4 Lecture notes). This is
the template UIC provides researchers to complete their consent documents.

Get a complete description of informed consent and other human subjects protections at the
UIC Office for the Protection of Research Subjects at: http://www.uic.edu/depts/ovcr/oprs/.




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                           Psychology 242, Dr. McKirnan                                                p. 8 of 17
                             Research paper overview



                                   Frequently asked questions
     Where do we get data for our papers?

     To facilitate your papers we will provide you with data during Week 12. You can also make
     up your own data, or collect real data. If you have real data available please see me to
     discuss if it is appropriate.

     As you can see from class, statistics can get complex, so keep your data sets simple. Make
     up data for your groups by deciding what the scales are that your variables are measured
     by, then write out a set of phony numbers for participants' "scores", then do your analyses.

     For example, if your data are attitude ratings, first decide what
     your rating scale is. If you decide on a 5 point rating scale, such                Attitude rating scale
     as the example given below, then of course all your data will be                   1. Disagree strongly
     numbers between 1 and 5.                                                           2. Disagree
                                                                                        3. Neutral
                                                                                        4. Agree
                                                                                        5. Agree strongly

                                                                          Put all your data and the calculations
Research question: Effect of smoking on lifespan                          you performed for your statistical
                                                                          analyses in an appendix. This
Data:   Age of death of demographically matched
                                                                          appendix will not count against the
        samples of smokers and non-smokers.
                                                                          page total for the paper.
            Group 1                              Group 2
            smokers                            non-smokers                The calculations should be similar to
                                                                          those I am giving you in the class
 Participant    Participant's         Participant         Participant's
                                                                          hand-outs, or that the book uses in
  number              Age               number                Age         the statistics section. (The formula
                                                                          for the t-test I used in class and for
     X1               67                   X1                  69
                                                                          your homework is more
     X2               55                   X2                  80         straightforward than the formula in
                                                                          the book).
     X3               37                   X3                  43
     X4               53                   X4                  58
     X5               57                   X5                  77
     X6               33                   X6                  43
     X7               47                   X7                  75
     X8               64                   X8                  56
     X9               52                   X9                  69
    X10               58                   X10                 76
   n = 10        M = 52.3                n = 10            M = 64.6




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                   Psychology 242, Dr. McKirnan                                            p. 9 of 17
                     Research paper overview


Can I do a correlation study for my paper, or must it be a t-test?

We want all papers to be based on a "true" experiment, where you have an experimental
group and a control group. However, if you have your own data or have a really good idea
for a correlation study, you can ask me or your TA for an exception to this rule.

Can I get extra credit by doing more analyses?

Yes! You can do an alternate analysis such as a chi square or a correlation as part of your
paper. You could, for example, test to see if you have the same number of men and women
in the control v. experimental group as part of your methods section. See your TA or me for
advice on this if you want to try it.

Is it necessary to include charts, tables, etc?

Yes, if your data or analyses call for it. A table of results -- such as mean score for groups --
is always very helpful (and saves time/space in writing!) in reporting research. Look at the
paper in the back of your book for a good example.


Do I need separate measures & procedure sections, or can I combine them?

Methods is the larger section that covers the nature of participants, study procedures, data
analyses, etc. If your study is complex each of these sections should be broken out. If you
are doing something relatively simple a single section called "procedures" could suffice. It is
usually better to err on the side of clarity -- break things into more sections if you think it will
help the reader understand where s/he is at any point in the paper. Look in your book for
examples.

How do I form a control group...what is that?

"I have 2 groups of smokers and I want to test for the influence of smoking on health. How
could I design a control group; what would it be?"

Clearly the control group in that design would have to be a non-smoking group. The choice
of a control group depends upon the research question; what are you "controlling for"? If
you are studying the effects of smoking on, e.g., cardiovascular health, than the control
group must be non-smokers. If you are examining the effect of, say, a certain type of health
promotion advertising campaign on decisions to quit smoking, than both groups would be
smokers: the experimental group would be smokers who are given the ads, and the control
group would be smokers who were not exposed to the ads. The research groups are always
defined by the research question you are asking.


Is there someone available to help me with statistics?

Raise statistical questions in discussion groups if possible; if you have a question many
others probably do as well. Your TAs should have office hours to discuss your statistics.
Look at the handouts available through class or on the class Web site, and look in the book
for examples of studies and statistical analyses.

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                  Psychology 242, Dr. McKirnan                                     p. 10 of 17
                    Research paper overview


Do I need an informed consent in my paper?
What if my experiment involves deception?

"My experiment includes the use of deception, where I use relaxation with physical therapy
patients, but do not tell them about that in advance....I believe I do not need an informed
consent, but rather I need a debriefing statement. Is this correct?"

You are part correct -- you need to spend time on your debriefing statement, to ensure that
no one leaves the experiment under duress, to bring them back to some attitude baseline,
explain clearly the need for deception and what you hypothesis was, etc. You always need
a signed informed consent statement if you are collecting names or any other identifying
information. Even if you do not collect names – for, say, an anonymous survey -- you must
have some form of statement (i.e., on a questionnaire...) stating that the person can leave
any time, or refuse to answer any question.

Students must include both an informed consent and a debriefing statement in an appendix
of their paper. These can be short, but must be complete. Look in your book for examples.

How many references do we need to the literature? Do we need to include the articles
in what we hand in?

You must have at least two references from regular psychology journals. You certainly are
welcome to include other references from books, text books, or popular magazines. Include
these in your references section, as per the example in the text. You should turn in the
abstracts of the two journal articles with your paper.




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                   Psychology 242, Dr. McKirnan                                             p. 11 of 17
                     Research paper overview



                              References and citations
a) The reference page

The references on your reference page should look like this:

       Author's last name, first initial, middle initial. (year published). Title of article. Title of
       Journal, volume ##, pp. of article.

       Adler, N. & Matthews, K. (1994). Health Psychology: Why do some people get
       sick and some stay well? Annual Review of Psychology, 45, 229-259.

On the reference page list every author for each article. The references should be in
alphabetical order by first author, and chronological order if an author has more than one
article.

b) Citing references in your text

There are 3 ways to cite a reference in the text: 1) non-quote citations, 2) exact quotes of
less than 40 words, and 3) exact quotes of 40 words or more.

1. Non-quote citations. You must have several general citations in your paper. Use these
citations when you state something that is not your own original idea or work, such as
stating what another researcher found in the area you are discussing. To get an idea of how
and when to cite references (it's often hard to know just when to reference an article), look
at your articles and see how those authors did it. Every article you cite in the text must be
given on the reference page, and every article on your reference page must be cited in the
text.

The general format is the authors' last names, and the year. The authors' names may be
part of the text, in which case the year is given in parentheses and you use the word "and"
between the last and second to last author. Alternately, the authors' names and year may
be in parentheses, using an ampersand. For example:

       "...Adler and Matthews (1994) argued some time ago that psychological factors are
       critical to health..."
       or:
       "...for some time different authors (e.g., Adler & Matthews, 1994) have argued that
       psychological factors are critical to health..."

If the article has two authors, write both into the citation every time, as above. If the article
has 3-5 authors, write them all in the first time you cite that article - e.g. (Jason, Barnes, &
Keys, 1996). After that, each time you cite that article, write the 1st author and "et al." - e.g.
(Jason et al., 1996). If an article has 6 or more authors, you can just write in the 1st author
and "et al." from the beginning. Remember, though, this is for citations in the text. For the
reference page, you have to list the all authors, even if an article has fifteen of them.

2. Brief quotes. For direct quotes of less than 40 words, put the text in quotation marks and
cite the paper as above, but add the page number:

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                   Psychology 242, Dr. McKirnan                                           p. 12 of 17
                     Research paper overview


     "Psychological variables are clearly important to physical health" (Adler & Matthews,
     1994, p. 45).

3. Longer quotes. For direct quotes of 40 or more words, do not use quotation marks -
indent the entire quote and put the quote citation after the text. You are not required to have
any direct quotes in your paper, and you should never have more than one or two. Only use
a direct quote when the author has said something in such a way that you couldn't possibly
improve upon it, or when the author's word choice it critical. Frequently using direct quotes
says to the reader that you don't really understand the material.

C) Referencing books:

There are two ways to reference books and book chapters, depending upon whether the
book was written by one person, or is an edited volume with chapters written by different
people. For the first type of book you cite the entire book, not the particular chapter you
read. It looks like this:

       author's last name, 1st initial., middle initial [continue this if multiple authors]. (year
       published). Title._ City, State where published: Publishing company.

       Agresti, A (1990). Categorical Data Analysis. New York, NY: John Wiley and
       Sons.

For a book where the chapters are written by separate people and you are only referencing
one particular chapter, use this format:

       Last name, 1st initial., middle initial [of the author or authors of the chapter you are
       referencing]. (year published). Title of chapter. In: 1st initial and last name of editor or
       editors, (Ed.) Title of Book. City, State where published: Publishing company. Page
       numbers.

       Bandura, A. (1991). Self-efficacy mechanism in physiological activation and
       health promoting behavior. In: J. Madden, (Ed.), Neurobiology of Learning,
       Emotion, and Affect. New York: Raven Press. Pp. 229-269.




6b5a04ab-dd3c-4c58-be5d-577536af4cbf.doc
 Psychology 242
   Introduction
    to Research        Dr. McKirnan, UIC informed consent template

                         Example of a consent document here


Elements of an informed consent document

Each element should have a short but descriptive statement describing the issue for the
participant. If any of the elements do not apply skip them.

Descriptions must be in simple, clear language, with a minimum of technical terms. Typically
after participants read the consent form they are asked to describe each element in their
own terms; participants who cannot understand or recall the key consent elements should
not be enrolled in the study.



                                                                   Leave box empty - For office use only

University of Illinois at Chicago
Consent for Participation in Research
“Title of your study here”

Why am I being asked?

You are being asked to be a subject in a research study
about [brief description of the study], conducted by
[name(s) of investigator(s)] at the University of Illinois at
Chicago and [names of any other cooperating institutions]. You have been asked to
participate in the research because [explain how subject was identified] and may be eligible
to participate. We ask that you read this form and ask any questions you may have before
agreeing to be in the research.

Your participation in this research is voluntary. Your decision whether or not to participate
will not affect your current or future relations with the University [or… insert the names of
any other cooperating institutions]. If you decide to participate, you are free to withdraw at
any time without affecting that relationship.

Why is this research being done?

[Give a very brief overview of the entire consent. Using lay language; summarize the
research purpose, procedures involved, the risks, benefits, and alternatives, if any.]




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                  Psychology 242, Dr. McKirnan                                         p. 14 of 17
                    Research paper overview


What is the purpose of this research?

The purpose of this research is: [Explain research question and purpose in lay language.]

What procedures are involved?

If you agree to be in this research, we would ask you to do the following things:

        Describe the procedures chronologically using simple language, short sentences
       and short paragraphs. If you have a complicated study use subheadings to organize
       this section. Define or explain any medical or scientific terms.

        Specify the subject's assignment to study groups, length of time for participation in
       each procedure, the total length of time for participation, frequency of procedures,
       location of the procedures to be done, etc.

        If there are calendars, flowcharts, tables or pictures, that would help explain the
       procedures, note what they are and attach them.

Approximately [total number of subjects] may be involved in this research at the University
of Illinois at Chicago. [If it is a multi-center study note the total number of subjects
anticipated and the number of research sites.]

What are the potential risks and discomforts?

The research has several risks:
[Explain any risks, discomforts, or inconveniences. Include the likelihood, severity, and
reversibility, if applicable, of each risk. For a simple questionnaire, for example, you may
cite any potential embarrassment at answering personal questions…]

       If there are significant physical or psychological risks to participation, the subject
       should be told under what conditions the researcher would stop the research itself or
       stop the subject’s participation in the research.

Are there benefits to taking part in the research?

[Describe any benefits to the subject or others. If there are no direct benefits to subjects
(e.g., money, access to treatment or a service), state that here. “Helping society” is not a
direct benefit of research.]

What other options are there?

[This is primarily for bio-medical research or, e.g., behavioral interventions, where by
participating in the research the person may get a service they would not otherwise have
available. If that is the case, explain how else s/he might get that service if s/he does not
want to participate in the research. For research that does not fit these categories skip this
item.]

Will I be told about new information that may affect my decision to participate?



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                  Psychology 242, Dr. McKirnan                                           p. 15 of 17
                    Research paper overview


[This is also primarily for bio-medical or intervention research, where preliminary results may
show a treatment to be (in)effective or more (less) risky than initially thought. If your
research is not in that general category skip this section.]
During the study we will inform you about any new findings (either good or bad) that may
change the risks or benefits of your participating in this research. This information may
cause you to change your mind about continuing in the study. If new information is provided
we will ask you to re-consent to continue participating in the study.

What about privacy and confidentiality?

Suggested text: The only people who will know that you are a research subject are
members of the research team. No information about you, or provided by you during the
research, will be disclosed to others without your written permission, except:
   - if necessary to protect your rights or welfare (for example, if you are injured and need
      emergency care or when the UIC Institutional Review Board monitors the research or
      consent process); or
   - if required by law.

When the results of the research are published or discussed in conferences, no information
will be included that would reveal your identity. If photographs, videos, or audiotape
recordings of you will be used for educational purposes, your identity will be protected or
disguised.

Any information that is obtained in connection with this study and that can be identified with
you will remain confidential and will be disclosed only with your permission or as required by
law.

        If information will be released to any other party for any reason, state the
       person/agency to whom the information will be furnished, the nature of the
       information, and the purpose of the disclosure.
        If activities are to be audio- or videotaped, describe the subject's right to
       review/edit the tapes, who will have access, if they will be used for educational
       purpose, and when they will be erased. Describe how personal identities will be
       shielded, disguised, etc.
        Give a brief description of how personal information, research data, and related
       records will be coded, stored, etc. to prevent access by unauthorized personnel.
        Explain how specific consent will be solicited, if any other uses are contemplated.
        If applicable, state if and when individual responses to survey questionnaires will
       be destroyed, following analyses of the data

What if I am injured as a result of my participation?

[This is primarily for bio-medical research, or behavioral studies where injury is possible,
e.g., studies of strenuous exercise. If your research is not in those general categories skip
this section.]

Suggested text: If you are injured during this research study treatment will be made
available through the University of Illinois at Chicago Hospital. However, you or your third
party payer, if any, will be responsible for payment of this treatment. There is no

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compensation or payment for medical treatment from the University of Illinois at Chicago for
such injury, except as may be required by law. If you feel you have been injured, you may
contact the researcher, [add name] at [add phone number].

If the research is sponsored by a for-profit organization, identify the sponsor and describe
the extent of compensation and/or payment for medical treatment available from the
sponsoring company.

What are the costs for participating in this research?

[Include an explanation of any research costs for which the subject will be responsible.
Typically there are none:]

There are no costs for participating in this research.

Will I be reimbursed for expenses or paid for my participation in this research?

        State whether the subject will be paid or offered other gifts (e.g., free care). If not,
       state this clearly.

        If the subject will receive payment, describe the amount, when s/he will be paid,
       and any pro-rated payments if s/he withdraws from the study or is withdrawn by the
       investigator.

        If the subject will be reimbursed for expenses such as parking, bus/taxi, baby-
       sitter, travel companion/assistant, etc., list payment rates.

Can I withdraw or be removed from the study?

You can choose whether to be in this study or not. If you volunteer to be in this study, you
may withdraw at any time without consequences of any kind. You may also refuse to
answer any questions you don‟t want to answer and still remain in the study. The
investigator may withdraw you from this research if circumstances arise which warrant doing
so.

        If appropriate, describe the anticipated circumstances under which the subject's
       participation may be terminated by the investigator without regard to the subject's
       consent.

        If applicable, explain the consequences of a subject's decision to withdraw from
       the research and state whether withdrawal must be gradual, for reasons of safety.

        Be sure that this aspect of terminating participation at the request of the PI is also
       noted in the section on Payment for Participation, and that the information in both
       sections is consistent.

Who should I contact if I have questions?

The researcher conducting this study is [add Principal Investigator’s name. Add other
relevant name(s) such as the faculty sponsor for a student]. You may ask any questions
you have now. If you have questions later, you may contact the researchers at: [Phone

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number(s), e-mail, address. If the researcher is a student, include the sponsor’s / adviser's
contact information.]

What are my rights as a research subject?

If you have any questions about your rights as a research subject, you may call the
University of Illinois at Chicago Office for Protection of Research Subjects at 312-996-1711.

What if I am a UIC student?

[Skip if the research does not ordinarily involve UIC students]
You may choose not to participate or to stop your participation in this research at any time.
This will not affect your class standing or grades at UIC. The investigator may also end your
participation in the research. If this happens, you class standing or grades will not be
affected. You will not be offered or receive any special consideration if you participate in
this research.

What if I am a UIC employee?

[Skip if the research does not ordinarily involve UIC employees]
Your participation in this research is in no way a part of your university duties, and your
refusal to participate will not in any way affect your employment with the university, or the
benefits, privileges, or opportunities associated with your employment at UIC. You will not
be offered or receive any special consideration if you participate in this research.

Remember: Your participation in this research is voluntary. Your decision whether or not to
participate will not affect your current or future relations with the University or [insert the
names of any other cooperating institutionsl]. If you decide to participate, you are free to
withdraw at any time without affecting that relationship. You will be given a copy of this form
for your information and to keep for your records.

Signature

I have read (or someone has read to me) the above information. I have been given an
opportunity to ask questions and my questions have been answered to my satisfaction. I
agree to participate in this research. I have been given a copy of this form.


Signature                                        Date


Printed Name
If participant is under 18 years old:


Signature of parent or guardian                  Date (must be same as subject‟s)


Printed name of parent or guardian



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