OLD DOMINION UNIVERSITY

PROJECT TITLE: A Programmatic Evaluation of Designers for Learning

INTRODUCTION
The purpose of this study is to conduct a program evaluation of service-learning projects that have been led by Designers for Learning. You are being asked to participate in this study because you have participated in a service-learning project with Designers for Learning or you are preparing to participate in an upcoming project.

The purposes of this form are 1) to give you information that may affect your decision whether to say YES or NO to the use of your data collected during your participation in this study, and 2) to record the consent of those who say YES to allowing the researchers to use and analyze the data collected in this study.

RESEARCHERS
Responsible Principal Investigator:
Jill Stefaniak, PhD, Assistant Professor, College of Education, STEM Education & Professional Studies

Investigators:
Jennifer Maddrell, PhD, Adjunct Assistant Professor in Instructional Design and Technology, Old Dominion University

DESCRIPTION OF RESEARCH STUDY
Purpose

Study Procedures
If you agree to take part in this research study, you will be asked to provide consent to the researchers using artifacts from service-learning projects that were conducted with Designers for Learning. Artifacts may include students' applications for service projects, discussion board forums hosted on Designers for Learning website, student reflections throughout the service project, completed instructional design documents and instructional design documents that were completed as a result of the project.

During this research study you’ll be asked to provide feedback and suggestions for ways Designers for Learning can improve for future service-learning projects. You will not be referred to by name to protect your identity.

RISKS AND BENEFITS
RISKS:  The risks to you will be minimal. There is a risk of the release of confidential information. 

BENEFITS:  Your participation may help improve future service-learning projects that are led by Designers for Learning.

COSTS AND PAYMENTS
There will be no costs to you for participation in this research study. The researchers are unable to give you any payment for participating in this study.

NEW INFORMATION
If the researchers find new information during this study that would reasonably change your decision about participating, then they will inform you.

CONFIDENTIALITY
All information obtained about you in this study is strictly confidential unless disclosure is required by law. The results of this study may be used in reports, presentations and publications, but the researcher will not identify you.

WITHDRAWAL PRIVILEGE
It is OK for you to say NO.  Even if you say YES now, you are free to say NO later, and walk away or withdraw from the study ‑‑ at any time. Your decision will not affect your relationship with Old Dominion University or Designers for Learning or otherwise cause a loss of benefits to which you might otherwise be entitled.
QUESTIONS
If you have any questions about this study now or in the future, you may contact Dr. Jill Stefaniak at the following phone number: 757-683-6696 or at jstefani@odu.edu.  If at any time you feel pressured to participate, or if you have any questions about your rights or this form, then you should contact Dr. Ed Gomez, Chair of the Darden College of Education Human Subjects Review Committee, Old Dominion University, at egomez@odu.edu.

VOLUNTARY CONSENT
By signing this form, you are saying several things.  You are saying that you have read this form or have had it read to you, that you are satisfied that you understand this form, the research study, and its risks and benefits.  The researchers should have answered any questions you may have had about the research.  If you have any questions later on, then the researchers should be able to answer them:

Dr. Jill Stefaniak, 757-683-6696, jstefani@odu.edu
Dr. Jennifer Maddrell, jmaddrel@odu.edu

If at any time you feel pressured to participate, or if you have any questions about your rights or this form, then you should contact Dr. Ed Gomez, Chair of the Darden College of Education Human Subjects Review Committee, Old Dominion University, at egomez@odu.edu. And importantly, by signing below (typing your name in the Participant's Name boxes below), you are telling the researcher YES, that you agree to allow the collection and use of your data in this study.

Question Title

* Participant's Name

Question Title

* Today's Date

Date
Please click the "Submit" button to complete your agreement. Thank you!
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