Screen Reader Mode Icon

Intro - Survey on members' experiences and beliefs on Disaster & Mass Casualties - Consent

Thank you for participating in our survey. Your feedback is important.
The survey has 20 questions and opportunity for comments.
It should take about 15 minutes to complete.
At the end, you will be given a link for the prize drawing.
AAST Disaster Committee: AAST Members Survey 2022

Online Survey Consent Form

You are being invited to participate in a research study titled AAST Disaster Committee:  Members Survey 2022. This study is being done by Dr Jay Doucet from the University of California - San Diego (UCSD) and members of the AAST Disaster Committee chaired by Dr Mark Gestring You were selected to participate in this study because you are or were a member or associate member of the American Association of Surgery of Trauma.

The purpose of this research study is to determine the experiences and beliefs of the members of the American Association for Surgery of Trauma and American College of Surgeons Committee on Trauma members regarding their personal and hospital’s disaster preparedness.  If you agree to take part in this study, you will be asked to complete an online survey/questionnaire. This survey/questionnaire will ask about your experience and beliefs about disaster preparedness and it will take you approximately 15 minutes to complete.

There may or may not be any direct benefit to you from this research. The investigator(s), however, may learn more about disaster preparedness of members and their healthcare facilities.

There are minimal risks associated with this research study.  Loss of confidentiality is a risk with any electronic data collection, however security of the respondents and their identity will be safeguarded at all times. Only the investigators will have access to the collected data. IP addresses will not be collected nor will any discrete identifying data.  Respondents will be coded by numbers. Data will be stored on the SurveyMonkey servers until downloaded into the statistical database maintained on the secured UCSD Trauma server. The Trauma server is secured at a UCSD server farm and access requires dual identification login from a UCSD account.  Only investigators will have passwords to the server files.  SurveyMonkeys’ security procedures can be accessed here: 

Results will only be presented in an anonymized manner, using percentages and proportions.  Results of single individuals that could lead to putative identification will not be reported.  There are about  1300 members of the AAST.  Data will be kept for five years and then be destroyed. A minimal risk of fatigue is involved in completing the survey, SurveyMonkey’s testing algorithm anticipates a 70% completion rate and estimates completion in 15 minutes.  Respondents can return to the survey at a later time if desired. Research records will be kept confidential to the extent allowed by law and may be reviewed by the UCSD Institutional Review Board and AAST.

Your participation in this study is completely voluntary and you can withdraw at any time by simply exiting the survey. Choosing not to participate or withdrawing will result in no penalty or loss of benefits to which you are entitled. You are free to skip any question that you choose.

If you have questions about this project or if you have a research-related problem, you may contact the researcher, Dr. Jay Doucet at 619-929-5060.   If you have any questions concerning your rights as a research subject, you may contact the UCSD Human Research Protections Program Office at 858-246-HRPP (858-246-4777).

Whether or not you chose to participate, you are eligible for the prize drawing of an iPad. A separate link will be provided.  Your responses do not determine your eligibility for the prize. By clicking “You agree” below you are indicating that you are at least 18 years old, have read this consent form, and agree to participate. 

Question Title

* 1. Do you consent to participate in the survey?

0 of 20 answered