Transformational Learning in Health Care Students
Through International Service
In Developing World Environments
School Education and Human Development, IRB #060639
Principal Investigator: Dr. Michael Marquardt
Researcher: Dr. Glenn Geelhoed
Informed Consent Form
I. INTRODUCTION: You are invited to take part in a research study. Before you decide to be a part of this study, you need to understand the risks and benefits. This consent form provides information about the research study. The researcher of this study will be available to answer your questions ND PROVIDE FURTHER EXPLANATIONS. If you agree to take part in the research study, you will be asked to sign this consent form. This process is known as informed consent. Your decision to take part in the study is voluntary. You are free to choose whether or not you will take part in the study. Your participation or non-participation will not affect your grades or your academic records in the program.
II. PURPOSE: The purpose or this research study is to measure, describe, and compare the actual and perceived benefits of an international medical missions experience among medical students at The George Washington University School of Medicine and Health Sciences.
III. PROCEDURES: The research will be conducted at the George Washington University. Your participation would entail the following: Phase I – At the conclusion of your international healthcare mission you would be filling out and sending the consent form to the researcher; and answering a 30 minute online two part survey called the Perceptions of an International Health Mission Questionnaire (PIHMQ). The first phase is a questionnaire which elicits information about demographics as well as previous experience living in another culture. Phase II – At three to six months following the international health care mission, you will be asked to respond to a further questionnaire on how the experience was assimilated in your further education and a possible later interview might be conducted on your reflection on the international experience.
IV. POSSIBLE RISKS: To the best of our knowledge, the things you will be doing have no more risk of harm than you would experience in everyday life. There can be some uncomfortable feelings during the interview process, because some questions on the interview would be about your personal experience, reflection, and perception. The researcher will try to make the questions as interesting and tactful as possible to reduce or eliminate these feelings. Other than that, no risks to the participants are involved.
V. POSSIBLE BENEFITS: You will not get any financial benefit from taking part in this study. The study will possibly benefit you by enriching you academically and personally, since it will provide an opportunity to reflect on your experiences and to understand cultural differences better. In addition, your participation may provide you with the satisfaction of helping adcance knowledge in the area on intercultural learning in medical education.
VI. COSTS: There are no costs associated with taking part in this study.
VII. COMPENSATION: You will not receive compensation for participating in this study.
VIII. RIGHT TO WITHDRAW FROM THIS STUDY: Your participation in this research study is voluntary. You may decide not to begin or to stop this study at any time. Your records will be used for research only.
IX. CONFIDENTIALITY & PRIVACY OF RESEARCH RECORDS: The nature of the study suggests that some of the participants may be aware of other participants. However, participants’ names and records will be private. Your records will be used for research purposes only. All names appearing on interview audiotapes will be replaced by pseudonyms at the time of tape transcription.
X. QUESTIONS: If you have questions about the procedures of this research study, please contact Dr. Glenn Geelhoed by calling (202) 994-4428 during workdays. If you have questions about the informed consent processor your rights as a research subject, please contact the Assistant Vice President of Health Research, Compliance and Technology Transfer at (202) 994-28995.
THIS IS TO CONFIRM THAT I HAVE READ THIS INFORMED CONSENT, THAT THIS STUDY HAS BEEN EXPLAINED TO ME, THAT MY QUESITONS HAVE BEEN ANSWERED, AND THAT I AGREE TO PARTICIPATE AND TAKE PART IN THIS STUDY.