THIS IS AN EXAMPLE AND WILL NEED TO BE UPDATED TO THE IRB APPROVED CONSENT FORM
UNIVERSITY OF WASHINGTON
CONSENT FORMThe Potential of Scholarly Studies in Harry Potter in Higher Education
Researchers: Harry Potter, Professor: Defense Against the Dark Arts, Hogwarts School of Witchcraft and Wizardry
We are asking you to be in a research study. This form gives you information to help you decide whether or not to be in the study. Being in the study is voluntary. Please read this carefully. You may ask any questions about the study. Then you can decide whether or not you want to be in the study.
KEY INFORMATION ABOUT THIS STUDY This section is required: - For studies initially approved by the UW IRB on or after 1/21/19, and
- When the consent document without this section and without the signature lines is greater than 2,000 words (approximately 5 pages, single-spaced, 1-inch margins).
This section is optional for all other studies and consent materials.The purpose of this section. The revised Common Rule human subjects regulations require that subjects be given a concise and focused presentation of key study information before being given other information. The goal of this section is not simply to provide an abstract or executive summary of the rest of the consent form but to assist potential subjects with understanding the reasons why one might or might not want to participate in the research. When writing this section, think about what a reasonable person from the study population would want to know and consider the following questions: - What are the main reasons a subject will want to join this study?
- What are the main reasons a subject will not want to join this study?
- What is the research question the study is trying to answer? Why is it relevant to the prospective subject?
- What aspects of research participation in this particular study are likely to be unfamiliar to a prospective subject, diverge from a subject’s expectations, or require special attention?
- What information about the subject is being collected as part of this research?
- What are the types of activities that subjects will do in the research?
- What impact will participating in this research have on the subject outside of the research? For example, will it reduce options for standard treatments?
- How will the subject’s experience in this study differ from treatment outside of the study?
- In what ways is this research novel?
A comprehensive description of key information would likely include: - That consent is being sought for research and that participation is voluntary
- A brief summary of the purpose of the study
- Duration of participation
- The main things the study will require of the subject (for example, study procedures, tasks the subject will have to complete, activities the subject will have to avoid)
- The most likely potential benefits
- The risks of participating in the study that would be of most significance to the subject population.
- Appropriate alternative procedures or courses of treatment, if any, that might be advantageous to the potential subject
Information presented in this section may be repeated in subsequent sections of the form but does not have to be. For some studies, it might be possible to incorporate all required information from the sections below into this section, as long as the presentation of that information remains concise and focused. For example, if the study poses no or limited risk and those risks are described in this section, they do not have to be repeated in the RISKS, STRESS AND DISCOMFORT section below. However, studies with extensive risk profiles for example, may need to elaborate upon the risks in the sections below. |
PURPOSE OF THE STUDY The six chapters in this section of the book examine the Potter series as literature, as the subject matter of college classes, and in relation to other literary works. With the exception of the first chapter in the section, they do not lend themselves naturally to student assignments. Rather, they are directed towards scholarly readers and college-level teachers.
STUDY PROCEDURES Six part procedure including the following chapters:
- "Reading J. K. Rowling Magically: Creating C.S. Lewis’s ‘Good Reader"
- "The Problem of Identity in Harry Potter and the Sorcerer’s Stone"
- "Of Young Magicians and Growing Up: J.K. Rowling, Her Critics, and the ‘Cultural Infantilism’ Debate"
- "High-Brow Harry Potter: J. K. Rowling’s Series as College-Level Literature"
- "Hogwarts vs. ‘The “Values” Wasteland’: Harry Potter and the Formation of Character"
- "Metaphor and MetaFantasy: Questing for Literary Inheritance in J. K. Rowling’s Harry Potter and the Sorcerer’s Stone"
RISKS, STRESS, OR DISCOMFORT
Could include Pottermaniaand picking up sticks to be used as wands.
ALTERNATIVES TO TAKING PART IN THIS STUDY
For studies involving interventions (educational, social, medical, or other) include descriptions of alternative procedures or standard care that are available if a subject chooses not to be in the study.
BENEFITS OF THE STUDY
Describe the expected benefits to individual subjects and/or society. State if subjects will not benefit from being in this study.
SOURCE OF FUNDING
This section is required only if there is external funding for the research.
For device clinical trials, state the following: The researcher for this study [insert PI’s name] is receiving payment from the study sponsor [insert sponsor’s name] for the time spent [brief description of PI responsibilities, such as “completing study-related duties outside of the surgical procedure”].
For all other research receiving external funding or other type of external support, state: The study team and/or the University of Washington is receiving [financial support, OR describe other type of support such as “the study drug”] from [insert sponsor’s name].
FINANCIAL INTEREST
This section is required when any investigator (as defined by UW policy GIM 10) has a Financial Conflict of Interest as defined by UW policy GIM 10. If no one has a Financial Conflict of Interest, this section should be omitted.
[Investigator name] has a financial or other relationship with [company name]. The University of Washington (UW) developed a Conflict Management Plan to reduce the possible effects of this relationship on your safety or welfare.
CONFIDENTIALITY OF RESEARCH INFORMATION
State whether data will be confidential (linked to identifiers) or anonymous (no links). If you think it is important for your specific study to eventually destroy identifiers (or links to identifiers), state something like, "The link between your identifiers and the research data will be destroyed after the records retention period required by state and/or federal law." State who or what other agencies (sponsors, other researchers, etc.) will have access to identifiable data. Do not state that research data will not be released to subjects, unless you have a contractual obligation with a sponsor or other group to prevent release of data. However, it is acceptable to state that there are no plans to release the data to subjects, or to not mention this issue at all. Do not make statements to the effect that only the research team will have access to the data.
Describe any limits to confidentiality (for example if study procedures may elicit information about child abuse, elder abuse, or harm to self or others). You might state:
All of the information you provide will be confidential. However, if we learn that you intend to harm yourself or others, we must report that to the authorities.
For all studies in which links between subjects' identities and the data will be kept, add: Government or university staff sometimes review studies such as this one to make sure they are being done safely and legally. If a review of this study takes place, your records may be examined. The reviewers will protect your privacy. The study records will not be used to put you at legal risk of harm.
For drug and medical device studies regulated by the U.S. Food and Drug Administration, add: The U.S. Food and Drug Administration (FDA) reserves the right to review study data that may contain identifying information.
For studies that are required to be listed in the federal clinical trials registry at www.clinicaltrials.gov, federal law requires that the following statement be included, without any revision: A description of this clinical trial will be available on http://www.clinicaltrials.gov, as required by U.S. Law. This Web site will not include information that can identify you. At most, the Web site will include a summary of the results. You can search this Web site at any time.
If your research involves the use of clinical services, items, or tests through UW Medicine, UW Physicians (UWP), or the Seattle Cancer Care Alliance (SCCA), (this includes most uses of the UW Clinical Research Center (CRC)) state: Your participation in this study will be noted in your UW medical record.
If applicable, state that a copy of the consent form will be placed in the subject's medical, educational, personnel, or other record.
If you are obtaining a federal Certificate of Confidentiality, insert the following language:
We have a Certificate of Confidentiality from the federal [insert the name of the institution that issued the Certificate, such as the National Institutes of Health]. This helps us protect your privacy. The Certificate means that we do not have to give out identifying information about you even if we are asked to by a court of law. We will use the Certificate to resist any demands for identifying information.
We can't use the Certificate to withhold your research information if you give your written consent to give it to an insurer, employer, or other person. Also, you or a member of your family can share information about yourself or your part in this research if you wish.
There are some limits to this protection. We will voluntarily provide the information to:
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- a member of the federal government who needs it in order to audit or evaluate the research;
- individuals at the University of Washington, the funding agency, and other groups involved in the research, if they need the information to make sure the research is being done correctly;
- the federal Food and Drug Administration (FDA), if required by the FDA;