CONSENT TO PARTICIPATE IN A RESEARCH STUDY
HIC # 10807
You are being asked to take part in a clinical research study. Before you can make an informed decision whether to participate, you should understand the possible risks and benefits associated with this study. This process is known as informed consent. This consent form will provide you with the information about this study and your rights so that you can make an informed decision. No guarantees or assurances can be made regarding the results of this study.
This consent form may contain words or information you do not understand. Dr. Scott Strayer or Marit Kington, the research study coordinator, who is familiar with the study, will explain anything that you do not clearly understand. Please ask as many questions as you need to make sure that you understand this study and why you are being asked to participate.
We invite you to participate in a study of handheld computer usage. The purpose of this study is to gather information about how residents and physicians use their handheld computers on a weekly basis. Up to 212 participants will be enrolled in this study at UVA, as well as other locations in the region. You are being asked to participate in this study because we are interested in knowing about your handheld computer use and the types of activities for which it is used. Even if you do not use a handheld computer, we are still interested in your responses and opinions regarding handheld computers.
All persons receiving an invitation are asked to participate in the survey. Your participation is entirely voluntary.
If you choose to participate in this study, you will be asked to respond to a few short questions about your handheld computer use. The survey containing these questions is entirely internet-based, meaning that you will receive an email invitation with a link that will direct you to the survey web site. Once you submit your answers to the survey, they will not be available for you to change. You will not be able to access or view the answers to your survey once you submit them. The survey should only take 10 minutes of your time. Once you have finished responding to the questions the survey will be over.
Research studies often involve some risks. There are risks of this study that are minimal and we do not anticipate any risks to you. Your responses will be kept confidential and only available to the study investigators. In addition, it is possible in any experiment that side effects, which are not now known, could occur. Precautions will be taken to prevent harmful side effects. You should contact Dr. Scott Strayer or Marit Kington if you think you are having side effects related to the study.
There is no benefit to you for participating in this study.
Alternatives to Participating in This Study
The only alternative is not to participate.
Privacy of Records
Any survey information and study
materials including the consent form you sign may be inspected by the
investigator of this study, and his/her research staff in order to conduct this
study. These individuals, or UVA on their behalf, may also release your study
information, this consent form and the information about you created by this
study to individuals and agencies responsible for the oversight of this study.
Other persons who would have access to the study records include federal, state
and local agencies having oversight over this research, for example, the United States Department of Health and Human
Services; and the University of
Virginia Human Investigation Committee (HIC) members or designates. The HIC is a special committee at the
If you do decide to withdraw from
the study and end this agreement, please notify Dr. Scott Strayer through email,
or in writing to The University of
Virginia Health System, Department of Family Medicine,
You will receive no payment for participating in this study.
Financial Costs of the Research
There are no financial costs to you for participating in this research study.
Compensation in Case of Injury
In the event you suffer injury directly resulting from the
research, no financial compensation for lost wages, disability, or discomfort
is available. Treatment for an injury
directly resulting from the research procedure that is not covered by your
insurance will be provided free of charge at the
Right to Refuse to Participate or to Withdraw Early From the Study
Participation in this study is entirely
You may be withdrawn from the study without your permission
at any time by the investigator conducting this study. Some situations in which this might occur are
if you do not follow the instructions given to you or if the investigator feels
your safety is at risk if you continue in the study.
If you have any questions
regarding research participants' rights, please contact the Human
Investigation Committee staff at the
I HAVE READ, OR HAD READ TO ME, THE ABOVE INFORMATION BEFORE ELECTRONICALLY AGREEING TO THIS CONSENT FORM.