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**Please complete this survey on a laptop or desktop. Do not complete this survey on a mobile device, such as a smart phone or tablet, as formatting errors will occur.**
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INFORMED CONSENT TO PARTICIPATE IN AN ONLINE SURVEY
You are invited to participate in a research study that is being conducted by Laura Heimlich, who is a doctoral candidate in The Graduate School of Applied and Professional Psychology at Rutgers University. The purpose of this pilot study is to determine 1) professional teacher and behavioral consultant perceptions and practices regarding the integration of digital media technology into classroom-based instruction, and 2) the potential utility of the Common Core Digital Media Website (CCDMI) as a resource for professional educators and behavioral consultants.
Approximately two hundred (200) subjects will participate in the study and each individual's participation will last approximately ten (10) minutes.
Participation in this study will involve the following: providing online informed consent, responding to online survey items, viewing a website and completing further survey items regarding the website and employment demographic information.
This research is confidential. Confidential means that the research records will include some information about you and this information will be stored in such a manner as to protect your privacy. Some of the information collected about you includes your professional email address and employment demographics. Your responses to survey items will be completely confidential. We will NOT know your IP address when you respond to the online survey. Your name and email address will not be stored with data from your survey. The researchers will not be able to link your professional email address with to your individual survey responses and the results. Instead, you will be assigned a computer generated participant number. This number will be kept securely by the research team only until study completion. Once this research project is complete, your professional email address will be shredded and no link between the survey data and identity will exist. The survey software that you will be using includes a Secure Socket Layer (SSL). SSL is a cryptographic protocol that provides communication security over the internet. SSL provides a reasonable guarantee that one is communicating with precisely the web site that one intended to communicate with (as opposed to an impostor) as well as ensuring that the content of communications between the user and site cannot be read or forged by any third party.
The research team and the Institutional Review Board at Rutgers University are the only parties that will be allowed to see the data, except as may be required by law. If a report of this study is published, or the results are presented at a professional conference, only group results will be stated. All study data will be kept for a minimum of three years.
There are no foreseeable risks to participation except the remote possibility that your professional email address would be inadvertently disclosed. However, the principal investigator has put in place adequate protections for your privacy in that all information provided will be kept confidential by using a randomly generated code in place of your email address. If you feel uncomfortable with a survey item you can skip that item or withdraw from the study all together by using the "exit survey" option. If you decide to quit at any time before you have finished the survey, your answers will NOT be recorded.
There are potential benefits from your participation in this study. You will be provided with hyperlinked access to the Common Core Digital Media Index (CCDMI), a resource that has been designed for the purpose of providing teachers and behavioral consultants with user-friendly access to digital media resources that are indexed according to Common Core State Standards. These resources may be used for the purpose of supporting Common Core instruction in general and special education classrooms.
Participation in this study is voluntary. You may choose not to participate, and you may withdraw at any time during the study procedures without any penalty to you. In addition, you may choose not to answer any questions with which you are not comfortable.
If you have any questions about the study or study procedures, you may contact myself at [email protected] or (732)445-5384.
You may also contact my faculty advisor, Dr. Michael Petronko, at:
The Graduate School of Applied and Professional Psychology Rutgers, The State University of New Jersey 797 Hoes Lane West Piscataway, NJ 08854 (732)445-2181 [email protected]
If you have any questions regarding your rights as a research subject, you may contact the IRB administrator at Rutgers University at:
Arts and Sciences IRB Rutgers, The State University of New Jersey Office of Research and Regulatory Affairs 335 George Street Liberty Plaza, Suite 3200 New Brunswick, NJ 08901 Telephone: (732)235-9806 Email: [email protected]
Additionally, if you are interested, you can be provided with the results of this study. If you would like to receive the results of this study, please email your request to [email protected].
You may print a copy of this consent page for your records.
By beginning the survey, you acknowledge that you have read this information and agree to participate in this research study, with the knowledge that you are free to withdraw your participation at any time without penalty.
Please click the "I Agree" box and then "Continue" if you agree to participate in this pilot study.
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How often are EACH OF the following goals identified by educators as the reason for referral for school-based behavioral consultation?
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Please rate how important you feel that it is to assess EACH OF the following factors when developing classroom-based positive behavior supports.
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What factors MOST OFTEN interfere with fidelity of implementation of the positive behavior support strategies that you recommend to consultees during school-based behavioral consultation?
Please drag and rank the following in order of factors (1st to 7th) that MOST often interfere with fidelity: |
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| | Administrator buy-in Teacher buy-in Student buy-in Items/activities identified as rewards do not have a robust or consistent reinforcing effect on desired behavior Intermittent reinforcement of problem behavior Inconsistent reinforcement of desired behavior Classroom demands are absent of factors that are inherently reinforcing of desired student behavior
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How potentially useful do you feel the integration of digital media technology into Common Core instruction to be as an antecedent intervention to support EACH OF the following student factors:
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How potentially useful do you feel digital media technology to be in the preparation of differentiated Common Core lesson plans developed by teachers? |
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Please drag and rank the following in order(1st to 7th) of the most important characteristics that make digital media technology potentially useful in differentiating Common Core content. |
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| | Content can be delivered at different paces and/or repetitively Teacher can select content and types of activities through which learning objectives are presented (video, audio recording, games) Content presentation can be differentiated (word-by-word/line-by-line read-aloud, text/background color) Technology-mediated instruction supports the development of students' digital literacy skills Student interest and preference can be incorporated into lesson design Content can be broken down into manageable components Highly interactive learning
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Would you find it valuable to be able to offer teachers support regarding the integration of digital media technology into Common Core instruction as an antecedent behavioral and academic support strategy? |
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Do you feel that the CCDMI is a useful resource to identify digital media technology to integrate into teacher developed Common Core Lesson plans? |
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How likely are you to reference the CCDMI during consultation with classroom teachers for the purpose of identifying digital media technology to integrate into Common Core lesson plans? |
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Do you feel that the CCDMI is a useful resource to identify digital media technology for the purpose of differentiating instruction? |
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How likely are you to reference the CCDMI during consultation with classroom teachers for the purpose of identifying digital media technology to differentiate instruction? |
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How likely are you to recommend the CCDMI to other colleagues? |
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How often do you use each of the following?
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THANK YOU FOR YOUR TIME TODAY!
To finish, please answer the following brief demographic questions |
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| To what grade levels do you provide behavioral consultation services? | | | | Do you provide behavioral consultation services to general education, special education or both? | | | | To what special education placements to you provide behavioral consultation services (self-contained, in class support, etc.) | | | | How many years have you been providing behavioral consultation in schools? | | |
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