AdventHealth University (AHU)
Online Consent Document to Participate in a Human Research Study
Study Title: Reducing Stress Among SRNAs: Implementation of a Pre-Matriculation Wellness Module
Principal Investigator (PI): Martin Rivera, DNP, CRNA, APRN
Co-investigator(s) (Co-Is): Vanessa Fernandez, RN, BSN, SRNA & Maria Klopfenstein, RN, BSN, SRNA
Introduction of the Study
You are invited to participate in a research study titled “Reducing Stress Among SRNAs: Implementation of a Pre-Matriculation Wellness Module.” You are being invited to take part in this research because your role as a pre-matriculation SRNA may help us understand the knowledge of wellness and stress management techniques among pre-matriculation SRNAs. The information gained can be helpful for future SRNAs. There will be 26-30 participants in this module, all which will be in your cohort at AdventHealth University. Your participation in this study is completely voluntary. You are not required to participate.
Purpose of the Study
The purpose of this study is to evaluate whether a pre-matriculation online learning module on wellness and stress management techniques results in a significant difference in knowledge of these topics among SRNAs.
If you agree to participate, you will be provided access information for an online module for you to take at your convenience within a one-month period. The module will take 60-75 mins to complete with a 20-item pretest and posttest. You will receive access information for two additional posttests at two weeks and 12 weeks into your Summer 2020 trimester. The module contains information about the history and causes of stress in SRNAs, common coping mechanisms among this population, and wellness and stress management techniques that have been shown to decrease stress levels. There will be 26-30 participants in this module, all which will be in your cohort at AdventHealth University.
Possible Risks and Discomforts Associates with the Study
This study involves minimal risk. Aside from investing your time to participate, you may find that some of the information regarding the stressful environment of nurse anesthesia school to be surprising. This information is meant to be informative and should not encourage increased anxiety before beginning the program. If at any time you feel uncomfortable or if you want to stop, close your browser and please contact a researcher. You do not have to give us any reason for not finishing the module or not responding to any of the posttest questions. In addition, although the risks of a breach of confidentiality or privacy are low, we cannot guarantee that your privacy or confidentiality will not be breached.
We do not guarantee or promise that you will receive any benefits from participation in this study. However, you may benefit by obtaining proper wellness and stress management techniques that can be used to deal with the stress of nurse anesthesia school. In addition, this study will hopefully increase our knowledge on effective ways to teach wellness and stress management techniques to SRNAs for maximum knowledge retention.
The research team will work to protect your confidential information. To protect your privacy, the pre/posttest will be anonymous. The information that you share will be kept private and stored in a locked room, and any information stored on computers are password protected. We will take steps to protect your privacy and confidential information, however we are unable to guarantee or promise that your privacy will not be breached. Governmental agencies and the IRB may request access to study related data. Data will be kept for three years following study completion. After three years, all notes will be shredded, and electronic files will be erased.
All research results will be presented without revealing any participant’s personal identity – false names and codes will be used as necessary. If you have questions about the research, your research rights, or if you experience any inconvenience or distress as a result of the research, please contact Martin Rivera at (407) 303-9331. You may also contact the IRB at (407) 303-9798 with questions about your research rights.
Sharing the Results
The knowledge that we obtain from your participation will be shared in the following ways. The team will submit the final manuscript with study results to a professional journal for dissemination. The team will present a final poster presentation in April of 2021 to the students and faculty of AdventHealth University. No information that you shared with us will be presented with your name or any other identifying information. All information when presented is de-identified without any links to you and presented as group data.
Your participation in this study is voluntary. You may choose to not to participate. The decision to participate or not participate in this research study is completely up to you. If you choose not to participate your refusal to participate in this research study will involve no penalty or loss of benefits to you. Refusal to participate or withdrawal from the study will have no effect on your academics with the nurse anesthesia department. If you choose to participate, you can change your mind later and withdraw your consent and discontinue participation from this study at any time. If you chose to withdraw informed the PI of your wishes. You can stop the module or posttest by closing your internet browser window.
Right to Refuse or Withdrawal from the study
You do not have to participate in this research study and choosing not to participate in this study will not involve any penalty or loss of benefit to you. The decision to participate or not participate in this research study is completely up to you. If you choose to participate, you can change your mind later and withdraw your consent and discontinue participation from this study at any time. If you chose to withdraw from the study informed the PI of your wishes.
There are no incentives or compensation for participating in this study. You will not receive any payment for being in this study. This will not cost you anything except for internet access.
Conflict of Interest
There is no conflict of interest, financial gain, or other inducements offered to any of the researchers in this project.
If you have questions, concerns, or complaints regarding this study you may contact the Principal Investigator at (407) 303-9331. You may also email him at Martin.rivera@AHU.edu. You may also contact AHU research office at (407) 407-609-1388 or AHU.Research.Office@ahu.edu or the IRB Office at (407) 303-5619.
If you have additional concerns or questions about the course or have trouble accessing the course, please feel free to contact Vanessa or Maria:
Vanessa Fernandez, RN, BSN, SRNA
Maria Klopfenstein, RN, BSN, SRNA
We thank you for your participation in this research study. The information that we gathered during this research will not be used or distributed to any other researcher for any other research purposes not clearly outlined in this consent form.
This research has been reviewed and approved by AdventHealth University Institutional Review Board, which is tasked to protect research participants from harm. If you want to learn more about the Institutional Review Board and its role in protecting research participants feel free to contact AdventHealth University IRB at (407) 303-5619.
- I have been invited to participate in research study entitled: Reducing Stress Among SRNAs: Implementation of a Pre-Matriculation Wellness Module
- I understand that my participation is voluntary.
- I understand that all data collected will be limited to the use disclosed above.
- I understand that I will not be identified by name in any presentation or publication.
- I am aware that all my information will be kept confidential and secured by the researcher.
- I understand that I may withdraw from the study at any time.
By continuing on to the module, you indicate that
- You have read the information about the study provided above
- You have had the opportunity to ask questions about the study by calling or emailing the researchers
- Your questions have been answered, if applicable
- You have been told that you can ask the IRB questions about your study rights by using the contact information provided
- You may print a copy of this consent for your personal records
- You voluntarily agree to participate in the study entitled: Reducing Stress Among SRNAs: Implementation of a Pre-Matriculation Wellness Module
If you would like to receive an electronic copy of this consent form, please email Dr. Martin Rivera at Martin.email@example.com
I have read the informed consent document and I voluntary consent to be a participant in this study.
For questions concerning informed consent, please contact Dr. Martin Riveria.
Martin Rivera, DNP, CRNA, APRN