Teacher Consent Form

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E

ORP USE ONLY:

The Pennsylvania State University

Office for Research Protections

Approval Date:

Expiration Date:

Social Science Institutional Review Board

xhibit D. Informed Consent Form for Teachers

INFORMED CONSENT FORM FOR TEACHERS

The Pennsylvania State University

Title of Project: The Effect of Connected Mathematics 2 (CM2) on the Math Achievement of Middle School Students in Selected Schools in the Mid-Atlantic Region: A Randomized Controlled Trial

Principal Investigators: Taylor Martin, Ph.D., Assistant Professor of Mathematics Education, University of Texas at Austin, 512.232.9686, taylormartin@mail.utexas.edu; Kelli Millwood, Ph.D., Research Associate, Regional Educational Laboratory-, Mid-Atlantic, 310.945.5157, kmillwood@relmid-atlantic.org.

Purpose of the study: The project (funded by the US Department of Education) is aimed at providing more students the opportunity to improve their problem solving math skills by receiving mathematics instruction grounded in a real-world context. The purpose of this study is to examine the effectiveness of the Connected Mathematics 2 (CM2) program designed to enhance mathematics instruction through the use of problem solving in real-world contexts. The program will be conducted in the ________School District during math class for an entire school year. This instruction will be under your direct supervision.

If you participate in this project, you will be trained by the Pearson, the developers of CM2. The research team will assist you in the project by helping with the administration of assessment and will visit your classroom on a regular basis (once a month). The project will last through the entire school year.

1. Procedures to be followed for consenting participants:

   1. Participation in a 5-day professional development session on Connected Mathematics 2.

   2. Completion of a basic demographic survey.

   3. Implementation of CM2 the program and build skills in this new instructional model

   4. Allow class time for consenting students to complete a pre-test of the Terranova Version 2 and a Math Interest Inventory survey. The research team will assist you in the administration of these tests and surveys.

   5. Use CM2 as your daily math curriculum for your classes.

   6. Submission of monthly online reports about your progress

   7. Allow researchers to observe your classroom three times during the academic year

   8. Allow class time, during the last month of the academic year, for consenting students to complete a posttest of the Terranova Version 2 and a Math Interest Inventory survey.

2. Discomforts and risks: There are no significant risks to you or your students in this study associated with computer use.

3. Benefits to your students: Work with the Connected Mathematics 2 program is expected to yield improved math skills and problem solving for your students.

4. Potential benefits to society: Poor math skills are a major problem for students in our society. If the Connected Mathematics program is successful the program can be refined for use in many settings.

5. Time duration of the procedures and study: The study will involve your 6^th grade mathematics students for the courses you teach in an entire academic year.

6. Statement of privacy: Your participation in this research is private. Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific district or individual. We will not provide information that identifies you or your district to anyone outside the study team, except as required by law. Only Dr. Martin and Dr. Millwood will have access to your identity and to information that can be associated with your identity. They assure that identifying information will not be disclosed and in the event of publication of this research, no personally identifying information will be disclosed. In addition, data will be recorded with identification numbers and without personally identifying information; the key linking the identification numbers to names will be stored in a secure location and only available to Drs. Martin & Millwood.

7. Right to ask questions: You have the right to ask questions and have those questions answered. For any questions about research procedures, please contact Dr. Taylor Martin, 512.471.8460, taylormartin@mail.utexas.edu or Dr. Kelli Millwood, 310.945.5157, kmillwood@relmid-atlantic.org. If you have questions about the rights of research participants, please contact the Office for Research Protections (814-865-1775).

8. Compensation: There is no payment to you for participating in this project. There is also no charge to you for your students’ participation.

9. Voluntary participation: I understand that my participation in this study is voluntary, and that I may withdraw from this study at any time by talking with the Principal or by contacting Drs. Martin & Millwood. In addition, I understand that I can decline to answer specific questions asked during this project.

This is to certify that I consent to participation as a volunteer in this program of investigation. I understand that I will receive a copy of this consent form. I have read this form, and understand the content of this consent form.

______________________________________ _____________________

Teacher Name Date

Your school name: __________________________________

I, the undersigned, verify that the above informed consent procedure has been followed.

______________________________________ _____________________

Investigator Signature Date

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 According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is xxxx-xxxx.  The time required to complete this information collection is estimated to average 5 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:  U.S. Department of Education, Washington, D.C. 20202-4651.  If you have comments or concerns regarding the status of your individual submission of this form, write directly to:  [insert program sponsor/office], U.S. Department of Education, 600 Independence Avenue, S.W., [insert building/room number], Washington, D.C. 20202-xxxx.