20 - NIDA OMB B10 Penn Med Script for Survey Administration 2-28-11 sh

Attachment B10:

Penn Med Script for Survey Administration

STUDY OF SUBSTANCE ABUSE DOC.COM MODULE PROJECT

March 2011

Attachment B10: Penn Med Script for Survey Administration

The following script will be used to administer the paper/pencil survey to medical students at the University of Pennsylvania School of Medicine (Penn Med). It is consistent with the information that will be included on the IRB-approved cover page of the survey and also submitted for local IRB for review and approval.

Dr. Paul Lanken (Doctoring Course Director) or Dr. Katherine Margo (Family Medicine Clerkship Director) will include the following points while introducing the NIDA substance abuse doc.com module study to medical students before distribution of Pre-Survey 1.

Recruitment Script

• Good morning/afternoon my name is <Insert name of presenter>. Today, I will talk about a survey we will be administering to Penn Med medical students. As part of Penn Med’s ongoing program evaluation of its educational program, medical students complete survey(s) to provide anonymous feedback to the medical school. Please read the cover letter attached to your survey.

• The completion of the surveys is required by all medical students; however, the use of a medical student’s survey results for research purposes is voluntary and optional. If a student decides to opt out of the research, there will be no adverse consequences. If you do not want your survey results to be used for research, please indicate this by checking the box at the bottom of the cover letter. Students who allow their survey results to be used for research will receive a [appropriate amount will be inserted] gift card to show our appreciation.

• The name of this research is the study of substance abuse doc.com module project and the sponsor is the National Institute on Drug Abuse. This online module was developed to enhance the knowledge of healthcare professionals about substance use disorders, their attitudes toward patients with substance use disorders, and their skills and their degree of confidence in communicating about substance use and abuse with their patients. The purpose of the study is to determine if this educational intervention influences medical students’ attitudes and patterns of behavior with patients who abuse substances. The study includes four surveys, which each take approximately 10 minutes to complete.

• There is a small risk of loss of privacy. However, extra measures will be taken to protect your privacy. No names or identifiers will be used in any study reports. There is no direct benefit to you for participating in this research study. However, the information you learn may benefit your medical school education, as well as your knowledge of treating patients with substance abuse issues. We hope you will consider allowing your feedback to be used for the research study.

• Do you have any questions? If so, please do not hesitate to ask.

• If not, I will now administer the consent form and survey. Please remember that if you would not like to have your results included in the research study, please check the box at the bottom of the cover letter. Again, there are no consequences for not participating.