Please complete the form below with Net Id, Name, Signature and
Date. Return the form to Joe Troy by one of the options below.
Option 1: Return the form to Joe Troy in room 149A
Undergraduate Library (lower level): Office hours MW 8amNoon, Tu 8am-10am
Option 2: Scan the completed form and email to Joe Troy,
jmtroy2@illinois.edu
Option 3: Return the form to the Undergraduate Library
Circulation Desk and they will forward the form to Joe Troy 149A
Undergraduate Library.
Attachment J
Informed Consent Form for Coding Camp Participation
Title of Project: Student/Library Collaborative Mobile Application Development
Responsible Principal Investigator: Lori Mestre, Head, Undergraduate Library,
lmestre@illinois.edu
Other Investigator(s): Jim Hahn, Orientation Services and Environments Librarian,
jimhahn@illinois.edu; David Ward, Reference Services Librarian, dh-ward@illinois.edu
Purpose of the Study: This study investigates methods for designing mobile library and
research applications using teams of students from various disciplines participating in a
coding camp.
1. Procedures to be followed: The study will consist of a two day coding camp in
which participants create new computer code to add to or enhance functionality to
existing software. The first day will take approximately 3 hours and will primarily
introduce you to the existing software. The second day will be approximately 8 hours
and primarily allow you to explore new ideas and develop new computer code to
extend the existing software.
The computer code created during the camp will be collected and later analyzed by
the investigators. The code will be analyzed to uncover possible new functionality
for library mobile apps. The code will also be analyzed to uncover ways to improve
existing functionality. Additionally, the code collected (or a derivation of the code)
may be used in software developed by the library.
Investigators will also make observations of the coding camp sessions. The purpose
of these observations is to see how different techniques and methods enhance
collaboration between student software developers and library staff.
2. Discomforts and Risks: There are no known risks beyond those experienced in
everyday ordinary life. Any discomfort you experience will be comparable to that of a
student working on a homework assignment.
3. Benefits: This research will help the library to design an ongoing program for
collaborating with students on the design of mobile library applications to increase
use of library resources and services.
4. Statement of Confidentiality: Investigators will not record your name with any
observation notes. Observation sheets and consent forms will be stored in a locked
filing cabinet in a locked office. Parts of the coding camp may be video taped. You
will only be video taped if your provide consent (see check-box at the bottom of this
form). Consent to be video taped is not a requirement for your participation.
Additionally, video from the coding camp might be disseminated on Library websites
that document grant activities. Even if you elect to be video taped, you have the right
not to have your image or any other identifiable information disseminated by the
library.
5. Whom to contact: Please contact Lori Mestre lmestre@illinois.edu with any
questions, or concerns about the research.
If you have any questions about your rights as a participant in this study or any
concerns or complaints, please contact the University of Illinois Institutional Review
Board at 217-333-2670 (collect calls will be accepted if you identify yourself as a
research participant) or via email at irb@illinois.edu
6. Compensation: You will not receive payment, however refreshments will be served
during the event.
7.
Cost of participating: There is no cost for participating.
8. Voluntariness: Your participation is voluntary. You may discontinue at anytime
without any penalty or loss of benefits to which you are otherwise entitled. The
decision to participate, decline, or withdraw from participation will have no effect on
your grades at, status at, or future relations with the University of Illinois.
9. Dissemination: Researcher will share the results in conference presentations and
academic papers. Your name will not be recorded with responses. Video recorded
images may be disseminated on media (such as a web site) only if you grant
permission via the check box at the bottom of the form. You can revoke your
permission to disseminate your image at any time.
10. Ownership of Intellectual Property: You will retain copyright to any code and/or
documentation that you develop during the Coding Camp. You will retain ownership
of any code and/or documentation that you develop during the coding camp. If you
choose, you may enter into an optional agreement with the University to assign coownership of code and/or documentation to the University. This optional agreement
would allow both you and the Library to use the code/documentation that you
develop at the Coding Camp in the future. Additionally you understand that the
Library may develop any concepts generated by the Coding Camp into future
applications.
•
I am 18 years of age or older.
•
I have read and understand the above consent form and voluntarily agree to
participate in this study.
•
I will be given a copy of this consent form to keep as a record.
_______________
Participant Net Id
______________________________________________
Participant Name
___________________________________
Participant Signature
_____________________
Date
I give permission for my participation to be video taped ___ (please check to grant
consent). Granting (or not granting) permission to be video taped is not a requirement
for participation.
I give permission for my participation to be video taped AND for my image to be
disseminated on media such as a grant web site ____ (please check to grant consent). I
understand that I may revoke my permission to disseminate my image (or any other
identifiable information) at any time. Granting (or not granting) permission to be video
taped and my image (or any other identifiable information) disseminated is not a
requirement for participation.