Informed Consent for Instructors in the UW-La Crosse Lesson Study Project
In the Lesson Study Project your students will be research subjects as you investigate their learning in
class. Instructors in the project will also serve as research subjects. As principal investigator I have two
major aims. One is to describe lesson study as a method of collaborative classroom inquiry among college
instructors. Lesson Study is practiced widely among Japanese elementary teachers, but there are no
examples of lesson study at the college level. This project will be the first time college teachers have used
lesson study. Thus one purpose of the project is simply to “show how it works.” A second aim is to
investigate how participation in the lesson study process affects instructors’ pedagogical thinking and
practices. Lesson Study is a different way to improve teaching, and it may produce important changes in
the ways that instructors understand both teaching and learning.
During the year I will collect various types of information about your experiences including your personal
reflections about teaching and learning, videotape clips of lesson study group meetings, and written work
you do as part of the project (e.g., the final Research Lesson Report at the end of the year).
It is likely that some of aspects of this project will be presented or published in the future. In keeping with
the ethical standards for doing research with human subjects, I am requesting your written permission to
include excerpts, examples and portions of your course work—both written and videotaped—for future
presentations and publication purposes. Your identity will remain confidential and none of the written
material will be identified with you individually. You also have the option not to be in the final edited
version of any video clips we produce for this project.
It is perfectly acceptable not to grant permission to use your work for these purposes, and I assure you that
your decision will not adversely affect my opinion of you or your experience in the project.
I have been informed that:
 this study investigates how college instructors use lesson study to improve teaching and learning.
 this study also investigates how participation in lesson study affects instructors’ pedagogical
knowledge and practices.
 examples of my written work and videotape segments of me may be used in publications and
presentations, and that none of the material will be identified with me individually.
 I can chose not to be in the final, edited version of video clips produced in this study.
 there will be no penalty if I decide not to give permission to use my material for the study.
If you have any questions about the study procedures please contact me at 785-6881 or
cerbin.will@uwlax.edu. Questions regarding the protection of human subjects may be addressed to Dr.
Bart VanVoorhis, Chair of the UW-La Crosse Institutional Review Board for the Protection of Human
Subjects, 785-8124.
—over—
Please sign and return this form to Bill Cerbin by February 7, 2005
145 Main Hall
I give my permission to use portions of my work in the Lesson Study Project, including written work and
videotape clips of me for publication and presentation purposes.
Participant__________________________
Date___________
Investigator_______________________
Date___________
I DO NOT give my permission to use portions of my work in the Lesson Study Project for publication
and presentation purposes.
Participant__________________________
Date___________
Investigator_______________________
Date___________