Informed Consent Form Sample

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Informed Consent Form

A Survey Consent Form

Informed Consent form for the third year Bachelor of Elementary Education students of the University of
Cebu Banilad Campus

Principal Investigator: Carly Mitzi D. Padro

Name of Organization: University of Cebu- Banilad

Research Title: The Effectiveness of MOODLE as the Learning Management System for the Online
Learning of Third year BEED students in University of Cebu- Banilad

This Informed Consent Form has two parts:

•Information Sheet (to share information about the research with you)

•Certificate of Consent (for signatures if you agree to take part)

You will be given a copy of the full Informed Consent Form

PART I: Information Sheet

Introduction

We, the third year BEED students of University of Cebu Banilad Campus are currently conducting a
research entitled: “THE EFFECTIVENESS OF MOODLE AS THE LEARNING MANAGEMENT SYSTEM (LMS)
FOR THE ONLINE LEARNING OF THIRD YEAR BEED STUDENTS IN UC- BANILAD.” In line with this, we are
inviting you to be a respondent of this investigation and request you to spare few minutes of your time
to answer this questionnaire honestly. However, you do not have to decide today whether or not you
will participate in this investigation. Before you decide, you can talk to anyone you feel comfortable with
about the research.

We would also humbly ask for your permission to allow us to get your Grade Point Average (GPA) in the
first semester of school year 2020-2021. Since it may seem confidential, we promise not to share
information about you and will not require you to indicate your name in the profiling part. The
information that we collect from this research project will be kept confidential.
PART I: Information Sheet

Purpose of the research

Studying about the efficacy of utilizing MOODLE as the learning management system for online learning
had been considered an emerging issue for the past years especially in this time of pandemic. This study
aims to determine the efficacy of utilizing MOODLE as the learning management system for online
learning in University of Cebu- Banilad. The findings of which will be used as the bases for an
intervention plan which will maximize the utilization of Moodle features.

Type of Research Intervention

This research will involve test questionnaire to measure the efficacy of MOODLE for online learning.

Participant selection

We have chosen the third year elementary education students of the University of Cebu Banilad
Campus because they are the ones who have already utilized various online learning platforms aside
from MOODLE. Their perceptions about MOODLE are best to include in this research project since they
can compare it with other online learning platforms.

Voluntary Participation

Your participation in this research is entirely voluntary. It is your choice whether to participate or not.
Whether you choose to participate or not, it does not affect your standing or grade in school. You may
change your mind later and stop participating even if you agreed earlier and this will not be taken
against you later on.

Procedures and Protocol

In this investigation you will be asked to a answer a questionnaire that will be dissiminated by the
researchers themselves during your free and your convenient time. It will be collected outright or after 7
days. The questionnaire can be read aloud and you can give the answer on those items that you intend
to answer. If you do not wish to answer some of the questions included in the questionnaire, you may
skip them and move on to the next question. The information recorded is confidential and no one else
except the researchers and the consultant will have access to the accomplished copies of the
questionnaire. The said copies of the questionnaires will be destroyed after 6 months.

To ensure that you will be able to have full understanding on the purpose of the study, the proponent
will first explain the objectives of the study and the intended benefits of the participants themselves.
Duration

The research takes place 6 months. During that time, you will be asked by the researcher/proponents to
answer the questionnaire during your vacant time or any of your convenient time and may submit
within seven (7) days. If you intend to answer the questionnaire immediately, then it will take for 30-45
minutes. You engagement as a respondent will only take once.

Risks

We are asking you to share some important details about yourself and we also let you answer some
questions that measure the efficacy of MOODLE. You must know that you do not have to give answer all
answers in the profiling part. If you do not like to answer some of the items that you are not
comfortable with, and that is also fine with us. You do not have to give reasons for not responding to
any question, or for refusing to take part in the survey. We will not be sharing with you either the
responses given by you.

Benefits

This research can be beneficial to the respondents considering that the researchers plan to design a
program that will help them in terms of utilizing MOODLE for online learning.

Reimbursements

You will not be provided with any payment to take part in the research.

Confidentiality

Because something out of ordinary is being done through research in the society and the College of
Teacher Education, it might draw attention. If you participate, other people in the community and the
society in general may ask you some questions.

I will not be sharing information about you. The information that I collect from this research project will
be kept confidential. Information about you and your perception that will be collected from this
research will be put away and no one but only the researcher can access to it. Any information about
you will have a number on it instead of your name. Only the researcher will know your number/contact
information and we will lock that information up with a lock and key. It will not be shared with or given
to anyone except to our adviser Ms. Sheilla Marie Falar.
Sharing the Results

At the end of the study, we will be sharing what we have learned from the respondents and with the UC
community. We will do this by meeting first the organization which can help us implement our project
especially among those who really need an intervention in terms utilizing MOODLE for online learning.
Nothing that you answered in the questionnaire will be shared with anybody outside the research. A
written report will also be given to the participants which that they can share with their families. We will
also publish the results in order that other interested people may learn from this research.

Where it is relevant, your plan for sharing the information with the participants should be provided. If
you have a plan and a timeline for the sharing of information, include the details. You should also inform
the participant that the research findings will be shared more broadly, for example, through publications
and conferences.

Right to Refuse or Withdraw

You may choose not to participate in this study and does not have to take part in this research if you do
not wish to do so. Choosing to participate or not will not affect your stay in the CTE department of the
University. You will still benefit from the implementation of the intervention program. You may stop
from answering the questionnaire at any time that you wish without either you losing your rights here.

Who to Contact

If you have any questions, you can ask them now or later, even if the study has started. If you wish to
ask questions later, you may contact any of the following:

Carly Mitzi Padro- 09059310493

Lorie Mae Algabre- 09436992363

Mary Rose Bonghanoy- 09661479400

Rotchelle Magno- 09667356294

Maria Lyn Lapuerta- 09506551934

This research proposal has been reviewed and approved by panel of reviewers at the University of Cebu-
Banilad Campus Research Ethics Committee, which is a committee whose task that human rights will not
be violated in the conduct of this investigation and to ensure that the researchers have properly
conducted the study. If you have any questions, please contact the UCAREC Chairperson, Dr. Juanito N.
Zuasula at 233-5503.

PART II: Certificate of Consent

I have read the foregoing information, or it has been read to me. I have had the opportunity to ask
questions about it and any questions that I have asked have been answered to my satisfaction. I
consent voluntarily to participate as a participant in this research.
Print Name of Participant:__________________

Signature of Participant: ___________________

Date: ___________________________

Day/month/year

If illiterate

A literate witness must sign (if possible, this person should be selected by the participant and should
have no connection to the research team). Participants who are illiterate should include their thumb-
print as well.

I have witnessed the accurate reading of the consent form to the potential participant, and the
individual has had the opportunity to ask questions. I confirm that the individual has given consent
freely.

Print name of witness_____________________ Participant’s thumb print

Signature of witness ______________________

Date ________________________

Day/month/year

Statement by the researcher/person taking consent

I have accurately read out the information sheet to the potential participant, and to the best of my
ability made sure that the participant understands that the following will be done:

1.

2.

3.

I confirm that the participant was given an opportunity to ask questions about the study, and all the
questions asked by the participant have been answered correctly and to the best of my ability. I confirm
that the individual has not been coerced into giving consent, and the consent has been given freely and
voluntarily.

A copy of this ICF has been provided to the participant.


Print Name of Researcher/person taking the consent________________________

Signature of Researcher /person taking the consent__________________________

Date ___________________________

Day/month/year

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