Informed Consent Form

This informed Consent form is intended for the Second Year Psychology Students of
Cavite State University- Silang Campus, who we are inviting to be our participant in
Experimental research entitled " Effectiveness of Pomodoro Technique on the
"Learning Outcomes of Students
 This Informed Consent Form has two parts:
Information Sheet (to share information about the study with you)
Certificate of Consent (for signatures if you choose to participate
 You will be given a copy of the full Informed Consent Form

Name of Researchers:

Name of Organization: Second Year, BS- Psychology

Title of the Study: Effectiveness of Pomodoro Technique on the Learning Outcomes

of Students

I. Information Sheet

Introduction
We are the Group 1 from Second Year, Section C, BS Psychology Department. We
are conducting the research titled “THE EFFECTS OF POMODORO TECHNIQUE
ON THE LEARNING OUTCOMES OF THE STUDENTS”. We are giving information
and inviting you on participating in this research. Prior to making your decision, you
have the right and the opportunity to ask questions regarding the study and decide
whether or not to join. If this consent form contains some information or words that
may be confusing for you, any of us would be happy to explain it. Any of the
researchers are willing to answer questions if you still have any.

Purpose of the research

Pomodoro Technique is a type of time management tool which is use for easier
studying and easy managing of schedule. The purpose of this research was to find
whether using pomodoro technique, a time management tool has affected the
learning outcomes of students. We want to know whether using pomodoro have an
effect of students’ scores. We know that your participation in this research have a
great help in achieving a result.
Type of research intervention
This research will involve your participation in a group discussion which revolve in
separating two groups which is the experimental and control group that would
answer a pre-test which would take 30 minutes or longer, you would also review
materials for 2hrs and answering a 30 minutes post-test after.

Participant Selection
You are being invited to participate in this research as we feel that your experience
as a student pass the standard in understanding pomodoro technique and its effects
to the learning outcomes.

Voluntary Participation
Your participation in this research is entirely voluntary, you have the choice whether
to participate or not. You have the right to decline in participating even if you had
agreed on participating earlier. The choice that you chose will not have any bearing
in the progress of the research. If you have any questions, you can ask any of us.

Procedures duration
Participant will undergo 3.5 hours of experimentation.
Students will be given a pre-test that they need to answer in the first 30 minutes of
the procedure. It will be followed by a 2-hour review session where the control group
will do it under the treatment of the Pomodoro technique while the experimental
group will do it without any treatment. Another 30 minutes will be given to answer the
post-test that the researchers prepared. Short breaks will also be given in between
sessions.

Risks
The risk of participating in this research are minimal, however it can be tedious and
take up to 3 or 4 hours. Immediately stop the test and let the researchers know if any
participants are experiencing emotional stress as a result of the questions they must
answer.
Benefits
It helps students avoid distractions at the same time they make more time to learn
and do their task. It benefits students to have motivation, which increases
productivity and concentration.

Reimbursement
Participants in this study may expect a return of expenses or reward.

Confidentiality
As researchers, we want to promote confidentiality as a core principle, thus all the
data we collect from participants will be handled in a manner that safeguards your
privacy. The information will only be accessible to the researchers. Participants may
indeed be assured that no one from our team will disclose any of your personal data.
Unless the we are required by law to report a particular incidence, participant data
will be kept private. These circumstances may include cases of abuse and a risk of
suicide. We will also refer you through using pseudonym during this process.

Sharing of result
You will be made aware of all the knowledge and conclusions we draw from your
data. The research summary will be given to each participant. We can send it to your
personal email or arrange an online meeting for a discussion of the results and
findings.

Right to refuse or withdraw

If you choose not to participate in our experimental research, you won't be forced to.
At any time during the research, you have the option to stop participating for any
reason.

Who to contact
You can ask now or later if you have any further concerns. Any member of the
research team can be contacted if you have any questions afterwards. Should you
have any questions, each researcher's contact information is provided below.
johnrovick.aligacion@cvsu.edu.ph
 patricia.barrientos@cvsu.edu.ph
kriziamae.bea@cvsu.edu.ph
francisca.colantro@cvsu.edu.ph
jerseylianne.cuenca@cvsu.edu.ph
daniela.cuizon@cvsu.edu.ph
applejoy.dino@cvsu.edu.ph
jayrom.gamay@cvsu.edu.ph
amavelle.layugan@cvsu.edu.ph
jeaamor.miralles@cvsu.edu.ph
deahlirra.mo-ay@cvsu.edu.ph
emmanuel.narisma@cvsu.edu.ph
atashajoeviel.ofianga@cvsu.edu.ph
ellyzayvonne.omega@cvsu.edu.ph
noahnn.ramos@cvsu.edu.ph
limarantone.sanjose@cvsu.edu.ph
jazmicaellavera.soriano@cvsu.edu.ph

II. Certificate of Consent

I have been invited to take part in experimental research that looked at the
effectiveness of Pomodoro technique on the learning outcomes of students.
I have read the information above myself or have had it read to me. I have been
given the chance to ask questions regarding it, and all of my questions have
received adequate responses. I willingly consent to participate in this study.

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.
The consent form was accurately read to the possible participant in front of me, and the
person had the chance to ask any questions. I attest that the individual voluntarily
provided his\her consent.
Print name of witness____________ Thumb print of participant
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:
 If the participant chooses to take part in a research project, he or she is required to
sign an informed consent form explaining the purpose of the study as well as the
participants' privacy right
 Participant agrees to voluntarily participate on the procedure of the learning
experiment as mentioned in the informed consent form, otherwise the participant has
the option to withdraw from the research at any point of time.
I certify that the participant was given the chance to ask questions concerning the study,
and that I have answered all of their inquiries honestly and to the best of my ability. I
confirm that the participant's consent was voluntarily provided and voluntarily given, and
that it wasn't forced upon them.
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