If you are interested in using this survey for a specific purpose (such as research or evaluation), please contact us.
Implied Informed Consent Form
for Social Science Research
The Pennsylvania State University
Title of Project: Transformative Learning Survey
Heather L. Stuckey
Associate Professor of Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
Division of General Internal Medicine
Mail Code H034, 500 University Drive
P.O. Box 850
Hershey, PA 17033-0850
Work: 717-531-0003 X 287632
Edward W. Taylor
Professor Emeritus of Lifelong Learning of Adult Education
Penn State University – Harrisburg
Doctor of Education in Lifelong Learning and Adult Education Progam
Middletown, PA 17057
Penn State University Institutional Review Board – phone: 814-865-1775
- Purpose of the Study:
The purpose of this research is to explore the learning that occurs in life-changing experiences.
- Procedures to be followed:
You will be asked to rate approximately 100 statements about specific life-changing experiences that happened in your adult life.
The survey will take 15-20 minutes to complete
- Statement of Confidentiality:
Your participation in this research is confidential. The survey does not ask for any information that would identify who the responses belong to. In the event of any publication or presentation resulting from the research, no personally identifiable information will be shared.
- Right to Ask Questions:
Please contact Heather Stuckey at (email@example.com) or Edward W. Taylor (firstname.lastname@example.org) with questions or concerns about this study.
- Voluntary Participation:
Your decision to be in this research is voluntary. You can stop at any time. You do not have to answer any questions you do not want to answer; however, in order to receive results from the survey and to have your data saved, you will need to answer each question and press “submit.”.
You must be 18 years of age or older to take part in this research study.
The data collected by this survey (will not contain any identifiable private information) could be used in future research studies or distributed to another investigator for future research studies without additional consent from the subject.
Completion and return of the survey imply that you have read the information in this form and consent to take part in the research. Please keep this form for your records or future reference.