University of Washington
Parent / Guardian Permission Form
A Games Based Learning and Problem Solving Framework Using Large-Scale Data mining.

Researchers:
Zoran Popović, Computer Science and Engineering, 206-543-4226, zoran@cs.washington.edu
Christy Ballweber, Computer Science and Engineering, 206-897-1817, christy@cs.washington.edu

Overview
-In this study your child will be asked to play an educational video game, that may increase your child’s understanding of certain math concepts.
-Risks: Some may feel that providing information for research is an invasion of privacy. Your child’s privacy will be protected by assigning a unique identification code so that your child’s data is not personally identifiable and only aggregated (non-personally identifiable) data will be reported to the academic community and our funders.

Researchers’ statement

We are asking your child to be in a research study. The purpose of this consent form is to give you the information you will need to help you decide whether or not to include your child in the study. Please read the form carefully. You may ask questions about the purpose of the research, what we would ask your child to do, the possible risks and benefits, your child’s rights as a volunteer, and anything else about the research or this form that is not clear. When all your questions have been answered, you can decide if you want your child to be in the study or not. This process is called ‘informed consent.’
The researchers listed above are available to answer questions about the study and may be contacted using the contact information above. Please note that we cannot ensure the confidentiality of information sent via email.

PURPOSE OF THE STUDY

Researchers from the University of Washington’s Center for Game Science (CGS) are working to learn more about how students learn math and science through education video games. The purpose of this study is to learn more about and understand the learning experiences that students like your child have when playing educational video games. We hope that this research will help teachers and school leaders find better ways of teaching students particular Math and Science concepts.

STUDY PROCEDURES

Your child would be asked to play an education video game during class as assigned by his or her teacher. We would like to collect information about your child’s game play (i.e. user clicks and movements through the game) and his or her performance on a pre and post-tests which will be administered by the teacher. The pre and post-tests will be between 10-15 math questions (maximum of 25 minutes) each. Assessments may be administered online or using paper and pencil. Participation in this research study will have no effect on your child’s grade and researchers will not grade your child. Also, with the teacher’s permission occasionally a researcher may come into the classroom to unobtrusively observe how the class engages with the technology.

When your child plays the education video game as assigned by the teacher, information or log data will be collected regarding your child’s use of the tool. Information such as your child’s progression through the exercises, how much time your child spends on certain parts, and how much your child seems to be learning will be collected. The research being conducted is only on your child’s log data, and pre and post-test data. Also, your child’s teacher will be able to see how your child is doing via a dashboard. Your child’s teacher may also provide researchers with your child’s age, gender and education level.

All the information we collect will be stored digitally. The data will be password protected as well as encoded; by encoded we mean that the data is made unreadable to anyone without knowledge of how to interpret the data. Only our researchers will be able to interpret the encoded data. Your child will be assigned a unique identification code so that his/her data is not personally identifiable to researchers.

RISKS, STRESS, OR DISCOMFORT

Some people feel that providing information for research is an invasion of privacy. We will protect your child’s privacy by assigning a unique identification code so that your child’s data is not personally identifiable.

SOURCE OF FUNDING

This research is funded by Bill and Melinda Gates Foundation. Aggregated (non-personally identifiable) data will be shared with our funders.

ALTERNATIVES TO TAKING PART IN THIS STUDY

Participation in the research is voluntary. If you decide that you do not want your child to participate, your child’s teacher will indicate your wishes and we will not include your child’s data in our research. In this case, your child’s data will only be used by your child’s teacher. Choosing to take part in this study, to not take part in the study, or to withdraw from the study will not affect your child in any way. Your child’s individual privacy will be maintained in all published and written data resulting from the study. Should you change your mind, after providing permission, please contact the researchers listed at the beginning of this form to rescind your permission.

BENEFITS OF THE STUDY

Improving learning in the STEM fields has become increasingly important in education worldwide. Finding ways to increase and facilitate learning helps educators achieve this goal. When technology based tools are designed correctly, they can promote deep and lasting learning in mathematics for all students, promote positive affect about mathematics, and can be adaptable to students’ pace of learning. Finding out how these tools can improve learning may be beneficial for schools across the world. Since the risks of this study are minimal, the benefits to society and education far outweigh any risks. Your child might not benefit personally from being in this study, or your child might benefit by learning more math or science or finding that he/she likes math or science.

OTHER INFORMATION

Your child will be given an opportunity to choose whether he/she wants to participate in the research prior to using the technology based tools. Our student assent form will be presented electronically to your child before they begin to use the educational tool (A copy of the student assent form is available at http://centerforgamescience.com/permissions/student). Information you and your child provide is confidential. All data collected from your child’s game play will not personally identifiable. To further protect your child’s identity, any findings, publications and presentations to our funders or other academic audiences will not reference the name of your child’s school or the city where it is located.

Name of Researcher                Signature of Researcher                Date

Copy to: Parent/Legal Guardian

Parent’s/Legal Guardian’s Statement
The study has been explained to me and I voluntarily consent to allow my child, _________________________ to participate.                                        Your Child’s Name

I do give permission for my child’s data to be used in the study.

I do not give permission for my child’s data to be used in the study.

If I have questions later  about the research, I can ask the researchers listed at the top of this form. If I have questions about my child’s rights as a subject, I may call the University of Washington Human Subject Division at (206) 543-0098 or via email at hsdinfo@uw.edu. I will receive a copy of this permission form and the signed permission form will be mailed back to the researchers and stored in a secured location.

Printed Parent/Legal Guardian’s Name        Parent/Legal Guardian’s Signature        Date

cc:     Parent/Legal Guardian and Investigator