As an occupational therapy practitioner working in a rural state, such as Wyoming or North Dakota, you have unique challenges and opportunities. This survey will help us identify factors that influence you job performance and satisfaction. Information collected as part of this survey is confidential. The information will be analyzed according to strict confidentiality standards and presented in aggregate form. Participation in this survey is voluntary. The survey will take approximately 10 minutes to complete.
UNIVERSITY OF NORTH
Title of Project: Work
Force Survey of Occupational Therapy Professionals in ND and WY: Factors
influencing job performance and satisfaction
Principal Investigator: Janet
Jedlicka, 701-777-2209, email@example.com
Hanson, 701-777-2218, firstname.lastname@example.org;
Marilyn G. Klug, 701-787-0089, Marilyn.email@example.com
Purpose of the Study:
purpose of this research study is to develop a demographic profile of the
occupational therapy work force in North Dakota and Wyoming. We would like to
gather current demographics and describe factors that influence job performance
and satisfaction. Of licensed occupational therapy professionals currently
practicing in North Dakota and Wyoming
Procedures to be followed:
will be asked to complete an online survey which will be approximately 64
questions, some being open-ended, others closed choice and matrix format.
are no risks in participating in this research beyond those experienced in
may have a better understanding of the factors influencing your job performance
may have a better understanding of the factors influencing your job
will take about 10 minutes to complete this online survey.
Statement of Confidentiality:
survey does not ask for any information that would identify who the responses
belong to. Therefore, your responses are recorded anonymously. If this research is published, no information
that would identify you will be included since your name is in no way linked to
survey responses that we receive will be treated confidentially and stored on a
secure server [only state if accurate].
However, given that the surveys can be completed from any computer (e.g.,
personal, work, school), we are unable to guarantee the security of the
computer on which you choose to enter your responses. As a participant in our
study, we want you to be aware that certain "key logging" software
programs exist that can be used to track or capture data that you enter and/or
websites that you visit.
Right to Ask Questions:
researchers conducting this study are Janet Jedlicka, Debra Hanson and Marilyn
Klug. You may ask any questions you have
now. If you later have questions,
concerns, or complaints about the research please contact Janet Jedlicka at
701-777-2209 during the day.
you have questions regarding your rights as a research subject, you may contact
The University of North Dakota Institutional Review Board at (701) 777-4279. You may also call this number with problems,
complaints, or concerns about the research.
Please call this number if you cannot reach research staff, or you wish
to talk with someone who is an informed individual who is independent of the
information about being a research subject can be found on the Institutional
Review Board website “Information for Research Participants” http://und.edu/research/resources/human-subjects/research-participants.cfm
will not receive compensation for your participation.
do not have to participate in this research.
You can stop your participation at any time. You may refuse to participate or choose to
discontinue participation at any time without losing any benefits to which you
are otherwise entitled.
do not have to answer any questions you do not want to answer.
must be 18 years of age older to consent to participate in this research study.
and return of the survey implies that you have read the
information in this form and consent to participate in the research.
keep this form for your records or future reference.