Transcription
QUT HealthFusion Team ChallengeStudent Registration FormPlease complete all sections on pages 1, 2 & 4 and submit to hftc@qut.edu.au or click the "SUBMIT" button on the final page.Please submit by 5pm on Friday 29th of May.Professional DetailsFirst name:Surname:Degree name:Current year of study:Intended year of graduation:Study load:List of other degrees/previousstudies in healthContact l InformationDo you have any specialdietary requirements?How did you hear about theHFTC?What motivated you toparticipate in the HFTC?Postcode:
QUT HealthFusion Team ChallengeResearch Participation ConsentINTRODUCTION:The HealthFusion team is conducting a long term research project to evaluate the effectiveness of the HFTC. As a participant in theHFTC, we invite you to take part in our research project by completing a survey before the event and after the event.TITLE:"The HealthFusion Team Challenge (HFTC): A mixed methodology evaluation of the effectiveness of a university based interprofessionaleducation (IPE) project."INVESTIGATORS:A/Prof. Monica Moran, Lecturer, Central Queensland University; A/Prof. Rosalie Boyce, Research Advisor, School of Pharmacy,University of Queensland; Prof. Lisa Nissen, Head of School, School of Clinical Sciences, Queensland University of Technology.1. By signing this document I hereby consent to take part in the research project titled: The HealthFusion Team Challenge(HFTC): A mixed methodology evaluation of the effectiveness of a university based interprofessional education (IPE) project.2. I acknowledge that I have read the student brief provided and that I have had the project, so far as it affects me, fullyexplained to my satisfaction by the investigators. I freely consent to my participation in the project.3. The details of the information gathering process has been explained to me. I understand that my participation involvesresponding to the voluntary pre and post-event online surveys and the voluntary post-event interview by phone or email toexplore my experiences of participating in the learning activity the HealthFusion Team Challenge.4. I am informed that the information I provide will be treated confidentially. The information I will provide will be kept onlywith an identification number. In the event of publication, there will be no personal identifying features published.5. I understand that I am free to withdraw from the study at any time with no adverse consequences.If you have any questions about the study at any time, feel free to contact the researcher, A/Prof. Monica Moran, Central QueenslandUniversity, [p] 07 4923 2234.Independent Contact:If you have any comments or complaints about the study you can contact the Ethics Officer, WMHSD Human Research EthicsCommittee on 07 3271 8674 or email ethics@qcmhr.uq.edu.au. All complaints will be treated in confidence, investigated fully and youwill be informed of the outcome.I hereby consent to my participation in the HFTC Research Project.Full Name:Date:
QUT HealthFusion Team ChallengeAdditional information for researchparticipantsTITLE:"The HealthFusion Team Challenge (HFTC): A mixed methodology evaluation of the effectiveness of a university based interprofessional education (IPE)project. "INVESTIGATORS:A/Prof. Monica Moran, Lecturer, Central Queensland University; A/Prof. Rosalie Boyce, Research Advisor, School of Pharmacy, University ofQueensland; Prof. Lisa Nissen, Head of School, School of Clinical Sciences, Queensland University of Technology.What this project is about:The aim of this research project is to examine from the student perspective the impact of the HealthFusion Team Challenge (HFTC) in the promotionof interprofessional learning and collaborative practice.The goal of university based interprofessional education (IPE) is to prepare students for effective and collaborative participation in health care teams.To achieve this, IPE methods must create meaningful learning experiences for students that will facilitate real change in their interprofessionalpractice. The HealthFusion Team Challenge (HFTC) is a possible means of achieving this goal.The overall rationale of this study is twofold: 1) To contribute to the development of an effective IPE programme that will produce graduating healthprofessionals who are prepared for effective and collaborative interprofessional practice and 2) To contribute to the under-developed body of IPEevaluation and evidence-based practice research.What you may be asked to do:You will be asked to take part in pre and post event online surveys, administered through an online service. You will also asked to participate in apost-event interview. This will be conducted on a one-on-one basis by HFTC facilitators and will take place either over the phone or through emailcorrespondence. The interview comprises 17 questions and is estimated to take approximately 20-25 minutes of the student's time.How will my privacy be maintained?Your privacy while participating in the study will be maintained at all times. You will be assigned a number with which all data pertaining to you willbe labelled. Files will be kept ina password protected data file in the School of Health and Rehabilitation Sciences and will only be accessibleby the researchers. Phone interviews will be recorded to assist in transcription and this recording will be destroyed directly after this has taken place.Your participation in this study is entirely voluntary and the decision to participate or not will not affect you adversely in any way. You will have theopportunity to withdraw from the research study at any time should you wish to do so, with no adverse consequences. Your participation in thisstudy will have no bearing on the outcome of the HealthFusion Team Challenge and judges and event organisers will be blind to your participationstatus.Benefit of participation:The purpose of this research is to improve the quality of interprofessional education for Health Science students. Whilst your involvement willcontribute to this, it may not be of any direct benefit to you.Will I receive feedback?:A summary of the overall outcomes of the study, as well as all data pertaining to you, will be made available to you on request. If you wish to viewthem please make your request to the contact below.If I have queries about the research:If you have any questions about the study at any time, feel free to contact the researcher, A/Prof. Monica Moran, Central Queensland University,07 4923 2234.Ethical clearance statement:This study adheres to the guidelines of the ethical review process of The University of Queensland. Whilst you are free to discuss your participation inthus study with the project staff (contactable on 07 3365 3451), if you would like to speak to an officer of the University not involved in the study,you may contact the Ethics Officer on 07 3365 3924.Monica MoranDate: 13/05/2013Chief Researcher
QUT HealthFusion Team ChallengePhoto/Video ConsentConsent form for use of images in QUT/HealthFusion publications and promotional materialsA photographic image (including a video recording) which is sufficiently clear to enable you to be identified asan individual is personal information. Queensland University of Technology has obligations under its privacypolicy (see www.mopp.qut.edu.au) to ensure that personal information is used and disclosed only in wayswhich are consistent with privacy principles. In general, personal information is not disclosed or publishedexcept where an individual's consent has been obtained.QUT/HealthFusion may occasionally reproduce photographic or video images of individuals in its publications,promotional and marketing material and on its website. These images are used to promote the University/HealthFusion or describe its activities.The images may be used for publicity and advertising purposes in any media and for commercial or noncommercial purposes of the University/HealthFusion.The University/HealthFusion would like to be able to use and reproduce one or more photographs or videoimages of you, which may be taken on the date of the event, for these purposes and is seeking your consent todo so. If you agree to this, please read and complete the consent below.ConsentI hereby consent to QUT/HealthFusion using, reproducing and disclosing photographic or video images of me as explainedabove.I agree that I will make no claim against QUT for any payment or fee for appearing in promotional material or advertisements andrelease QUT from any other claims arising out of the University's use of the images of me.Full Name:Date:Submit by EmailPrint Form
QUT HealthFusion Team Challenge Student Registration Form. Please complete all sections on pages 1, 2 & 4 and submit to hftc@qut.edu.au or click the "SUBMIT" button on the final page. Please submit by 5pm on Friday 29th of May. Professional Details. First name: Surname: Degree name: Current year of study: Intended year of graduation: Study load:
