Consent Form for Arts Integration Teacher Interview

This study will examine how teachers integrate music and visual arts into other classroom
subjects. This form includes information about this study, how this interview is voluntary, the
possible risks and benefits of your participation, and other information that gives you the ability
to make a decision about whether or not you would like to participate in this interview. You may
ask the researcher any questions you may have at any given time.
Study: Arts Integration in Science, Math, Social Studies, English Language Arts, and Bible
Classes
Researcher and Title: Annelise VanDyken, Calvin College Elementary Education student
Project Advisors and Titles:
Prof. Marj Terpstra, Education department; Prof. Phillip Hash, Music Education department
Institution: Calvin College
Address and Contact Information:
arv43@students.calvin.edu
616-856-4141
Annelise VanDyken
1271 Kinney NW
Grand Rapids, MI 49534
1) Purpose of Research: My goals for this study include observing how teachers use art in
math, science, social studies, Bible, and English language arts lessons; compiling examples of
projects that teachers have done with their students that demonstrate art integration;
understanding the benefits and challenges of integrating art in an elementary school classroom;
and suggesting possible projects and guidelines that integrate visual art and music in the
elementary and middle school classroom.
2) Expected Duration of Participation: The interview should take approximately 30 to 45
minutes, but that number depends on the amount of information you have to share about arts
integration. I am free to go shorter or longer as the conversation leads. I may send you follow up
emails if I am in need of clarification or additional information.
3) Procedures: The interview will have a semi-structured layout. I will be using it for all of the
teachers that I interview during my study. I will use selected portions of the information you give
me to build up my website for this study. This will be the dissemination of my findings, including
professional research, suggestions for possible projects, emerging themes, and other similar
information. I will make the website as privatized as possible, only being used for my
organization and final presentation. I will give the presentation to interested members of the
Calvin College community as the culmination of my work as an honors student.
4) Potential Risks: There is minimal risk in your project in that your art project ideas and
reflections on art integration will be organized on a website I made specifically for this study and
shared through a presentation. To minimize this risk, I will allow you to review your contributions

to ensure accuracy. If you would not like certain information to be shared in a presentation, you
do not have to answer a particular question.
5) Potential Benefits:
1) Identifying visual art and music integration strategies.
2) Informing the Calvin College teacher education community of reasons behind
arts integration and how this can be done effectively in a classroom setting.
6) Privacy and Confidentiality:
1) I will change all of the names of teachers and schools that I use in my study on
my website and in my presentation. The real names and places will be in a password
protected file limited to the sight of myself and my advisors.
2) All of the data collected (i.e. interview information) will be stored in password
protected files that will only be available to myself, my advisors, and the International
Review Board (IRB).
3) I will ask for your permission to take pictures of student examples of art projects
that are brought up as part of the interview. The pictures will be used for illustrative
purposes in for my website and final presentation.
7) Your Rights to Participate, Say No, or Withdraw: Participation in this study in completely
voluntary. You have the right to say no and may withdraw completely at any point in time without
any explanation. If we have made it partway through the interview, I will permanently discard
any collected information or samples.
8) Costs: There are no costs to participating in this study.
If you have any questions or concerns about your role or rights as a research participant or
would like to register a complaint about this study, you may do so anonymously by contacting
the Chair of the IRB Committee of Calvin College.
IRB Chairperson
Office of the Provost
Calvin College
3201 Burton Street SE
Grand Rapids, MI 49546
irb@calvin.edu
9) Documentation of Informed Consent:
Your signature below means that you voluntarily agree to participate in this research study.
_______________________________________________
Signature

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Date