![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 49. Go back in thread:
Posted by mair on October 28, 2001, at 11:44:42
In reply to Re: New informed consent procedure, posted by akc on October 27, 2001, at 22:23:50
> Bob - I think I weigh in here a bit with Shar. On the one hand, I'm very relieved actually that you're doing something like this. I've frankly been concerned in the past that you did too little to protect yourself. Also this might cut down on some of the types of remarks that were made in that sometimes tedious discussion that ensued after you published that article.
On the flip side - my this is intimidating, even to the initiated! Physicians, schools, camps, travel groups and just about everyone else out there ask people to give "informed consent" all the time, but I've never been quizzed on my understanding of what I've consented to. The quiz may not be a bad idea, but it does go on. As with akc, I'm not sure I'd go through all this if I weren't already pretty attached to this site. What if you did this: What if you broke your consent down important point by important point with questions starting out like "Do you understand that your post may be quoted in a research paper?" to give an example. And then people would answer something like "I understand and agree to this term" as to each of your questions. I'm not sure I'm explaining this very well but the idea would be to remove some of the intimidation of the quiz format and yet get people to focus on and address each important concept.Mair
Posted by Dr. Bob on October 28, 2001, at 13:53:34
In reply to Re: New informed consent procedure, posted by mair on October 28, 2001, at 11:44:42
> > Are you saying there should be fewer questions or no questions at all?
>
> Different, and fewer, items to acknowledge.
>
> SharHmm, in retrospect, maybe I should've just asked you all to suggest questions in the first place... Sometimes I do just get an idea and go with it...
Any suggestions for better questions?
> I just don't get the quiz. Why is it not sufficient to have the written statement? I did not realize that to have informed consent, you had to give a quiz? Is that a departmental requirement? A requirement within your particular field?I hesitate to admit it now... but the quiz was my idea. I thought it would help reassure the IRB. One aspect of informed consent is that the person needs to be competent to make the decision. In person, you can assess how much someone understands as you explain something. But here I can't do that. But passing a quiz is pretty good evidence of competence.
A more general point could be that in some cases communication online may need to be more explicit than in person. Like with tone of voice. Sometimes in person that's how you know what someone means. But sometimes online I think you have to ask.
> From my legal way of thinking, I would think it sufficient to have a statement... Sure, some won't read it -- but that happens all the time -- with medical treatment, legal representation, buying a house -- people make all sorts of major decisions, decisions they know better than to make without reading the fine print, but they do it anyway.
Well, just because something happens all the time doesn't necessarily make it OK... Maybe it wouldn't be such a bad thing if people had to pass a quiz before buying a house? Also, I thought the quiz was more about basics than fine print -- and wouldn't have expected regulars to have a very hard time with it. Were there aspects that really weren't so clear before?
> I think this goes back to what is this site really about -- is it research or is it support?
The thing is, it's both. Mainly support (and education), but partly research, too.
> I think this quiz thing is a really big deal. Especially for someone who is in a lot of mental and emotional pain -- usually those who are first stumbling upon PB. One of the hard things to do when your meds are messed up or you life is in shambles, is to think linear -- but yet, you ask those people to take this quiz. That doesn't mean they aren't together enough to give informed consent -- but it is one thing to give consent, another to take a quiz.
That's actually a concern sometimes, that people who are in a crisis might not "think linear". I have some problems with "first, do no harm", but that might be one way to look at this.
Someone might be together enough to give informed consent, but not enough to take the quiz? Because it's too many extra steps?
> I guess my thought is that there has to be some other way to do this without the quiz. I sure hope this is not being forced upon you, so you can revisit this procedure.
>
> akcI'm open to suggestions, and yes, I think I can work with the IRB...
> I found your new registration process considerably more trouble than consenting to major surgery and slightly less time-consuming than buying a new house.(sigh) And I'm to assume you were happy with the surgery and the house? :-)
> However, had I had to deal with this obstacle course 2 years ago, I wouldn't have been one of the participants. I'd have "bailed" before I even *got* to the quiz--too many steps for something I wasn't sure I could, or wanted, to do in the first place.
This isn't to say that it isn't great to have you :-) but is it such a bad thing for people to be more sure that this is in fact what they want? There have always been people who've "lurked" a long time before posting. And of course those who still haven't posted...
> My concern is that this quiz may be a "straw that breaks" for too many potential participants. Of course, *any* quiz may have that effect. But this one has an academic-qualifying flavor that, if you find it difficult, is inhibiting--and, if you don't, is just very annoying.The quiz itself has that flavor, or the information before and after? If there's some way to make the quiz more palatable, I'd love to do that, but some of the language before and after is required as is by the IRB.
> If some sort of quiz is a research sine qua non, a more user-friendly one would (IMHO) feature no more than 5 Qs, reiterate important points in some of the Qs, be mostly fill-in-the-blank, supply or approve answers Q by Q, and end with a consent option. The focus of this feature would then shift from proving competence to reinforcing information, but I think that the comprehension end point wouldn't be much different.
Hmm. I'm not sure what you mean by "reiterate important points". Fill-in-the-blank would be better than multiple-choice? It would be hard for the server to "grade" fill-in-the-blank... One question at a time would be better than all at once? I myself like being able to get an overview and to decide myself in what order to take the questions...
The idea really is more to prove competence than to reinforce information. If I reinforce and reinforce and reinforce, but still someone doesn't understand, is their consent be valid?
> I hope that this is "much ado about nothing." A counter on the first registration page to compare "hits" against registrations might be interesting, tho.
>
> medlibI hope so, too, I do still want people to benefit from this -- although I realize fewer people may this way... The counter would be a measure of how much of a deterrent the new procedure is? Interesting idea...
> On the one hand, I'm very relieved actually that you're doing something like this. I've frankly been concerned in the past that you did too little to protect yourself. Also this might cut down on some of the types of remarks that were made in that sometimes tedious discussion that ensued after you published that article.Thanks...
> What if you broke your consent down important point by important point with questions starting out like "Do you understand that your post may be quoted in a research paper?" to give an example. And then people would answer something like "I understand and agree to this term" as to each of your questions.
>
> MairHmm, another vote for one at a time...
My concern with a system like that is that people might just zip through the whole thing, answering "yes, I understand" or "yes, I agree" every time, just to be done with it. Which really wouldn't accomplish anything. I know this isn't major surgery, but what if I were proposing to do major surgery and the patient said, "sure, sure, just give me the form and let me sign it so we can get on with things"?
Thanks for the input, which I understand comes from wanting the best for the board. I'll try to do what I can. And thanks for not jumping ship! :-)Bob
Posted by KB on October 28, 2001, at 19:40:02
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 28, 2001, at 13:53:34
I didn't really have difficulty with the quiz, though I was mildly annoyed by the disruption in my logging-on routine, but when I got to the part where I had to remember my password, I was stumped!!! I got it eventually, but . . .
Posted by tina on October 29, 2001, at 10:36:36
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 28, 2001, at 13:53:34
>
> My concern with a system like that is that people might just zip through the whole thing, answering "yes, I understand" or "yes, I agree" every time, just to be done with it. Which really wouldn't accomplish anything. I know this isn't major surgery, but what if I were proposing to do major surgery and the patient said, "sure, sure, just give me the form and let me sign it so we can get on with things"?
>
THis is the reason for your quiz, yes? So this doesn't happen.I liked the quiz idea. It's good to double check myself and this quiz helped me to understand the point of psychobabble which I think sometimes gets lost in the conversation.
Perhaps the ones who have such a problem with the quiz are the ones that should be monitored and checked?
I really don't see the big deal here. It's only 10 questions and if you read the information, the questions are easy. Plus, you can go back and back and back again to get it right. What is the problem here people?? Why is this such a tempest in a teacup??
Maybe I'm just too canadian.....but I say Well done Doc! Good idea. Leave it the way it is. You can't please all the people all the time and if you keep trying, you'll end up on the "poster" side of this board, not the doctor side. :)
Posted by Dr. Bob on October 29, 2001, at 12:00:14
In reply to Re: New informed consent procedure, posted by KB on October 28, 2001, at 19:40:02
> when I got to the part where I had to remember my password, I was stumped!!!
Hmm, that's come up before... I might be able to get it "automatically remembered" for you, let me look into that...
Bob
Posted by Dr. Bob on October 29, 2001, at 12:16:26
In reply to Re: New informed consent procedure, posted by tina on October 29, 2001, at 10:36:36
> I say Well done Doc! Good idea. Leave it the way it is. You can't please all the people all the time
Thanks! I learned early on that I couldn't please everyone all the time, but still I want to try to be open to feedback -- and please at least some people some of the time. :-)
Bob
Posted by akc on October 29, 2001, at 13:02:32
In reply to Re: New informed consent procedure, posted by tina on October 29, 2001, at 10:36:36
> What is the problem here people?? Why is this such a tempest in a teacup??
I guess my point (and problem) is that some of the people in the biggest emotional crisis might have the biggest trouble with this. It seems like no big deal at all when I am happy go lucky. However, there have been days that such a quiz would have been virtually impossible. Yet, I would not have been incompetent -- just overwhelmed. And I think there is a big difference. Just because I am having a really bad time does not mean I am incapable of giving informed consent.
Dr. Bob speaks above about being able to judge in person whether a person is able to give informed consent. There is a lot of things a person can do "in person" that is impossible on-line. Ask different questions, read body-language, give additional information, ask for questions, etc. Dr. Bob is using the quiz to take the place of a lot of that stuff. My opinion is that it is a poor substitute. Hence, some people who could really benefit from this site may only get limited use (just reading the posts) or none at all (not feeling "welcome," they quickly move on).
Now here comes the big problem -- I don't have a better idea. Dr. Bob is right that my just let them read it and sign it (when we know they won't read it) is not informed consent. Even if that happens in a lot of contexts in the real world (both on line and off), doesn't make it "right." Unless Dr. Bob begins to interview each person who wants to join Psycho-Babble, there has to be a process that he can use to judge whether a person has some concept of what's going on. I hate the quiz idea -- I still think there has to be a better way. But I am still racking my brain to come up with that idea.
akc
Posted by stjames on October 29, 2001, at 18:27:00
In reply to Re: New informed consent procedure » tina, posted by akc on October 29, 2001, at 13:02:32
> > What is the problem here people?? Why is this such a tempest in a teacup??
> Now here comes the big problem -- I don't have a better idea. Dr. Bob is right that my just let them read it and sign it (when we know they won't read it) is not informed consent. Even if that happens in a lot of contexts in the real world (both on line and off), doesn't make it "right." Unless Dr. Bob begins to interview each person who wants to join Psycho-Babble, there has to be a process that he can use to judge whether a person has some concept of what's going on. I hate the quiz idea -- I still think there has to be a better way. But I am still racking my brain to come up with that idea.
>
> akcJames here....
Perhaps if people are unable to read a short para and answer some questions correctly, they may not benefit from this forum. It is in written form and requires the same skills.
james
Posted by akc on October 29, 2001, at 19:19:33
In reply to Re: New informed consent procedure, posted by stjames on October 29, 2001, at 18:27:00
>
> James here....
>
> Perhaps if people are unable to read a short para and answer some questions correctly, they may not benefit from this forum. It is in written form and requires the same skills.
>
> jamesWe all know that some who come here are not the most together -- they ramble, are even not too coherent. That does not mean that they are unable to give informed consent or even benefit from this forum. And even in my short time (5 or so months), I have seen some who have entered in such a condition benefit greatly from this forum(and I am certain from changes/adjustments in meds, other therapy) to a point that they are as articulate as the best of us.
I don't know, it's the quiz -- this comes from someone who has no problems with tests of any type -- three degrees, excelled at all levels. But I have tutored and taught and have seen the paralysis the word "quiz" can bring. Combine that with the emotional and mental difficulties many bring to this site, I just think the quiz thing is a big stumbling block for a particular segment of folks who would otherwise benefit -- and who would otherwise (like in a person to person setting) be more than capable of giving "informed consent."
So I continue to make a big deal of this. And I continue to be stumped at the solution.
akc
Posted by Dr. Bob on October 29, 2001, at 23:29:19
In reply to Re: New informed consent procedure » tina, posted by akc on October 29, 2001, at 13:02:32
> I still think there has to be a better way. But I am still racking my brain to come up with that idea.
Thanks for working on this. Let me know what you come up with!
Bob
Posted by Dr. Bob on October 30, 2001, at 1:02:44
In reply to Re: had to remember my password, posted by Dr. Bob on October 29, 2001, at 12:00:14
> > when I got to the part where I had to remember my password, I was stumped!!!
>
> I might be able to get it "automatically remembered" for youOK, I was able to do that, but trying it out, I realized it's just putting off the inevitable, because your password's required to confirm the update later, anyway...
Bob
Posted by Gracie2 on October 30, 2001, at 1:35:54
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 28, 2001, at 13:53:34
Ya'll are spoiled. I've mentioned this before and will be happy to say it again - research some other mental health sites and be astounded by the legal tripe one must be required to consent to EACH and every time you sign on; the website is not responsible for any personal action that may result from information obtained, written or implied, from said website. The website does not condone or permit the discussion of any drugs or the effect of such drugs, prescribed or otherwise. The website does not allow discussion of suicide, self-mutilation or any form of abuse,
and any poster who attempts such discussion will be permanently banned.
At some websites, your initials are required after each paragraph explaining forbidden topics;
again, you must do this each time you sign on.It is also important for Dr. Bob to explain that he is not available for psychiatric advice, although he was kind enough to reply to me personally when I felt that I had recieved personal threats from another poster who had somehow obtained my e-mail address. His role as a
mediator and referee only is not often understood by posters, but it is a necessary role to prevent PB from becoming the kind of immature "chatroom" that most of us are so disgusted with.In the past, some posters have been outraged to learn that their comments were used in published studies, although their identities were kept completely anonymous. This attitude mystified me to the point of giving it some real thought. Although you must register to post on PB, anyone on the internet, worldwide, has access to PB and is able to read any message posted. Why would being quoted in a small, specialized study enrage anyone as long as their privacy was protected? Were they unaware that PB communication was not protected by the CIA? Did they expect some kind of publisher's rights and a copyright fee, as if their paragraph or two was equal to a rendition
of "War and Peace"? Come on, people.So all that had to be covered. We are fortunate that we aren't required to take this test every time we wish to post, as some websites require.
It wasn't a big deal, and it didn't warrant all the pissing and moaning, particularly in today's world where too many people have their lawyer on
"speed-dial".
So let's all pop a Xanax and cool off.
-Gracie
Posted by akc on October 30, 2001, at 6:47:15
In reply to I agree with the procedure, posted by Gracie2 on October 30, 2001, at 1:35:54
> It wasn't a big deal, and it didn't warrant all the pissing and moaning, particularly in today's world where too many people have their lawyer on
> "speed-dial".
> So let's all pop a Xanax and cool off.
> -Gracie
I am the lawyer that too many people have on their speed-dial. I'm not big on unwarranted lawyer stabs. I'm not mad at Dr. Bob -- so I don't need the Xanax. I just believe there has to be a different solution. Probably there is not one. But, I hope there is. I just happen to think that this process is going to be a big deal for a segment of people -- people who are going to be left outside of Psycho Babble, at best looking in, who could benefit. That I want to go to bat for these folks is okay, is it not? There is a difference in trying to figure out how to make the process "better" and "pissing and moaning." It is my hope in continue to post about this that instead of being jumped for "pissing and moaning" that maybe other babblers could come up with some ideas. Creativity has never been my strong side. But as some of the babblers have already attempted, there may be other solutions out of which would allow Dr. Bob to get his "informed consent" and would allow the biggest population of people to participate in this "experiment" that we have been fortunate to participate in. I am trying to generate discussion, not attacks.akc
Posted by Gracie2 on October 30, 2001, at 19:15:57
In reply to Re: Ideas? » Gracie2, posted by akc on October 30, 2001, at 6:47:15
AKC-
I apologize for the lawyer comment. I meant no offense to lawyers, only "sue-happy" people. However, since these people need to hire lawyers that agree to represent them, I realize why my comment was offensive to you and I'm sorry.The Xanax comment was an attempt at a joke.
As for the test, I saw nothing wrong with it because of the reasons I stated, but I did not view the test as a way to exclude anyone, nor would I want it to. This, to me, was a whole new idea, and I thank you for pointing it out. I saw the test only as an explaination of PB policies and a CYA agreement with posters necessary for Dr. Bob, although I don't feel strongly about the test format, which I guess is what bothered most people. If it would be just as legally effective to print out a page of policies and procedures and have the poster sign a one-time agreement (I have read the above and agree, etc.)then that's fine with me.
I have been with PB for some time and guess that my language can become over-familiar. Please pardon the "piss and moan" comment; that's just my redneck showing.
Gracie
Posted by akc on October 30, 2001, at 21:55:34
In reply to AKC, posted by Gracie2 on October 30, 2001, at 19:15:57
Thanks for the apology.
I think Dr. Bob and I have quickly agreed that just relying on folks reading and acknowledging they have read is not sufficient to guarentee that people are really informed -- it is too likely that people will actually "cheat."
The quiz does guarantee some basic understanding. I just think there has to be some other way that prevents people from just saying they have done something, but doesn't put people under a spotlight. That there has to be a better way of translating the person-to-person evaluation through cyber-space.
It may be that in Dr. Bob's head, he has a list of questions that in person he would check off with an individual who is enrolling in a study. That person may not be aware that they are being "quizzed." That is what I am after here. Is there a way that this information can be presented to a person who wants to sign up and then information gained back from that person so that the person is not feeling like he or she is being tested, when in fact, the end result is the same? Am I even making sense? Am I beating a dead horse? I am starting to feel like I am the only one that really cares about this issue. If so, I will let it go.
akc
Posted by Shar on October 30, 2001, at 22:58:24
In reply to Re: Still after ideas. » Gracie2, posted by akc on October 30, 2001, at 21:55:34
AKC, I think this is a very important issue, and I am not wild about the quiz either. I believe, though, that people (adults?) not be too much saved from themselves. That is, what happens here, at worst, will mimic reality--where people don't read things and just sign, or where they skim through and then sign.
I believe that with some basic trickery and deceit, asking just a few questions would suffice, and give the good Dr. what he wants. I don't know if the quiz approach could be avoided completely, but if the items are REALLY EASY, one line long, and the responses are in mixed form--true, false; yes, no; multiple choice--the person must read to get the answer. And all that can be guaranteed online is that the items are read; not understood. Even the good Dr's quiz provides evidence more of rote learning than comprehension.
Shar
Posted by medlib on October 31, 2001, at 0:25:25
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 25, 2001, at 8:25:39
Dr. Bob--
If a quiz of some sort is deemed absolutely necessary, I believe that there are ways to make one less intimidating. One alternative would be to omit the terms "quiz" and "100%" entirely. The final paragraph of information could lead into a set of 5 or 6 questions with a statement such as, "In order to help us verify that you've read and understand this information, please answer the (#) questions below." [Instructions could follow, if necessary.]
Questions themselves could be shortened in number and made more user-friendly by combining restatement of an important point with a related choice. For example:
Q: The only "real" information required to register for as a member of PB is your valid email address. This address WILL / WILL NOT automatically be included in your posts, and WILL / WILL NOT be included if your post is included in a study.
Q: Messages on PB may be posted only by group members and Dr. Bob. They may be read by ANYONE ON THE INTERNET / GROUP MEMBERS ONLY.I believe that your point about online communication needing to be more explicit is well taken. Therefore, answer options should contain *only* material covered specifically in the consent information.
Linking the facts about payment into one sentence seems much more memorable than separating them. "There is NO charge for posting messages on PB, and NO payment is made when posts are included in a study."
If it's not a Halloween prank, the Q re deliberately misleading statements seems quite unnecesarily alarming. Unless it's to weed out paranoids, why introduce potential for conspiracy when it's not mentioned in the consent text? Dramatically stated wrong possibilities can be more memorable than duller correct facts.
Re user-friendly question presentation:
--Several studies have shown that info provided at the point of need is better remembered. Scoring Q-by-Q does that. (Test overviews seem more appropriate to competitive exams in which strategy may affect scores.)
--Options presented in color are more easily noticed. Correct answers which turn green, wrong ones which turn red, and the relevant answer quote in blue below makes more of an impact.
--Finally, sets of questions which take up less space usually are perceived as less difficult overall. (That is, where alternative answers appear in the body of the question).The only option other than questions of some type that I see is the initialed consent to each paragraph. Anything that slows the scroll speed and/or requires an interactive response calls attention to the text.
Another 2 cents worth---medlib
Posted by Dr. Bob on November 1, 2001, at 8:27:44
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 28, 2001, at 13:53:34
[really in reply to: http://www.dr-bob.org/babble/admin/20010718/msgs/2257.html]
> if i were a new poster, i don't know if i'd bother with the quiz in able to "join." when i was doing web-searches for these kinds of sites, my depression was peaking and cognition nil.
That could be an argument *for* a quiz: if people show up and aren't cognating, then maybe it's better (though arguably somewhat paternalistic) if they *don't* just start posting right away...
Bob
Posted by akc on November 1, 2001, at 10:32:23
In reply to Re: boo to the quiz, boo, posted by Dr. Bob on November 1, 2001, at 8:27:44
> [really in reply to: http://www.dr-bob.org/babble/admin/20010718/msgs/2257.html]
>
> > if i were a new poster, i don't know if i'd bother with the quiz in able to "join." when i was doing web-searches for these kinds of sites, my depression was peaking and cognition nil.
>
> That could be an argument *for* a quiz: if people show up and aren't cognating, then maybe it's better (though arguably somewhat paternalistic) if they *don't* just start posting right away...
>
> BobOr just the opposite. Maybe they are the ones who need to ask questions the most. They may not understand what is happening with the meds they are on, the side effects, how long it will take, etc. And while it can be helpful to read other's posts about their questions and see responses, there is just something different about being able to post your own questions and getting feedback. Again, just because the person is not the most together cognitively, does that necessarily make them unable to give informed consent? Outside of the internet - in the "real" world of studies, it is my assumption, maybe it is wrong, that it is not the case. True, you have to have it together a certain amount -- but I think the fact the person is able to search then net, find PB, and post demonstrates some togetherness. But that is one level of togetherness - a quiz is another, I believe, much higher. I'm sticking to this because I believe it is important we come up with a better method. For just these folks -- in need of the information here, in a response to their question -- their personal need.
akc
Posted by Dr. Bob on November 1, 2001, at 13:42:45
In reply to Re: Change?, posted by medlib on October 31, 2001, at 0:25:25
> One alternative would be to omit the terms "quiz" and "100%" entirely. The final paragraph of information could lead into a set of 5 or 6 questions with a statement such as, "In order to help us verify that you've read and understand this information, please answer the (#) questions below."
That's an idea, let me think about that...
> Questions themselves could be shortened in number and made more user-friendly by combining restatement of an important point with a related choice. For example:
> Q: The only "real" information required to register for as a member of PB is your valid email address. This address WILL / WILL NOT automatically be included in your posts, and WILL / WILL NOT be included if your post is included in a study.Hmm, that's interesting, too, combining questions and giving it more of a fill-in-the-blank feel... But what you're "restating" is currently a question itself...
> Linking the facts about payment into one sentence seems much more memorable than separating them. "There is NO charge for posting messages on PB, and NO payment is made when posts are included in a study."
That second piece is currently in the information, but not part of the quiz. You're not suggesting I add something to the quiz, are you? :-)
> the Q re deliberately misleading statements seems quite unnecesarily alarming. Unless it's to weed out paranoids, why introduce potential for conspiracy when it's not mentioned in the consent text? Dramatically stated wrong possibilities can be more memorable than duller correct facts.
But will people remember that it's wrong? This has in fact come up before; to some people, "research" connotes "manipulation".
> --Several studies have shown that info provided at the point of need is better remembered. Scoring Q-by-Q does that. (Test overviews seem more appropriate to competitive exams in which strategy may affect scores.)
> --Options presented in color are more easily noticed. Correct answers which turn green, wrong ones which turn red, and the relevant answer quote in blue below makes more of an impact.Doing it question by question, with color-coded feedback, would impart the information more effectively than just giving them a list of the questions they got wrong? :-)
Maybe I've taken too many of those competitive exams. :-) But for me it's not just strategy, it's also just nice to know what I'm dealing with. Like having an outline before starting to write.
> Another 2 cents worth
2 dollars at least! :-)
Bob
Posted by Jane D on November 2, 2001, at 0:28:35
In reply to Re: boo to the quiz, boo, posted by Dr. Bob on November 1, 2001, at 8:27:44
>
> That could be an argument *for* a quiz: if people show up and aren't cognating, then maybe it's better (though arguably somewhat paternalistic) if they *don't* just start posting right away...
>
> BobI was wondering when someone would bring that up. Of course, I could have raised it myself but I needed to pass the quiz first. :-)
Posting is not risk free. The subject IS stigmatizing no matter how much we argue it shouldn't be. Using your real name is something people need to think very hard and clearly about. If someone can't focus their thoughts enough to pass the quiz they probably should not be making that decision. This is not an "Ask the doctor" site where questions get an official answer but I've seen new posters who assume that it is. The more desperate and impaired a poster is the crueler it is to leave them hanging, waiting for an official answer that they are unlikely to get. The quiz does help make sure that people know that. Finally, and this applies to readers too, the answers are not screened and edited (not censored - a plus in my mind) and they are sometimes wrong but I have seen posters who seemed to assume that they were reviewed and sanctioned. Perhaps it is paternalistic - I'm not sure - but I think it's a good idea to make sure that people understand as much as possible about the nature of the board before posting.
There is one item that I'd like to see added, if not to the quiz, than to the headers of the pages (or at least the FAQ). You state "The only messages Dr. Bob takes responsibility for are his own." I'd like to see it made a bit more prominent that nobody else has an official role on the site.
I didn't see anything wrong with the format of the quiz myself. Remember our mantra: people who are unhappy post more. (And before anyone gets massively offended I am talking only about personal preferences in test styles here not ability.) Finally, didn't anybody figure out how easy it is to cheat on that test? What DID you spend your school years doing? Of course, figuring out how to cheat might imply competence to consent...
Jane
Posted by susan C on November 4, 2001, at 12:03:13
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 25, 2001, at 8:25:39
Dear Dr Dash Bob,
Ok, you got me to respond. I think I have found something, a perspective that has not yet been directly addressed.
Educational level, ie reading level. I was and still am particularly impressed with the intelligence level represented by the posters on this board. Their command of the english language shows advanced training and some posters disclose their professions. In general, when someone posts, they address their response to the level of the question. Sometimes not, as when a question is answered simply by a reference. Many a time I have ended up in the middle of a research paper totally lost because I have no clue as to some even fundamental science of how the brain works.
Now, I am getting off track. My comment about your 'quiz' is the language. I agree it could be simpler in format, but it could also be simpler in language.
The average reading level in the USA is about 5th grade, which is the level that newspapers and the Readers Digest is written. 25 million people, mostly males, have a reading level of less than third grade (I have done some volunteer work in literacy). Add to that English As A Second Language. This does not mean these people do not have access to the internet...
IMHO, unless you state that part of the goal of your research is to limit the participation to people who have college degrees or the equivilant, I would encourage you to simplify your language.
For those of us who have 'survived and thrived' in the academic environment, sometimes we don't see these things. I hope that clarifed something.
'you can't please all the people all the time'
mouse
susan C
Posted by Dr. Bob on November 7, 2001, at 13:22:36
In reply to Re: New informed consent procedure, posted by susan C on November 4, 2001, at 12:03:13
> I agree it could be simpler in format, but it could also be simpler in language.
>
> The average reading level in the USA is about 5th grade...That's a good point. The IRB requires that it be "in a language understandable to someone who reads at a 7th grade level". Word gives the "Information about Study" section before the quiz a Flesch-Kincaid Grade Level score of 7.1 and the quiz itself a 7.4 (to make them complete sentences, I used a single random answer for each question).
The "Agreement to Consent" section after the quiz, however, is directly from the IRB, so I don't have any control over it...
Bob
Posted by Dr. Bob on November 7, 2001, at 13:29:31
In reply to Quiz » Dr. Bob, posted by Jane D on November 2, 2001, at 0:28:35
> There is one item that I'd like to see added, if not to the quiz, than to the headers of the pages (or at least the FAQ). You state "The only messages Dr. Bob takes responsibility for are his own." I'd like to see it made a bit more prominent that nobody else has an official role on the site.
It's actually been there in the FAQ for a long time:
http://www.dr-bob.org/babble/faq.html#purpose
But I think it's a good idea to add it to the headers. Plus it's easy to do. So there it is! Thanks for the suggestion,
Bob
Posted by JohnX2 on November 14, 2001, at 3:47:24
In reply to Re: New informed consent procedure, posted by Dr. Bob on October 25, 2001, at 8:25:39
I'd like to know if my posts ever make it
into a journal study. Not that they're great
or anything. It would be interesting to know.
I'm not to wild about this new procedure, I
had to change my password and ID and pass the
"test" to get back to posting and helping
people.-john
> > [The] view ... of the Department of Health and Human Services ... is that research is "systematic investigation ... designed to develop or contribute to generalizable knowledge."
>
> > I'll submit this to [my IRB], and we'll see what they say.
>
> They have in fact deemed this research -- the "generalizable knowledge" is how online communities work and affect the mental health of their members -- and have approved it.
>
>
> > What I am envisioning is a warning message that new registrants would have to go "through" to register their name here--I am thinking that this step could create a moment of thought about this that could really help.
> >
> > What do you think?
>
> It's now considered research, so explicit informed consent -- just such a "moment of thought" -- is now required. As Noa suggested, I've incorporated this into the registration process. To be consistent, everyone, and not just new registrants, will need to consent.
>
> I'd be interested in feedback. If you don't want to consent to post something, just email me directly: dr-bob@uchicago.edu
>
> Bob
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