Medical Student Research Program - Adviser Proposal Review

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Student Information

Class

Last Name

First Name

Today's Date

Faculty Research Adviser Information

Name (last, first, degree)

Email Address

Phone Number

Department

Address (if off-site)

Project Information

Project Title

Keywords (for data search purposes)

Review

Overall Goal of the MSR

Dr. George Harrell, the founding Dean of the Penn State College of Medicine, established the Medical Student Research (MSR) program as an integral part of the curriculum. The purpose of the MSR program is to promote, through a mentored research project, the development and application of critical thinking and problem solving skills that are fundamental to the integration of medical science and clinical care.

Students gain an understanding of the research process, limitations and variability of data, and the translation of research and critical thinking skills to clinical practice. We expect our students to be able to articulate a relevant research question, decide on appropriate methods to address the question, collect and analyze the data, reach proper conclusions, and write a scientific report summarizing their work, including implications for further inquiry and/or clinical practice.

How does this project meet the goals of the MSR program?

Briefly summarize the significance of the student's work in this field (if successful, where would you publish this work?)

What was the student's contribution to the origin and development of the research question?

Many students work on aspects of the project initiated by the advisor. Others develop their own research questions.

Human Subjects

Does this project involve human subjects in any manner (including surveys, charts, etc.)?

Has the student been added to your IRB protocol?

IRB Number

Pending

IACUC

Does this project involve any vertebrate animals?

Has the student completed appropriate training and OSHP screening?

Has the student been added to your IACUC protocol?

IRB Number

Pending

Others

Where will this project be performed?

IRB Number

Pending

Intellectual Property

Is this project part of an effort that involves further development of existing intellectual property, or is directed to developing new intellectual property?

Other than the U.S. government, are there intellectual property provisions associated with any of the project's funding or any materials or other resources that will be used?

IP Agreement

Please consider the circumstances further and indicate if you agree with the following

I understand that, according to Penn State Research Administrative Guideline 12, any intellectual property arising from the student's contribution belongs to the student. I do not believe that this arrangement would inappropriately distinguish this student from other students in my laboratory.

Please initial to indicate your agreement

Per my consultation with the Office of Research Affairs or the Office of Technology Development, fulfillment of obligations to sponsor(s) or sources of materials requires that the student assign his/her rights to any intellectual property arising out of the research to the university. I have discussed this with the student, and he/she has completed the appropriate assignment form (please attach the completed form).

Please initial to indicate your agreement

Completed Form

Working on this project would require the student to assign intellectual property rights to the university or to an external sponsor. I have discussed this with the student, and he/she has completed the appropriate form to transfer intellectual property rights to the university or external sponsor (please attach the completed form).

Please initial to indicate your agreement

Completed Form

Other

Feel free to include any additional comments here

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Agreement

I have reviewed this proposal and attest that the resources needed by the student to complete their part of the study within the timeframe indicated will be made available.

Your name

Entering your name and submitting the form serves in lieu of a physical signature. A copy of the information will be emailed to you for your records.

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Contact Information