The code block below illustrates how one might use # and // as comments in your logic and calculations.

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The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

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Required format:

sPEwPrq6b9NrbBaCx2hbKcsP3vPnWFJijZRufNZd8KQSHS6Pk77dH3SyMkCssv

DART Research Interest Form

Please complete all items below. This information will be used to help match your interests with potential research opportunities within our program.

Name:

* must provide value

Are you at least 18 years old?

* must provide value

Yes

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Are you a US citizen?

* must provide value

Yes

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Do you hold a VISA?

* must provide value

Yes

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If yes, what is the expiration date?

* must provide value

M-D-Y

Explain any additional considerations or sponsorship requirements:

* must provide value

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Current Institution:

* must provide value

Current Training Level:

* must provide value

Email Address:

* must provide value

Phone Number:

* must provide value

Anticipated Start Date:

* must provide value

M-D-Y

Anticipated End Date:

* must provide value

M-D-Y

Please enter the estimated number of hours that you could reasonably commit per week to research activities

In-person:
Virtual:

Please describe research experience you are seeking and your expectations:

* must provide value

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What are your interests within the scope of addiction?

* must provide value

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Do you have research experience?

* must provide value

Yes

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If yes, please describe in 2-3 sentences:

* must provide value

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List any statistical software packages with which you have experience (SPSS, SAS, R, etc.):

SPSS

SAS

Other

Please rate your level of comfort running SPSS:

0 1 2 3 4 5 6 7 8 9 10

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Please rate your level of comfort running SAS:

0 1 2 3 4 5 6 7 8 9 10

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Please rate your level of comfort running R:

0 1 2 3 4 5 6 7 8 9 10

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Please describe any other statistical software packages with which you have experience and rate from 0-10 your level of comfort:

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List any electronic data capture systems with which you have experience:

Excel

REDCap

Qualtrics

Other

Please rate your level of comfort using Excel:

0 1 2 3 4 5 6 7 8 9 10

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Please rate your level of comfort using REDCap:

0 1 2 3 4 5 6 7 8 9 10

reset

Please rate your level of comfort using Qualtrics:

0 1 2 3 4 5 6 7 8 9 10

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Please describe any other electronic data capture systems with which you have experience and rate from 0-10 your level of comfort:

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From 0-10, how comfortable are you with carrying out a background literature search?

* must provide value

0 1 2 3 4 5 6 7 8 9 10

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Indicate types of existing or planned faculty projects you are willing to work on (check all that apply):

* must provide value

Systematic review

Data extraction / analysis / chart review (Epic or other EMR data)

QI Survey

Patient-facing research activities

State or national-level data sets (e.g., overdose rates, substance use surveys, etc.)

Indicate current UMB access and research certifications you possess (check all that apply):

* must provide value

Not a UMB affiliate

UMB email

EPIC account

REDCap account

Cicero account

HIPAA training

CITI Human Subjects Training

Good Clinical Practice Training

Have you identified a mentor or faculty member you wish to work with?

* must provide value

Yes

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Please provide the name of the mentor/faculty member you want to work with:

* must provide value

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How did you hear about us?

* must provide value

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Please upload a current c.v. or resume and submit.

* must provide value

Upload file

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.