Akmi Metropolitan College Research Generic Ethical Approval Application Form

for Undergraduate Students
This completed form has to be approved by the Queen Margaret University Research Ethics Committee Complete this form if you are an undergraduate student who plans to undertake a research project which re uires ethics approval via the !MC and QMU Ethics Review "rocedure# $our %upervisor decides if ethics approval is re uired and& if re uired& what procedure must be followed& and if your proposed project should be classed as 'low risk( or potentially 'high risk(# This form should be accompanied& where appropriate& by all )nformation %heets * Covering +etters * ,ritten %cripts which you propose to use to inform the prospective participants about the proposed research& and*or by a Consent -orm where you need to use one# Once you have completed this research ethics application form in full and other documents !here appropriate check that your name the title of your research pro"ect and the date is contained in the footer of each page# $f your Supervisor has classed the pro"ect as %lo! risk&' • Email this form& together with other documents where applicable& to your %upervisor. and • %ign and date Anne( ) of this form and provide a paper copy to your %upervisor# $mportant *ote for Supervisors' -ollowing the ethics review the %upervisor must provide the academic department(s Ethics !dministrator with a copy of the 'low risk( research ethics application that s*he reviewed and a completed Ethics Reviewer(s Comments -orm indicating the ethics decision that s*he took in relation to it# The Ethics Reviewer(s Comments -orm can be downloaded here/ !!!#sheffield#ac#uk+ris+other+gov, ethics+ethicspolicy+further, guidance+universityprocedure-+revie!ersc The Ethics !dministrator reserves the right to consult the Chair of the academic department(s Ethics Review "anel 0or e uivalent1 of s*he has concerns that projects classed as low risk should in fact have been classed as potentially high risk# $f your Supervisor has classed the pro"ect as potentially %high risk&' • Email this form& together with other documents where applicable& to your department(s Ethics !dministrator. and • !sk your %upervisor to sign and date Anne( - of this form and provide a paper copy of it to your department(s Ethics !dministrator# Ethics !dministrators are listed at/ www#sheffield#ac#uk*polopoly2fs*3#443567*file*Ethics8!dministrators#pdf

Title of research project: A2. )f you have marked bo<es marked 7 then you also need to obtain confirmation that appropriate University insurance is in place# To do this email insurance=shef#ac#uk and re uest a copy of the 'Clinical Trial )nsurance !pplication -orm(# )t is recommended that you familiarise yourself with the University(s Ethics "olicy >overning Research )nvolving ?uman "articipants& "ersonal 9ata and ?uman Tissue before completing the following uestions# "lease note that if you provide sufficient information about the research 0what you intend to do& how it will be carried out and how you intend to minimise any . involves taking new samples of human biological material 0e#g# blood& tissue1 7 involves additional radiation above that re uired for clinical care 7 involves investigating a medical device 7 . /ostgraduate. Name of Student: 9epartment/ *ame of Supervisor/ Email/ Tel#/ A4# /roposed /ro"ect 2uration' %tart date/ End date/ A5# Mark %6& in one or more of the follo!ing 3o(es if your research' involves adults with mental incapacity or mental illness involves prisoners or others in custodial care 0e#g# young offenders1 involves children or young people aged under 3: years involves using samples of human biological material collected before for another purpose involves taking new samples of human biological material 0e#g# blood& tissue1 7 involves testing a medicinal product .University Research Ethics Application Form for Undergraduate .ethics+ethicspolicy A1.0aught Students $ confirm that $ have read the current version of the University of Sheffield %Ethics /olicy Governing Research $nvolving 1uman /articipants /ersonal 2ata and 1uman 0issue& as sho!n on the University&s research ethics !e3site at' !!!#sheffield#ac#uk+ris+other+gov.

risks1& this will help the ethics reviewers to make an informed judgement uickly without having to ask for further details# .

A8# i# 9riefly summarise' 0he pro"ect&s aims and o3"ectives' 0this must be in language comprehensible to a lay person1 ii# 0he pro"ect&s methodology' 0this must be in language comprehensible to a lay person1 A:# .hat is the potential for physical and+or psychological harm + distress to participants< A=# 2oes your research raise any issues of personal safety for you or other researchers involved in the pro"ect< 0especially if taking place outside working hours or off University premises1 A># $f yes e(plain ho! these issues !ill 3e managed# 1o! !ill the potential participants in the pro"ect 3e' i# $dentified< .

ii# Approached< iii# Recruited< A?# .ill informed consent 3e o3tained from the participants< $E% $f informed consent or consent is *O0 to 3e o3tained please e(plain !hy# -urther guidance is at/ www#sheffield#ac#uk*ris*other*gov8 ethics*ethicspolicy*policy8notes*consent @ A A?#)# This uestion is only applicable if you are planning to obtain informed consent/ 1o! do you plan to o3tain informed consent< @i#e# the proposed process<A' A)B# .hat measures !ill 3e put in place to ensure confidentiality of personal data !here appropriate< A))# .ill financial + in kind payments @other than reasona3le e(penses and compensation for timeA 3e offered to participants< 0)ndicate how much and on what basis this has been decided1 .

ill the research involve the production of recorded media such as audio and+or video recordings< $E% @ A A)-#)# This uestion is only applicable if you are planning to produce recorded media/ 1o! !ill you ensure that there is a clear agreement !ith participants as to ho! these recorded media may 3e stored used and @if appropriateA destroyed< >uidance on a range of ethical issues& including safety and well8being& consent and anonymity& confidentiality and data protection( are available at/ www#sheffield#ac#uk*ris*other*gov8ethics*ethicspolicy*policy8notes For Undergraduate .A)-# .0aught Students Student 2eclaration @0he student completes Anne( ) if the Supervisor has classed the student&s proposed research pro"ect as %lo! risk&A 0he Supervisor needs to receive an electronic copy of the form and other documents !here appropriate plus a signed dated paper copy of this Anne( ) %the Student 2eclaration&# -ull Research "roject Title/ insert here $n signing this Student 2eclaration $ am confirming that' . /ostgraduate.

if s+he has classed the student&s proposed research pro"ect as potentially %high risk&A 0he Ethics Administrator needs to receive an electronic copy of the form and other documents !here appropriate plus a signed dated paper copy of this Anne( .• • • The research ethics application form for the above8named project is accurate to the best of my knowledge and belief# The above8named project will abide by the University(s '>ood Research "ractice %tandards(/ www#sheffield#ac#uk*ris*other*gov8ethics*good The above8named project will abide by the University(s 'Ethics "olicy >overning Research )nvolving ?uman "articipants& "ersonal 9ata and ?uman Tissue(/ www#sheffield#ac#uk*ris*other*gov8ethics*ethicspolicy %ubject to the above8named project being ethically approved ) undertake to adhere to any ethics conditions that may be set# ) will inform my %upervisor of significant changes to the above8named project that have ethical conse uences# ) will inform my %upervisor if prospective participants make a complaint about the above8named project# ) understand that personal data about me as a researcher on the research ethics application form will be held by those involved in the ethics review process 0e#g# my %upervisor and the Ethics !dministrator1 and that this will be managed according to 9ata "rotection !ct principles# $ understand that this pro"ect cannot 3e su3mitted for ethics approval in more than one department and that if $ !ish to appeal against the decision made this must 3e done through the original department# • • • • • @ame of %upervisor/ @ame of student/ insert name insert name sign here Signature of student' 2ate' insert date For Undergraduate .%the Supervisor 2eclaration&# .0aught Students Supervisor 2eclaration @0he Supervisor completes Anne( . /ostgraduate.

-ull Research "roject Title/ insert name $n signing this Supervisor 2eclaration $ am confirming that' • • • The research ethics application form for the above8named project is accurate to the best of my knowledge and belief# The above8named project will abide by the University(s '>ood Research "ractice %tandards(/ www#sheffield#ac#uk*ris*other*gov8ethics*good The above8named project will abide by the University(s 'Ethics "olicy for Research )nvolving ?uman "articipants& 9ata and Tissue(/ www#sheffield#ac#uk*ris*other*gov8ethics*ethicspolicy %ubject to the above8named project being ethically approved ) will undertake to ensure that the student adheres to any ethics conditions that may be set# The student or the %upervisor will undertake to inform the Ethics !dministrator of significant changes to the above8named project that have ethical conse uences# The student or the %upervisor will undertake to inform the Ethics !dministrator if prospective participants make a complaint about the above8named project# ) understand that personal data about the student and*or myself on the research ethics application form will be held by those involved in the ethics review process 0e#g# the Ethics !dministrator and*or reviewers1 and that this will be managed according to 9ata "rotection !ct principles# $ understand that this pro"ect cannot 3e su3mitted for ethics approval in more than one department and that if $ and+or the student !ish to appeal against the decision made this must 3e done through the original department# • • • • • @ame of %upervisor/ @ame of student/ insert name insert name sign here Signature of Supervisor' 2ate' insert date .

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