This template is provided as a guide. You may expand the spaces between each heading as required. Please remove
any headings that are not relevant to your proposal or add any new headings that are required by your proposal, but are
not available here.
It is suggested that you retain the order of the headings. However, within each heading, you may rearrange the order of
the information that you consider appropriate. Please note that the proposal should be as concise and precise as
possible. Also, please reference appropriately.
Please use either of the following fonts: Arial (10) or Times New Roman (11 or 12). Do not use ALL CAP or bold font,
except for title and headings. Format your documents and remove any extra spaces between words, paragraphs or
pages. Delete any instructions or any irrelevant information from your final proposal. Please format your proposal and
remove any gaps or black spaces or blank pages.
Ensure that the file does not exceed 5MB in size.
RESEARCH STUDY PROPOSAL
1. Title of the project.
2. Project summary.
This should not exceed 1 page and should contain brief, but sufficient information on the project i.e. equivalent to an
abstract.
3. 1 Main goal and objectives.
State the goal and objectives of the project.
3.2 Secondary objectives (if any).
These are subsidiary objectives that could be studied during the course of the project but are not the main objectives of
the study; they are optional.
4. Research question(s).
State the specific research questions that will enable the achievement of each objective, which will finally lead to
achievement of the goal.
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5. Methods.
Please address the following. If it helps, you may reorder sequence of these headings or blend them together to improve
readability.
Study design and study methodology: State what study design is applicable to this study and explain how the study
will be conducted.
Setting: Please give information on the location and contexts of the setting where the study will be conducted.
Study population and study subjects: Please state the study population and study subjects and explain clearly the
inclusion and exclusion criteria.
Sample size and sampling techniques: State the sample size that is required for the study. For quantitative studies,
please show the sample size calculation. For qualitative studies, justify your sample size. Please explain how the study
subjects will be selected and how they will be recruited into the study.
Study variables including their definitions and their measurements (the ways in which they will be measured):
Please explain all study variables and include both dependent and independent variables as well as covariates.
Study Techniques/ methods and study tools: Specify tools to be used for data collection. Please describe what
measures are to be used to test the applicability, validity and reliability of the tools. If using already validated tools,
please indicate appropriate references.
Describe what data will be collected and how they will be collected.
6. Data management and analysis plan.
Describe the analysis and management plan. This is not merely stating which statistical package will be used, but to
explain how the research questions will be answered, which variables are to be analysed, what information will be
produced etc Explain how the data will be stored and for how long, how confidentiality will protected etc.
7. Dissemination of results and publications plan.
8. Expected direct products.
What will be the products (outputs) of this study?
9. Implications of study results on patient safety practice and/or interventions.
Expected results and potential contribution of the project to patient safety.
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10. Risks, assumptions and quality assurance.
State the assumptions upon which this study is based. Discuss the difficulties or risk that may affect the implementation
of the projects. Explain possible solutions to deal with these difficulties and outline strategies for ensuring the quality of
the study.
11.1 Ethical considerations.
Illustrate that your research proposal is acceptably safe, respect the rights of participants, treat data with confidentiality
etc. Discuss any other issues that are likely to raise ethical concerns and how you will address them.
11.2 Informed consent form.
If your study involves human participants, describe how you plan to obtain informed consent from the research
participants. If applicable, please attach the informed consent form.
12. Project plan and duration.
Provide an outline of the project plan. Indicate when the project will commence, specify the time that each phase of the
project is likely to take and specify what the milestones are and when they will be achieved.
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13. Timelines:
Please indicate key activities to be conducted and/or milestones to be achieved and when they are expected. The project should be limited to 18 months at the most. The
table below is illustrated as a guide. You may use other methods to illustrate your work plan.
Please add more lines as needed or remove unused lines as appropriate.
Key milestones
MONTH (from project commencement)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Progress report
(required)
Final report
(required)
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14.1 Budget*
Please provide a detailed breakdown of the funds requested, along with a justification for each item. Please add or remove lines as needed.
Budget item
Status in
institution*
(add more lines as needed)
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Local salary
scale of
institution
% of full-time
devoted to the
project
6 months
US $
12 months
US $
18 months
US $
Total
US $
Personnel**
Scientific staff (name and functional title)
1.
2.
3.
Technical staff (name and functional title)
1.
2.
3.
Other staff (name and functional title)
1.
2.
Subtotal
# Total budget cannot exceed $US 25 000. Please consult the Conditions of Grants for admissible expenses.
* Indicate for each employee whether or not he/she receives a regular salary from the institution.
**Consult TSA terms and condition before completing the budget form
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Budget page 2
Items below are provided as a guide. Items can be added or deleted as appropriate.
Budget item
(add more lines as needed)
2
6 months
US $
12 months
US $
18 months
US $
Total
US $
Supplies
(add sub-items as needed)
3
Subject costs
Costs of transportation for study
participants
4 Travel of project personnel
(specify)
5 Equipment*
Equipment
Packing, freight and insurance costs
Equipment maintenance
6 Other costs (specify)
* Equipment costing up to US$ 1 000 each must provide details of all supplies required. Items costing over
US$1 000; include specifications, packing, freight and insurance costs. Attach additional sheets as necessary.
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7. Budget Summary
6 months
US $
12 months
US $
18 months
US $
Total
US $
Personnel (1)
Supplies (2)
Subject costs (3)
Travel of project personnel (4)
Equipment (5)
Other costs (6)
GRAND TOTAL
* Where applicable, please indicate the exchange rate used to convert local expenses into US$
14.2 Budget justification.
Discuss and justify the costs stated in the budget table. State the value of the project costs in local currency and how
they compare with other similar projects conducted in the same areas.
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