L&LS Ethics Approval Form (MS Word , 106kb)

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Language & Linguistic Science ethics committee
research approval request form
If you are collecting any data from human subjects, you must fill out this form. You may not
begin data collection until you receive notification that your research has been approved.
It is your responsibility to familiarise yourself with the University's Code of practice and
principles for good ethical governance. There is a set of Guidance Notes accompanying this
form; it is recommended that you read through the notes first to help you plan your
responses to the questions, and to reflect on any ethical questions raised by your planned
research. The particulars of your answers to some of the questions may differ depending on
the research design of your individual project, but the Guidance Notes offer advice and in
some cases sample wording for answers. If you have any additional queries, do not hesitate
to contact your supervisor or the Chair of the Ethics Committee at <linguisticsethics@york.ac.uk>
NB: If you are collecting data from NHS patients or staff, or Social Service users or staff, you
will need to apply for approval through the Integrated Research Application System (IRAS) at
https://www.myresearchproject.org.uk/Signin.aspx
 Staff: please fill in the IRAS form first and send your completed form to L&LS
 Students: applications for approval through IRAS should normally be pre-reviewed
by the L&LS ethics committee
Completed forms should be submitted to the L&LS Ethics Committee as follows:
1. One electronic copy of the compliance declaration and one electronic copy of the
Ethics form including the Information sheet and consent form entitled “SURNAME
ethics submission MONTH YEAR” via email to <linguistics-ethics@york.ac.uk> Any
other questionnaire submitted should be pasted at the end of the ethics form to
create a single submitted document.
2. One signed Compliance form, to be submitted to the department office, once
approval has been granted.
Initial decisions will normally be made and communicated within two weeks of the receipt of
your complete application.
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SUBMISSION FORM
1a. Please provide the following details about the principal investigator at YORK
Name of Applicant:
Email address:
Telephone:
Staff/Student Status:
Dept/Centre or Unit:
Head of Department:
Chair of Dept. Research
Committee:
Language & Linguistic Science
Peter Sells, peter.sells@york.ac.uk
Dunstan Brown, dunstan.brown@york.ac.uk
1b. Any other applicants (for collaborative research projects)
Name of Applicant:
Email address:
Telephone:
Staff/Student Status:
Dept/Centre or Unit:
Head of Department:
Head of Research:
(if applicable)
2. (STUDENTS ONLY) Please provide the following supervisory details for your
project:
PLEASE NOTE: By submitting this form, you confirm that your supervisor has approved the
summary of your research proposal and the participant information sheet.
1st Supervisor, email
address
2nd Supervisor, email
address
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3. Please provide the following details about your project:
Title of Project:
Date of Submission to
L&LS Ethics Committee:
Project Start Date:
Duration:
Funded Yes/No:
If funded, give source:
External Ethics Board
Jurisdictions:
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4.
Summary of research proposal
4.1 Aims and objectives of the research
Please outline the questions or hypotheses that will be examined in the research.
(PLEASE DO THIS IN A WAY THAT WILL BE COMPREHENSIBLE TO NON-LINGUISTS.)
[500 words max.]
4.2 Methods of data collection
Outline how the data will be collected from or about human subjects.
4.3 Recruitment of participants
How many participants will take part in the research? How will they be identified and
invited to take part in the study? How will informed consent be obtained?
4.4 Participant information sheets and consent forms
Please attach (to the end of this form):
(1) the project information sheet to be given to all participants and
(2) the informed consent form (n.b. failure to submit these documents will result in
your application being returned without decision).
i. Please confirm you have included the participant information sheet and the consent
forms to be given to all participants with your submission to L&LS. If these have not been
attached, please explain why this is the case.
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ii. Are the results to be given as feedback or disseminated to your participants (if yes
please specify when, in what form, and by what means)
4.5 Anonymity
In most instances the Committee expects that anonymity will be offered to research
subjects. Please set out how you intend to ensure anonymity. If anonymity is not being
offered please explain why this is the case.
4.6 Data Collection
All personal and sensitive data must be collected and stored in accordance with the Data
Protection Act 1998. Please set out all the types of data you will be collecting (e.g.
interviews, questionnaires, recordings)
i. Please detail type(s) of data.
ii. Where is the data to be collected and where will it be stored electronically?
Please describe what protection there will be in relation to electronic storage.
iii. Where is the data to be stored in paper form? Please describe how this will be
protected.
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iv. At what point do you propose to destroy the data?
v. If you are sharing data with others outside your department, what steps are you taking
to ensure that it is protected?
vi. If the data is to be exported outside the European Union, what steps are you taking to
ensure that it is protected? (Note: you must identify how you will comply with Data
Protection Act 1998 requirements.)
4.7 Perceived risks or ethical problems
Please outline any anticipated risks or ethical problems that may adversely affect any of
the participants, the researchers and or the university, and the steps that will be taken to
address them. (Note: all research involving human participants can have adverse
effects.)
i. Risks to participants (e.g. emotional distress, financial disclosure, physical harm,
transfer of personal data, sensitive organisational information…)
ii. Risks to researchers (e.g. personal safety, physical harm, emotional distress, risk of
accusation of harm/impropriety, conflict of interest…)
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iii. University/institutional risks (e.g. adverse publicity, financial loss, data protection…)
iv. Financial conflicts of interest (e.g. perceived or actual with respect to direct payments,
research funding, indirect sponsorship, board or organisational memberships, past
associations, future potential benefits, other…)
v. Please draw the committee’s attention to any other specific ethical issues this study
raises.
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5. Ethics checklist
Please confirm that all of the steps indicated below have been taken, or will be taken, with
regards to the above named project submitted for ethical approval. If there are any items
that you cannot confirm, or are not relevant to your project, please use the space provided
below to explain.
Please tick if true, otherwise leave blank:
☐
☐
☐
☐
☐
☐
☐
☐
☐
Informed consent will be sought from all research participants where appropriate
All data will be treated anonymously and stored in a secure place
All Relevant issues relating to Data Protection legislation have been considered
(see http://www.york.ac.uk/recordsmanagement/dpa/)
All quotes and other material obtained from participants will be anonymised in all
reports/publications arising from the study where appropriate
All reasonable steps have been taken to minimise risk of physical/ psychological harm
to project participants.
All reasonable steps have been taken to minimise risk of physical/mental harm to
researchers
Participants have been made aware of and consent to all potential futures uses of
the research and data
With respect to indemnity Sue Final (University IP Manager e-mail: sue.final@york.ac.uk)
has been made aware of the research, where appropriate
There are no known conflicts of interest with respect to finance/funding
If applicable, please explain in the space below why any of the above items have not yet
been confirmed:
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6. Other comments
Are there any issues that you wish to draw to the Committee’s attention (it is your
responsibility to draw the committee's attention to any ethical issues that may be of
perceived or actual interest)?
7. Submission Checklist for Applicants
Finally, please sign the form and ensure that all of the indicated documents below are sent
electronically to via email to <linguistics-ethics@york.ac.uk >.
☐ L&LS Application form
☐ Consent form for participants
☐ Information Sheet for participants
8. Signed undertaking
In submitting this application I hereby confirm that there are no actual or perceived
conflicts of interest with respect to this application (and associated research) other than
those already declared.
Furthermore, I hereby undertake to ensure that the above named research project will meet
the commitments in the checklist above. In conducting the project, the research team will be
guided by the Social Research Association’s/AHRC’s/ESRC’s ethical guidelines for research.
……………………………………………...………….. (Name of Lead Researcher/Principal Investigator)
……………………………………….. (Date)
……………………………………………...………….. (Name of Supervisor (if relevant))
……………………………………….. (Date)
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