Psychology 3100 Class Project Form (Version of June 25, 2014)
Please note: If you intend to use the results of your project to “develop or contribute to generalizable
knowledge” [45 CFR 46.102(d)], your project must be reviewed and approved by the Clemson
University IRB prior to implementation. Clemson University IRB Website
Approved
► Research may begin as of the date of determination listed below.
Not approved
Printed Name of Reviewer: ___________________________________
___________________________________
Signature
______________________
Date of determination
►Research Title
►Principal Investigator
(The PI must be a Faculty Instructor)
Name:
Signature:
Date:
►Graduate Student Instructor
(if applicable)
Name:
Signature:
Date:
►Undergraduate Student Investigator
Name:
Signature:
Date:
►Undergraduate Student Investigator
Name:
Signature:
Date:
►Undergraduate Student Investigator
Signature:
►Class Project Dates
Name:
Date:
Anticipated start date:
Anticipated end date:
(Projects are approved for one semester only.)
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Screening questions: If you check Yes to any of the questions below, your research will not be
approved as a Psychology 3100 project.
Does any part of the research require that participants be deceived?
Yes
No
Will the research pose more than minimal risk; that is, will it expose human
participants to discomfort or stress beyond the levels encountered in daily life?
Yes
No
Will you ask participants about illegal activities (a category that includes
drinking by persons under 21 years of age)? Will you focus on topics of a
highly personal and private nature (e.g., sexual behavior, sexuality, alcohol
and/or drug use)?
Yes
No
Will fetuses, pregnant women, or individuals involuntarily confined or detained
in penal institutions (or their substitutes) be participants in the study?
Yes
No
Will minors (people under the age of 18) be participants in the study?
Yes
No
Will identifiable private information (e.g., educational or medical records) be
collected from other sources?
Yes
No
1. Study Purpose: In non-technical terms, provide a brief description of the purpose of the study.
Description:
2. Study Sample: (Groups specifically targeted for the study)
Describe the participants you plan to recruit and the criteria used in the selection process. Indicate if
there are any special inclusion or exclusion criteria.
Description:
Age range of participants:
Projected number of participants:
University students
Educationally / economically disadvantaged *
Employees
Persons incompetent to give valid consent *
Military personnel
Other–specify:
*State need for using this type of participant:
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3. Study Locations:
Clemson University
Other University / College
Other – specify
You may need to obtain permission if participants will be recruited or data will be obtained through
schools, employers, or community organizations. Are you required to obtain permission to gain
access to people or to access data that are not publicly available? If yes, provide a research site
letter from a person authorized to give you access to the participants or to the data.
Research Site Letter(s) are not required.
Research Site Letter(s) are attached.
Research Site Letter(s) are pending and will be provided when obtained.
4. Recruitment Method:
Describe how research participants will be recruited in the study. How will you contact them?
Attach a copy of any material you will use to recruit participants (e.g., advertisements, flyers,
telephone scripts, pitches on Facebook, on other social media sites, or via email, cover
letters, or follow-up reminders).
Description:
5. Participant Incentives:
a. Will you pay participants?
Amount: $
Yes
No
When will money be paid?:
b. Will you give participants incentives / gifts/reimbursements?
Yes
No
Describe incentives / gifts/reimbursements:
Value of incentives / gifts/reimbursements: $
When will incentives / gifts/reimbursements be given?:
NOTE: Credit is NOT available for Psychology 3100 projects through the SONA system.
6. Informed Consent:
Attach a copy of the informational letter you plan to provide to your participants. A template for
Psychology 3100 informational letters is available at http://www.clemson.edu/psych/ugrad/psych310-resources/
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7. Procedures:
a. What data will you collect?
b. How will you obtain the data (e.g., surveys, interviews, experimental procedures)?
c.
How much time will it take to complete the survey, experimental procedure, etc.?
d. How many data collection sessions will be required? Will this include follow-up sessions?
e. How will you collect data?
in-person contact
telephone
snail mail
email
website
other, describe
Please include copies of surveys, interview questions, or data sheets for your
experiment or observation. If survey or interview questions have not been fully
developed, provide information on the types of questions to be asked, or a description of
the main issues that will be covered in the survey / interview.
f. Will you audio record participants?
g. Will you video record participants?
h. Will you photograph participants?
Yes
Yes
Yes
No
No
No
8. Protection of Anonymity: Describe the security measures you will take to protect the anonymity
of the information obtained. Will participants be identifiable either by name or through demographic
data? Where will the data be stored and how will it be secured? Who will have access to the data?
(Because data from all research projects should be retained by the investigator, we do not offer to
protect anonymity by destroying raw data.)
Description:
Submission Instructions: Please submit this printed form with your signature(s) to your
Psychology 3100 instructor, along with your CITI training certificate(s), your informational
letter, your recruitment flyer or social media pitch, and all materials that participants will see
(surveys, instructions, experiment sheets, etc.).
After your instructor approves the project, a copy of this application will be filed in the
Psychology Department office.
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