University Research Ethics Committee FACULTY/DEPARTMENTAL SUB-COMMITTEES Application for Ethics Review of Undergraduate and Taught Postgraduate Programme Dissertations/Projects For student dissertations/projects that involve human participants, their tissue and/or their data Section 1: Self-Certification (For Supervisor Use Only) tick () as appropriate Yes No Have you received University Training in Research Ethics? Will the project involve only healthy adult participants completing a questionnaire or participating in an interview / discussion group on a non-sensitive subject? If your answer to both questions above is ‘YES’ then you may be able to ’ Self-Certify’ this research. If your answer to either question above is ‘NO’ then you cannot ‘Self-Certify’ this research. This application is for an undergraduate project. This application is for an MSc/MA project. V2/10/14 1 Section 2: Project Details (To Be Completed by Student) Faculty/Department Project Title Name of Supervisor Supervisor’s email address Name of student Project Start Date Insert the date when you expect to start data collection Project End Date Insert the submission deadline for your final Dissertation/Project Report Project Aims Provide a brief summary of your research topic and the aims of your study (max. 150 words). Please make sure that this section is written so that nonexperts in your academic discipline can understand what your project is about. V2/10/14 2 Project Description Describe the methods you will use in your study including study material and task(s). Attach questionnaires and/or examples of any other material to this form so that the Ethics Committee can see what your participants will be requested to work on. Describe your participant sample including any inclusion/exclusion criteria. Describe how and where you are going to recruit your participants. If your project is likely to raise any ethical issues or requires any particular ethical considerations, state here what they are and how you are going to deal with them. Provide an explanation here if the study title on your participant information leaflet and consent form is different from the project title on this ethics application form. Where will the project take place? State where data collection will take place. V2/10/14 3 Gatekeeper’s permission? tick () as appropriate If data collection takes place off campus, e.g., in schools, public buildings or business premises, you may need gatekeeper’s permission. Not applicable V2/10/14 I confirm that written gatekeeper’s permission will be obtained. 4 Section 3: Project & Participant Information (To Be Completed by Supervisor & Student) tick () as appropriate Yes No Will the project use human cells, tissues or fluids? If the answer is ‘Yes’ you will need to consider the ‘Human Tissue Act’. Will the project use live animals, animal cells, tissues or fluids? If the answer is ‘Yes’ you will need to consider the ‘Scientific Procedures Act’. Will the project genetically modify cells? If the answer is ‘Yes’ you will need to consider the Safety Regulations in this area of work. Will the project involve any other methodologies than questionnaires, interviews or focus groups? If the answer is ‘Yes’ you will need to obtain UoS faculty/departmental research ethics subcommittee approval. Does the project address any sensitive topics? If the answer is ‘Yes’ you will need to obtain UoS faculty/departmental research ethics subcommittee approval. Will all research participants be ‘healthy’ adults? If the answer is ‘No’ you will need to obtain UoS faculty/departmental research ethics subcommittee approval. Will the project involve participants under the age of 16 yrs? If the answer is ‘Yes’ you will need to obtain UoS faculty/departmental research ethics subcommittee approval. Will any of the participants be classified as vulnerable adults? If the answer is ‘Yes’ you will need to obtain UoS faculty/departmental research ethics subcommittee approval. Will participants be likely to lack mental capacity to consent to taking part in the project? If the answer is ‘Yes’ you may also need ethical review from an NHS research ethics committee. Will any of the participants be NHS patients? If the answer is ‘Yes’ you may also need ethical review from an NHS research ethics committee. Will any of the participants undergo an invasive procedure? If the answer is ‘Yes’ you may also need ethical review from an NHS research ethics committee. Will data collection take place via the internet? If the answer is ‘Yes’ you should conduct your study in compliance with the British Psychological Society (2013). Ethics Guidelines for Internet-mediated Research. http://www.bps.org.uk/system/files/Public%20files/inf206-guidelines-forinternet-mediated-research.pdf V2/10/14 5 V2/10/14 6 Yes No I confirm that I have considered the professional research ethics code relevant to my academic discipline. Please insert title of the document below ………………………………………………………………………. I confirm that I shall conduct my study in compliance with the professional ‘Ethics Code’ named above and the ‘University of Sunderland Research Ethics Principles’ http://www.sunderland.ac.uk/images/Research%20Ethics%20Principles.pdf I have attached copies of Participant Information Leaflet Study Material e.g., questionnaires, examples of interview themes, sample questions of a self-developed questionnaire, examples of any material presented to participants Consent Form(s) If applicable Student’s signature: Date: Supervisor’s signature: Date: Important to Note: Applications must be submitted electronically by project supervisors. o Details and deadlines for submission can be obtained from the University Research Ethics Committee web site www.sunderland.ac.uk/research/researchservices/governanc e/researchethics/#d.en.51507 Students are not allowed to start data collection before ethics approval has been obtained. V2/10/14 7