Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
Psychology Independent Study and IS by Dissertation Proposal, Ethics and
Risk Assessment
Independent Studies projects, like all other research projects in psychology, have to be carried
out in accordance with British Psychological Society Ethical Principles for Conducting
Research with Human Participants. We will monitor the ethical conduct of your IS project
throughout the duration of the project, starting when you first submit the IS Proposal Form.
Work with your IS supervisor to complete the IS proposal. You should discuss a draft proposal
with them well before the deadline, and send them the final draft a few days before the
deadline so they can let you know they are happy with it before you submit it.
It is important that you carefully follow the guidance notes that accompany this form as
omission of essential information will lead to a delay in gaining ethics approval.
Details of how to submit the form (and when) will be made available on the module
homepage.
Your name:
Student ID:
Unimail address:
Address:
Telephone number:
Programme (please
delete as appropriate)
BSc Psychology
Module name and code
(please delete as
appropriate)
Independent Study (6PS990, campus)
JHS
Independent Study (6PS898, online)
IS by Dissertation (6PS899, campus)
IS by Dissertation (6PS889, online)
Name of supervisor
Provisional title of proposed study
1. What is the aim of your study? What are the objectives for your study?
2. Explain the rationale for the study (refer to relevant research literature in your response).
3. Provide an outline of study design and methods.
4. What resources will you require?
5. Please provide references for any sources cited in sections 2 & 3 above.
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Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
6. Please provide a detailed description of the study sample, covering selection, sample profile,
recruitment and if appropriate, inclusion and exclusion criteria.
7. Are payments or rewards/incentives going to be made to the participants (not including
Participation Points)? If so, please give details below.
8. Does your project involve working with people under the age of 18 or vulnerable adults? Please
consult the Policy for Psychology Research Projects with Vulnerable Participants or speak to your
supervisor or the module leader if you are unsure. If “yes” please answer the questions below. If “no”
please continue to question 10.
9. Can you confirm the following? Please delete as appropriate
I will at no time be alone in a room with a participant: Yes, I can confirm this / No, I cannot confirm this
I do not have any convictions that would disqualify me from undertaking a research project involving work
with anyone under the age of 18: Yes, I can confirm this / No, I cannot confirm this
Do you already have a CRB check certificate (or Certificate of Good Conduct if based outside the U.K.)?
Yes / No
10. Do you propose to carry out your project partly in non-English language? Yes / No
If so, please give details (for further information please consult the Independent Study Projects in nonEnglish Language document).
11. Please indicate how you intend to address each of the following ethical considerations in your
study. If you consider that they do not relate to your study please state “N/A”.
a. Consent:
b. Deception:
c. Debriefing:
d. Withdrawal from the investigation:
e. Confidentiality and anonymity:
f.
Protection of participants:
g. Observation research:
h. Giving advice:
i.
Research undertaken in public places:
j.
Data protection:
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Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
k. Animal Rights:
l.
Environmental protection:
12. Do you intend to request clearance from any other body/organisation? Please delete as
appropriate: Yes / No
If Yes, who?
13. Are there any further ethical implications arising from your proposed research? Please delete
as appropriate: Yes / No
If “yes” please give details below
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Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
RISK ASSESSEMENT FORM
This form must be completed before any work involving risk to health, safety or welfare is carried out.
Name (of person carrying out task)
Designation (of person carrying out task) e.g:
Student/Year
Task (Description of task being assessed
Start Date
End Date
Date (of making the risk assessment)
Location of task
Hazard and Risk: Definitions: A hazard is something with the potential to do harm (to people or property). Risk
is the likelihood of the potential for harm being realised. Look only for hazards which you could reasonably
expect to result in significant harm under the conditions in the workplace or in the field (i.e. Significant Risk)
Consider the activity or work area and identify if any of the hazards listed below are significant. Please highlight
those that are relevant
1
2
Fall of person
Fall of objects
7
8
Machinery
Tools/equipment
13
14
Electricity
Noise or vibration
19
20
Substances
High pressure
25
26
3
Tripping/Slipping
9
15
Hot/cold surfaces
21
Fire/explosion
27
4
Manual handling
10
16
Lighting
26
Violence
Repetitive work
11
17
Workstation
layout/space
Radiation
22
5
23
Housekeeping/waste
material
12
18
Temperature/weather
24
Confined
space
Buildings and
glazing
29
6
Mobile work
equipment
Mechanical
lifting
Display screen
equipment
Sharp objects
Drowning
Psychological
effects
Human error
Peripatetic/lone
working
Other(s)
30
WHO MIGHT BE HARMED? As well as yourself, others may be at risk because of the task that you are undertaking. Think
about who may be at risk as a result of your activity. E.g. *other laboratory users, * fellow students, *supervisors,
*staff/colleagues, *cleaners, *participants, *members of the public, *contractors, *maintenance personnel, *persons with you
in the field
LIST HERE ANYONE OR ANY GROUP OF PEOPLE WHO MAY BE AT RISK – State “N/A” if appropriate
(If the assessment is for a student project, you may need to write the name of the responsible adult accompanying the
student)
WHAT MEASURES ARE NECESSARY TO CONTROL (REDUCE) THE RISKS? – Only complete this
section if it is applicable to your project
If there are significant risks the following principles (in order) will help to ensure that the risks are adequately
controlled.
1 Remove the risk completely i.e., don't do the task, do something less risky. 2 Employ a less risky method of
obtaining the same results.
3 Prevent Access to the Hazard (e.g. by guarding.) 4 Make sure you are adequately informed of the risks and
trained to cope with them.
5 Organise work to reduce exposure to the hazard. 6 Be accompanied by an experienced person who can
manage the risks.
7 Use Personal Protective Equipment. 8 Provide emergency procedures. (Including first aid provision where
necessary.)
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Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
Hazards/Risks
(What could go wrong)
List here the control measures to be used to reduce
the significant risks to a tolerable or trivial level. (How
are you going to stop it going wrong?)
Level of risk after control
measure
High, Medium, Low
Refer to University Risk
Evaluation Matrix
WHAT STUDENTS NEED TO DO WHEN THE RISK ASSESSMENT FORM IS COMPLETED
It is of paramount importance that the information in the risk assessment is available to you during the
process to which it relates. HAVE A COPY WITH YOU.
1. Submit as part of the IS Proposal, Ethics and Risk Assessment document
2. Follow the recommendations and control measures made in the assessment.
3. If any of the conditions or procedures change, notify your supervisor immediately. A new
assessment must be made.
Appendices to the proposal and risk assessment
Attach on further pages below, but all in one document, the text of materials that will be used for the
project. These should include all the information that your participants receive, in the order that they
receive it, from the invitation to participate through to the debriefing. For example, this is likely to
include all of the following:
Invitation to participate
Consent form
Instructions to participants
Debrief information
In addition, the following may be included: questionnaires, interview schedules, test materials, focus
group/interview questions
What happens next?
Please ensure this document is submitted directly to your supervisor by the proposal deadline. It will be
reviewed first by your supervisor and, if necessary, the ethics committee.
You will receive written feedback on the ethics review in an email from your supervisor. This will tell
you that either:



Your proposal has been approved and your project may proceed
Your proposal has been approved conditionally and the project may proceed when your supervisor
has confirmed that certain conditions have been met
Partial resubmission of the proposal is required, with further information or documentation, which
will then be reviewed by the ethics committee
Full resubmission is required, and a revised proposal and accompanying materials will then be
reviewed by the supervisor and the ethics committee as necessary.
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Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
The information supplied is, to the best of my knowledge and belief, accurate. I clearly
understand my obligations and the rights of the participants. I agree to act at all times in
accordance with the British Psychological Society Ethical Principles for Conducting
Research with Human Participants (downloadable from www.bps.org.uk) and the
University of Derby Policy and Code of Practice on Research Ethics
(http://www.derby.ac.uk/research/ethics-and-governance/research-ethics-and-governance). In
addition, I understand that my supervisor and the IS module leader is entitled to monitor
and investigate the ethical conduct of Independent Studies projects at any stage in their
progress.
Can you confirm your agreement with this declaration? Please delete as appropriate:
Yes / No
Date of submission by applicant:
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Independent Study & IS by Dissertation Proposal, Ethics and Risk Assessment Form
For Supervisor use only:
Does this proposal require an additional review? Yes / No
(Please note that an additional review is essential if students answer “yes” to Qs 7, 8, 10, 12 or 13. In
addition, please request an additional review if you have any concerns regarding risk or ethics involved
in this project).
I believe there are no significant ethical issues and I am confident this study can be conducted:
Yes / No
(Please note that you can answer “yes” to this question even if you have requested an additional review)
Please provide any further details, as necessary in your correspondence with the module leader.
If you have answered “no” and “yes” to both of the above, respectively, please contact your IS student
and inform them of the outcome:


The proposal has been approved and the project may proceed
The proposal has been approved conditionally and the project may proceed when the supervisor has
confirmed that certain conditions have been met
If the proposal requires an additional review, following the review please contact your IS student and
inform them of the outcome:




The proposal has been approved and the project may proceed
The proposal has been approved conditionally and the project may proceed when the supervisor has
confirmed that certain conditions have been met
Partial resubmission of the proposal is required, with further information or documentation, which
will then be reviewed by the ethics committee
Full resubmission is required, and a revised proposal and accompanying materials will then be
reviewed by the supervisor and the ethics committee as necessary.
If the proposal requires an additional review please send this form to the module leader (t.hunt@derby.ac.uk)
along with any further information that you believe would help reviewers.
For record keeping purposes, it is important that you c-c the module leader into the email to your
students informing them of the outcome of their proposal.
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