Scribd
Upload
21 views

03 - Ethical Approval Application Form

Uploaded by

abiel1402
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
21 views

03 - Ethical Approval Application Form

Uploaded by

abiel1402
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 11

Ethical Approval Application Form

1. ADMINISTRATION DETAILS

Researcher:

School/Research Centre/Programme (as applicable)

Title of Project:

Supervisor/Research Centre Director/Head of Department:

Date:

Type of research

Undergraduate Postgraduate Staff member External to DKIT

There is an obligation on the lead researcher to bring to the attention of the School Ethics Committee any issues with
ethical implications not clearly covered by this application form.
2. APPLICATION FORM CHECKLIST

Please complete the ethics application form below and provide additional information as attachments.

My application includes the following documentation: INCLUDED NOT APPLICABLE


(mark as YES) (mark as N/A)

Recruitment advertisement

Participant Information Leaflet

Participant Informed Consent form

Questionnaire/Survey

Interview/Focus Group Questions

Debriefing material

Evidence of approval to gain access to off-site location

Ethical Approval from external organisations.

If ethical approval from external organisations is pending give


details below

Details
3. PROJECT DETAILS

a) Lay description (Maximum 200 words)

Please outline, in terms that any non-expert would understand, what your research project is about, including what
participants will be required to do. Please explain any technical terms or discipline-specific phrases.
b) Research objectives (Maximum 150 words)

Please summarise briefly the objectives of the research,

c) Research location and duration

Location(s)/Population*

Research start date

Research end date

Approximate duration
* If location/Population other than DKIT campus/population, provide details of the approval to gain access to that
location/population as an appendix.

4. PARTICIPANTS

YES NO N/A

Do participants fall Minors (under 18 years of age)


into any of the
following special People with learning or communication difficulties
groups? Patients

People in custody

People engaged in illegal activities (e.g. drug-taking)

Have you given due consideration to the need for satisfactory Garda clearance?

5. SAMPLE DETAILS

Approximate number

Where will participants be


recruited from?

Inclusion Criteria

Exclusion Criteria

Will participants be remunerated, and if so in what form?


Justification for proposed sample size and for selecting a specific gender, age, or any other group if this is done in
your research.
6. RISKS TO PARTICIPANTS

a) Please describe any risks to participants that may arise due to the research. Such risks could include physical
stress, emotional distress, perceived coercion e.g. lecturer interviewing own students. Detail the measures and
considerations you have put in place to minimize these risks

b) What will you communicate to participants about any identified risks? Will any information be withheld from
them about the research purpose or procedure? If so, please justify this decision.
7. INFORMED CONSENT

YES NO N/A

Will you obtain active consent for participation?

Will you describe the main experimental procedures to participants in advance?

Will you inform the participants that their participation is voluntary and may be
withdrawn at any point?

If the research is observational, will you ask for their consent to being observed?

With questionnaires, will you give participants the option of omitting questions they
do not want to answer?

Will you tell participants that their data will be treated with full confidentiality and
that, if published, it will not be identifiable as theirs?

Will the data be anonymous?

Will you debrief participants at the end of their participation?

Will your project involve deliberately misleading participants in any way or will
information be withheld?

If you answer yes, give details and justification for doing this below.
a) Please outline your approach to ensuring the confidentiality of data ( that is, that the data will only be
accessible to agreed upon parties and the safeguarding mechanisms you will put in place to achieve this.)
You should include details on how and where the data will be stored, and who will have access to it.

b) Please outline how long the data will be retained for, if it will be destroyed and how it will be destroyed.
8. DECLARATION

I have read and understand the DkIT guidelines for ethical practices in research and have read and understand the
data protection guidelines.

Signed: Name:

Date:

(Researcher)

Signed: Name:

Date:

(Supervisor/Research Centre Director/Head of Department)


9. STATEMENT OF ETHICAL APPROVAL

Supervisor/Research Centre Director/Head of Department

This project has been considered using agreed procedures and is now approved/ referred to the Ethics Committee

Signed: Name:

Date:

Chair of Ethics Committee

This project has been considered by the Ethics Committee and ethical approval is granted.

Signed: Name:

Date:

You might also like