Request for Ethical Approval for Individual Study / Programme of Research

by University Students (Independent Study Proposal Form)

Please use this form to seek formative feedback from your supervisor PRIOR TO SUBMISSION via the
Ethics Monitoring System. This form mirrors that on the EMS so you will be able to cut and paste your
answers when you are ready to upload your application.

Project Title

What is the aim of your study?

The aim should be one or two sentences for a short description

What are the objectives for your study?

Please provide a numbered list of objectives (we advise a maximum of 5)

Are there any research partners (specific staff members) within the University of Derby involved in the project?
If collaborating with University staff members please add them here

Are there any research partners external to the University of Derby involved in the project? If yes, please provide details.

Project start date

If you do not have a confirmed date please use your closest estimate

Project end date

Estimated end date of your project

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 Does this project involve human participants?
NOTE: If you select no some of the following questions will not be available to answer.
If you select yes, make sure you include the university approved participant information sheet.

If yes, should your research adhere to the British Psychology Society code of ethics and conduct?
Typically this relates to applications in the field of psychology (if in doubt, please seek advice from a relevant subject
specialist). More information is provided on the EMS form.

Does your study involve data collection with any persons who could be considered vulnerable (under 18 years, or the
elderly, or those with physical or mental disabilities)?

Does your project involve collecting data within NHS organisations or from any NHS employees or patients?
If yes, further approval will also be required. Approval letters are required from organisations - these should be provided on
letter headed paper, or from the relevant company email address.
In some cases, approval may be required from within other University departments. If in doubt, please discuss with your
supervisor or a relevant College Research Ethics Committee member.

Does it involve collecting or analysing primary or unpublished data about people who have died or other data that is
already in the public domain?

Does your study involve direct access to an external organisation?

If yes, an approval letter will need to be attached at the end of the application. Approval letters are required from
organisations - these should be provided on letter headed paper, or from the relevant company email address.
In some cases, approval may be required from within other University departments. If in doubt, please discuss with your
supervisor or a relevant College Research Ethics Committee member.

Does your study involve species not covered by the Animals Scientific Procedures Act (1993)?
If your research involves non-human vertebrates in their natural settings or behavioural work involving invertebrate species
not covered by the Animals Scientific Procedures Act (1993) select yes to this question.

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 Does your study involve ionising radiation?

Does your study involve the evaluation of medical devices, or the testing of medicinal and pharmaceutical products?
If your study involves medicinal products or medical devices, approval from the Medicines Healthcare Regulatory Authority
(MHRA) may also be required.

Does your study involve Her Majesty's Prison and Probation Service?
If yes, upload of approval will be required at the end of the application

Does your study involve serving offenders, professionals who work with them, or questions relating to criminal offences?
 Researchers are responsible to ensure that they check whether individuals or organisations who could participate
in their study may be subject to the Integrated Research Approval System (IRAS), and researchers must
have both university ethics approval and IRAS approval prior to any data collection with such individuals or
organisations.
 Researchers are responsible to ensure that any possible data collection relating to criminal offences is designed
to minimise ethical issues as well as meeting requirements under the Data Protection Act 2018 and the General
Data Protection Regulation (GDPR).
 Researchers in the UK may not generally be required to report criminal offences to authorities, but reporting is
mandatory with respect to inter alia serving offenders (see IRAS), money laundering, terrorism and terrorist
finance, and conventions on reporting suspicions of child abuse and neglect.
 Researchers should exercise caution and rigorously follow guidance to minimise potential ethics issues,
reputational damage as well as civil and criminal liabilities.

Does your study involve a need to see, acquire or store material that could be viewed as illegal or that may attract the
interest of the police, security or intelligence services?
 Researchers are responsible to demonstrate that access to any material that could be viewed as illegal is solely
for university-affiliated research purposes, and this potential defence may only be available to researchers who
adhere to the university policy on "Handling Sensitive Research Material" as well as any ethics and supervision
advice specific to their study.
 Researchers should exercise caution and rigorously follow guidance to minimise potential ethics issues,
reputational damage as well as civil and criminal liabilities.

Will your study have any impact on the natural or built environment?
This will apply to research focused on natural sciences and environmental projects. Consideration is required of the impact of
your research on the environment, both in terms of scale and longevity.

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 Has this research been funded by an external organisation (e.g. a research council or public sector body)? If yes, please
provide the name of the funder

Has this research been funded internally? If yes please provide details:
Name of internal fund

Funding amount

Term of funding

Date funding agreed

Have you submitted previous requests for ethical approval to the committee that relate to this research project? If yes,
please provide previous application reference.

Brief review of relevant literature and rationale for study

Please keep this concise. Supporting citations should be added separately in the box below (Max 500 words)
Here you should refer to the context of your research, justifying why your research is worthwhile and explain how it fills the
gaps in knowledge on a specific topic. This short literature review can include a range of academic sources, not necessarially
focussing on your study area. Usually we would expect 5-10 citations here.

Cited references for any sources in the sections on rationale, methods etc.
Include your references here (from your rationale, study design and methodology. There is no word limit.

Outline of study design

This refers to the general structure, type of methodology and timeline of the research project. Max 1000 words

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 Outline of study methods
Max 1000 words

Please provide a detailed description of the study sample, covering recruitment, selection, number, age and if appropriate,
inclusion and exclusion criteria.
Please consider if your research involves vulnerable adults or children.
Please seek advice from your supervisor or Research Ethics Committee Chair if further information is required.

Are payments or rewards/ incentives (e.g. participation points) going to be made to the participants? If yes, please provide
details.

Do you propose to carry out your project partly in a non-English language? If yes, please provide details.
If yes, the applicant must provide a valid translation and back-translation of all materials that will be given to participants
(e.g., invitation to participate, brief, instructions, consent form, debrief, scale items, etc.), using an official, certified
translation service (to be paid for, if required, by the ethics applicant) or by a professional person, such as a known academic.
The same (translated) materials must then be translated back into English by a different person, based on the same criteria as
noted above.

Ethical Considerations
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 explain why.
Consent
An informed consent for will need to be attached at the end of the ethics application. The consent of participants in research,

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 whatever their age or competence, should always be sought, by means appropriate to their age and competence level. For
children under 16 years of age and for other persons where capacity to consent may be impaired the additional consent of
parents or those with legal responsibility for the individual should normally also be sought.
Note: this is not just participant studies, this includes consent of use of existing data, consent from land owners etc.

Interviews/focus group Each participant will be sent a Participant Information Sheet (see Attachment Number) to inform them
on the study. On the day of the interview/ focus group, the researcher will outline the purpose of the study, the procedures to
ensure anonymity, and the use to which the data will be put. The participants will be asked if they have read and understood
the Participant Information Sheet and will be requested to sign a consent form (see Attachment Number ). The form will be
completed on the study day and will be signed in the presence of the study scientist. Participants will be given a copy of the
signed consent form.
OR
Questionnaires Completing the questionnaire will act as giving consent, this is a common practice in Social sciences. The
questionnaire will include an introduction paragraph which explain the purpose of the research, the procedures to ensure
anonymity and the use to which the data will be used. At the end of the introduction paragraph, participants will be allocated
a unique identifier and will be reminded to keep that number safely as this number must be use in any communication.
Participants will need to provide this unique identifier if they choose to withdraw from the study. Participants will have up to
three weeks after the completion of the questionnaire to withdraw if they wish too. The draft questionnaire is available in
Attachment Number.
OR
Access to land* The researcher must provide evidence that a letter of consent has been sent from the landowner to give access
to his/her land. The letter is available in Attachment Number.

Deception
Research involving any form of deception can be particularly problematical, and you should provide a full explanation of why a
covert or deceptive approach is necessary, why there are no acceptable alternative approaches not involving deception, and
the scientific justification for deception.

The study is not deceptive; participants will be informed on the context of the research as well as the aims of the research.
Participants will be aware on how the data will be used for this project. This information will be included in the participant
information sheet (see attachment). In addition, if participants have any questions, they will be able to contact the researcher
by email or phone as researcher contact details will be provided in the participation information sheet.
OR
The study is deceptive in order to collect the information the researcher needs without the participants knowledge of the
context. If the participants knew about the context, this may impact on their contribution and the data collected would not be
reliable. However, the participants will be aware that data is collected and how the data will be used for the project. In
addition, if participants have any questions, they will be able to contact the researcher by email or phone as researcher contact
details will be provided in the participation information sheet (see attachment number).

Debriefing
A debriefing sheet will need to be attached at the end of the ethics application. Debriefing is a process of reflection once the
research intervention is complete, for example at the end of an interview session. How will participants be debriefed (written
or spoken feedback)? If they will not be debriefed, give reasons.
Please attach the written debrief or transcript for the oral debrief. This can be particularly important if covert or deceptive
research methods are used.

Interview/Focus group At the end of the focus group/interview, the researcher will sum up the key findings. Participants will
also receive a debriefing note to thank them for their time. Furthermore, as a validity check, participants will be sent a
summary of the focus group/interview and will be asked to comment on whether this is a fair and accurate reflection of the

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 session. They will also be able to provide further comments (see attached). Participants will be reminded that they can
withdraw up to two weeks after taking part in the research by informing the student and providing their unique identifier.
OR
Questionnaire: The last section of the online questionnaire will include a debriefing section, thanking the participants for their
time and information provided as well as a reminder on how to withdraw if the participants change their mind about their
participation. Participants will be reminded that they can withdraw up to three weeks after taking part in the research by
informing the student and providing their unique identifier.
OR
Access to land It is good practice to thank the landowner for letting you use his land, you can include in the letter some of the
key findings from your observations, mapping, etc.if relevant.
Withdrawal from the investigation
Considerations for withdrawal from study and withdrawing participant data.
Leaving the study: Participants should be told explicitly that they are free to leave participation in the study at any time
without jeopardy. You need to ensure participants clearly understand how and when they can leave the study.
Withdrawing Data: Participants also have the right to withdraw their data in retrospect, after you have collected it. You will
need to clarify what participants need to do in order to withdraw their data, and at what point they will no longer be able to
do this (i.e. after the data has been analysed and disseminated).
Please make clear to participants the distinction between withdrawal from the study and withdrawal of data.

Participants will be informed that they can withdraw from the research at any time prior the final analysis of the data [insert
date here]. Participants do not have to give a reason and this will not affect their future participation in forthcoming research.
Participants can inform their wish to withdraw to the researcher by email [add university email here] and they must provide
the unique identifier allocated to them in their correspondence to the researcher.
Anonymity and confidentiality
You must protect a participant's anonymity (so no-one could identify participants) or confidentiality (i.e., no one but
researchers could identify participants; e.g., interview studies) unless they have given their permission to be identified (if they
do so, this must be stated on the Informed Consent Form).
You must ensure processes are in place to protect the identity of participants taking part in research.
Please consult the University's GDPR policy for further information

Once recruited onto the study, participants will be assigned a code number or unique identifier, with only the named study
scientist being able to link codes to participants. All personal information will be kept confidential. All data collected during the
interviews/focus groups/observation/questionnaires will be anonymized. [For focus groups /interviews: at the start of the
interview/focus group, the researcher will remind the participant(s) that anything that is discussed should not be reported
outside of the interview/focus group].[For questionnaire, No personal details will be kept, all questionnaires are anonymous
and coded. Questionnaires will be store securely on password protected Tablet and computer and only accessible by the
researcher [add name researcher here].
Protection of participants
Are the participants at risk of physical, psychological or emotional harm greater than encountered ordinary life? If yes,
describe the nature of the risk and steps taken to minimise it.

The participants are at no physical, psychological or emotional harm.

NB: If themes discussed during the focus groups/interviews may lead to the participants becoming distressed, then ensure you
have the appropriate guidance in place. For example, you may refer the participants to a specific charity (e.g. Samaritans,
etc.).
Observational research
If observational research is to be conducted without prior consent, please describe the situations in which observations will

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 take place and say how local cultural values and privacy of individuals and/or institutions will be taken into account.
Note this refers to human participants only.

This research is not an observation.

NB: If it is an observation you need to ensure the participants are aware they are being observed (i.e. is it deceptive or not).
Consider whether or not you are recording personal data or data that could identify a person (i.e. are you taking photos of
individual? If so, you need a consent form and a participant information sheet). If so, how do you deal with this.
Giving advice
Students should not put themselves in a position of authority from which to provide advice and should in all cases refer
participants to suitably qualified and appropriate professionals.

The researcher will not provide any advice to the participants as part of this research.
Research undertaken in public places
You should pay particular attention to the implications of research undertaken in public places. The impact on the social
environment will be a key issue. You must observe the laws of obscenity and public decency. You should also have due regard
to religious and cultural sensitivities.

Note: consent must be obtained from zoo/ landowner/company etc. you must state where your data collection will take place.
You should confirm that your study will not negatively impact the environment, public, staff and why you won’t. You must
state that you will seek permission before commencing data collection.

It is anticipated that the focus groups/interviews/observation will take place in a public area (e.g. [type examples here). The
researcher will follow the Code of Conduct for students and be mindful of working in a public area. For security reasons, the
researcher will leave a schedule of his/her whereabouts (including mobile phone contact number) with friends and/or family
members. It is anticipated that some of the work may take place at weekend to facilitate participation.
Environmental protection
Consideration is required of the impact of your research on the environment, both in terms of scale and longevity. Particular
consideration should be given in the context of
 vulnerable or threatened species or populations
 the introduction of material (including biological) not already present in an area or to a level which will influence
biological, ecological and/or geophysical processes.
 environmental samples should be collected in such a manner which preserves the aesthetic qualities for natural rock
and soil formations and does not damage or destroy their geoheritage.
 destruction and/or intrusion at a significant scale in space and/or time and relative to the size of populations and
habitats affected, and ecological and geophysical processes applying in the area of the following nature:
 deliberate damage?
 taking of plants and animals?
 behaviour manipulation or use of intrusive techniques?
 potential, political, socio-cultural significance.
Note; Invertebrates do not require protection by law, but it is good practice to address this
• Confirm that you will
– Invertebrates: treat animals carefully, respectfully, and avoid unnecessary killings
– Vertebrates: observational – again not required by law, but complete as above
– Preserve animal welfare at all times (do no harm!)
• Vertebrates: If more than observational, animal rights are required by law – can’t be negligent, state the training and
licenses you hold

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 You must do your utmost to protect the environment at all times (lab, fieldwork etc.)
• Lab – how will you dispose of contaminated waste? – COSHH forms – Speak to technicians
• Fieldwork – how will you leave the site after your study? Especially important if you are working in a protected area

GDPR- collecting personal data

If collecting personably identifiable data, please explain further below.
What is GDPR?
The EU's General Data Protection Regulation came into force in 2018 and provides guidance and rules on the collection and
processing of personally identifiable data - that is, any information that can help identify a person, and sensitive data - sex,
religious beliefs, etc.
During projects, this kind of data may need to be collected as part of a study. Please explain in the box provided how you will
be ensuring that only necessary data is collected, and the reasoning for why you will be doing so.
If you are unsure on how GDPR may impact your study, please consult your supervisor, or alternatively contact the GDPR
team:
GDPR at the University
Our Data Protection Officer (DPO) is Helen Selby who you can contact on (01332) 591954. Alternatively, you can
email [email protected].
Further information on how we handle your information can be found here on our website
- https://www.derby.ac.uk/its/datagov/privnotice/.

Note: Hard copies of data must be locked away at all times when not in use. Electronic data needs to be password protected
(both files and any storage device). You must ensure that participants cannot be identified- consent forms and questionnaires
must be stored separately. Participants should provide their own unique ID number- only this number will be used for
identification of sample/ questionnaire response. Participants must opt-in to your study via written consent. Confirm that all
data collected will comply with University of Derby data protection regulations.

Researchers will be collecting data from your participation in this [interview/focus group/questionnaire/observation] which is
associated with [topic of the project]. This is the legal basis on which we are collecting your data and while this allows s us to
use your data, it also means we have obligations towards you to:
• not seek more information from you than what is essential and necessary for the study.
• make sure that you are not identified by the data by anonymising it using ID codes.
• use your anonymised data only for the purposes of this study and for any relevant publications that arise from it.
• store data safely in password-protected databases to which only the named researchers have access
• not keep your information for longer than is necessary (usually for seven years)
• safely destroy your data by shredding or permanently deleting them The University of Derby will act as the Data Controller
for this study. This means that the University is responsible for looking after your information and using it properly.
Researchers on the project with access to the data have been trained and have been very careful to ensure the security of your
data. The study was approved for its ethical standards by The University of Derby Environmental Sciences Research Ethics
Committee. However, in the unlikely event that you feel you need to make a complaint regarding the use of your information,
you can contact the Data Protection Officer at the University of Derby: James Eaglesfield (01332) 591762 or The Information
Commissioners Office 0303 123 1113. Further information about the project can be obtained from DETAILS OF [supervisor]
Basis for collecting data
If you are not collecting data, select “not applicable”
 Consent
 Contract
 Legal obligation
 Legitimate interest
 Vital interest
 Public task/function

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  Not applicable (only use when no data is being collected)
Consent: The individual has given clear consent for you to process their personal data for a specific purpose.
Contract: The processing is necessary for a contract you have with the individual, or because they have asked you to take
specific steps before entering into a contract.
Legal obligation: The processing is necessary for you to comply with the law (not including contractual obligations).
Legitimate interest: The processing is necessary for your legitimate interests or the legitimate interests of a third party,
unless there is a good reason to protect the individual’s personal data which overrides those legitimate interests.
Vital interest: The processing is necessary to protect someone’s life.
Public task/function: The processing is necessary for you to perform a task in the public interest or for your official
functions, and the task or function has a clear basis in law.

Data retention
How long do you intend to keep the data? Keep in mind the minimum retention period is 7 years.
Where will the data be stored?
Do you intend to share the data; if so who with?

Upon completion of the research, information stored electronically (including digital recordings of interview) will be password
protected and accessed only by named study scientist. Material will be stored for the duration of the study, which is envisaged
to finish in [date]. At the end of the study period, transcripts/questionnaires will be archived for a period of seven years. The
digital recordings of the focus group/interview will be deleted, together with any electronic documents that feature study
participants’ names and addresses. Hard copy documents featuring respondents’ names and addresses will be shredded.

Rights of data subject

Have you considered the below rights of the data subject?
The right to be informed
The right of access
The right to rectification
The right to erasure
The right to restrict processing
The right to data portability
The right to object
Rights in relation to automated decision making and profiling

The participants are informed of the research (participation information sheet) and participants also have access to the data
collected as a copy of the transcript of the focus group/interview will be sent to them to check the transcript reflect the
information provided in the session. Participants will have an opportunity to make rectification or delete comments in the
transcript if necessary. The participants will have the right to withdraw their participation, therefore restricting processing of
the data. The right to data portability and the rights in relation to automated decision making and profiling do not apply to
this research.
Commercial sensitivity
Information whose disclosure would, or would be likely to, prejudice the commercial interests of any person (an individual, a
company, the public authority itself or any other legal entity) e.g. trade secrets, profit margins or new ideas.
For applicants seeking permission from prisons or medical institutions please be aware of the sensitive nature of data
collected.

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 Are you using non-standard software to store or analyse data?

If yes, a DPIA may be necessary- please contact the governance team for further details. Storing and Analysing Data
 Ensure all data you collect is stored and only shared on your Office 365 or other university-approved accounts
(e.g., Qualtrics), where necessary information will be shared via OneDrive, not by attaching it via email or an
email attachment in the file format specified by the account.
 Do not use unencrypted USB sticks, instead opting to use as above.
 Only collect the minimum amount of data needed for your project, if it isn't needed don’t collect it.

DPIA
A Data Privacy Impact Assessment may be required in certain circumstances where a third party are being used to store or
process data collected. It is a process to help you identify and minimise the data protection risks of a project. Please
contact [email protected] to discuss and/or set up a DPIA.

Are there any other ethical implications that are additional to this list? If yes please provide details.

Have/do you intend to request ethical approval from another body/organisation? If yes, please provide details

Do you intend to publish your research?

If you intend to publish data from human research participants, informed consent needs to be sought. Also if you intend to
store anonymised data in an open-archive for the purposes of open science, that must be stated in the consent.
Participants also need to be made aware that once data is published or a duration specified in the study consent is passed,
they will no longer be able to withdraw their data from research. You may need to consider stating a date or a duration for
withdrawal on any consent and participant information forms.

Have the activities associated with this research project been risk-assessed?

Attachments
 Cover letter/invitation to participants
 Informed consent forms for participants
 Participant information sheet (Information sheet for participants prior to consenting to take part in research)
 Debriefing material (information for participants following participation
 Informed consent from other parties/organisations
 Relevant testing materials
 Other (more detailed literature review/ methodology; risk assessment; questionnaires; focus group questions;

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 psychometric scales; interview questions; COSHH forms; GDPR data protection statement; DBS certificate)

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