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Request for Ethical Review For Research Involving Humans Approved by RRU Academic Council September 20, 2012 If your research involves human participants then it most likely requires an ethical review by the Royal Roads University Research Ethics Board (or one of its subcommittees). Please refer to the Royal Roads University Research Ethics Policy for specific guidance on identifying research that requires ethical review. The Royal Roads University Research Ethics Policy will assist you in understanding the questions below and will help you formulate your responses. If you have additional inquiries, contact your Project Advisor or Academic Supervisor or the Research Ethics Coordinator. Research involving human participants cannot be initiated until the Request for Ethical Review has been approved. (This includes sending out invitations for participation, as well as any data-gathering.) Incomplete requests for Ethical Review will not be considered – all questions must be answered and all requested attachments provided. Please do not delete any of the questions or prefatory materials. If you need more space than provided, please attach additional blank sheets. Please remember to note the number of your response. Please have your academic supervisor submit the completed form, via email, to ethicalreview@ royalroads.ca. Please allow four weeks for the decision of the Research Ethics Board. If you use this template please ensure that all notes in blue are removed before sending for review I. PRINCIPAL INVESTIGATOR Name: Note: When you are conducting research in your own organization, we also need to know your position in the organization in order to determine where you sit in the organizational hierarchy vis-à-vis potential participants in the research. This helps to assess power-over and/or conflict of interest. Please include these details here or in the section on conflict of interest below. Faculty / Program: (Please specify) Faculty Graduate Student Undergraduate Student Staff Other (Please Specify): A. CONTACT INFORMATION Page 1 of 23 Request for Ethical Review For Research Involving Humans Address: City: Province: Postal Code: Home Phone: ( ) Work Phone: ( ) Cell Phone: ( ) Other: ( ) E-Mail: Please use the current email address which you check regularly. Correspondence and/or approval will be sent to this address. If Student, specify: FACULTY PROJECT ADVISOR / ACADEMIC SUPERVISOR Name: Office Phone: ( ) Extension: E-Mail: Faculty Members Only - Specify Your Supervisor: Supervisor: If applicable, specify: SPONSOR / CLIENT Name: Same issue as above re: your sponsor’s position in the organization. This helps to assess power-over and/or conflict of interest. Please include these details here or in the section on conflict of interest below. Company: Office Phone: ( ) Extension: E-Mail: If Faculty member, specify: SUPERVISOR AND SCHOOL/FACULTY Name of Supervisor: Page 2 of 23 Request for Ethical Review For Research Involving Humans Office Phone: ( ) Extension: E-Mail: Faculty Members Only - Specify Your Supervisor: Your School/ Faculty: CO-INVESTIGATORS (If Any) Name, position, and if applicable, affiliation with other institution, mailing address, email address, and telephone. B. CONFLICT OF INTEREST Provide full details of any actual, perceived, or potential conflicts of interest (economic, family-related or otherwise) on the part of the principal investigator and/or co- investigators. For example, if you plan to incorporate into your research staff whom you employ, students whom you teach, or fellow employees, this constitutes a conflict of interest. Because the researcher has power over potential participants in areas outside of the research, such individuals may perceive their participation to be coerced, and are therefore not fully free to refuse participation in your research, regardless of your best intentions. Please indicate how you would acknowledge and address this issue. What measures would you take to ensure research participants are aware of potential or actual conflict? Any and all conflicts of interest must be disclosed in your consent documentation (as outlined in Question IX). Please see the Tri-Council guidelines for Conflict of Interest here: http://ethics.gc.ca/eng/policy-politique/initiatives/tcps2-eptc2/chapter7-chapitre7/#toc07-1 If the researcher might be perceived as benefitting over and above any benefits associated with completing a Master’s degree, please explain them here. For example, if the results of the study will benefit – or will be perceived as disproportionately benefitting – the researcher (or researcher’s family members) in terms of reputation or economic status, it is best to disclose these up front. Conflicts of interest should be avoided wherever possible. If there is a serious conflict of interest, students’ proposals may be rejected and/or may need to go through a full, rather than an expedited, review. Take into account any real or perceived conflicts of interest related to the supervisor, sponsor, or inquiry team members. Do you supervise or have influence over individuals in the study? If so, please explain how you would minimize undue influence over these individuals? Page 3 of 23 Request for Ethical Review For Research Involving Humans Explain here how you are mitigating any power-over relationships between your potential participants and you, your supervisor, your sponsor, and/or your inquiry team members. When the study might provoke controversy or difficult feedback, potential participants with whom you have direct power-over should be excluded as they may experience a sense of coercion in the study and therefore will not be able to give their voluntary (free) consent. Drawing upon the support of a neutral third party facilitator or inquiry team member may be a possibility when direct reports are involved. If applicable, please ensure these details are included in information communicated with potential participants (appendices). Is there any possibility that the activities or results of your study could impact negatively on the organization? Yes No If Yes in what ways might the activities or results of your study impact negatively on the organization? If this is a potential outcome, please explain how you would mitigate this impact. II. SHORT TITLE OF PROJECT Project Title: (10 Words Max.) 1. Provide 4 keywords / 2. phrases that describe the project: 3. 4. III. SUMMARY OF PROPOSED RESEARCH Provide a brief but complete description, in non-technical language, of the purpose, objectives and research questions of the project. Use no more than one page. Page 4 of 23
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