FINAL REB FORM (finallll) - Seneca College€¦ · REB FORM 1: REB APPROVAL FOR RESEARCH APPLICATION Instructions: If you, as a Senecan, are planning to conduct research that involves

Seneca � REB � Form � 1� –� September � 2014 �

REB FORM 1: REB APPROVAL FOR RESEARCH APPLICATION

Instructions:

If you, as a Senecan, are planning to conduct research that involves the collection of data from human participants, complete this application for ethics approval from the Seneca Research Ethics Board (REB).

Note that some activities are exempt from ethics review (please refer to the document ‘Research Ethics Process at Seneca College’ before filling out this form as you may find it helpful).

If your project involves multiple institutions and you already received ethics clearance from another institution, do NOT fill out this form. Instead, complete the ‘REB Approval for Research Approved by Another Institution Form’ (REB Form 3).

There are 4 parts in this form:

• PART A: Researcher(s) Information• PART B: Description of Study Methodology & Procedure• PART C: Ethical Implications & Protection

• PART D: Implications for the Institution

Complete all 4 parts and submit your application along with any supporting documentation (see table below) directly to: [email protected]

NOTE: The Seneca REB requires that ALL applicants receive approval from the appropriate Seneca department responsible for the institutional data involved in the research study they are seeking approval for.

Internal Seneca applicants must receive approval to conduct their research study from their immediate supervisor when applying to the REB. The supervisor’s signature must be obtained on the appropriate Seneca REB Forms.

Research Ethics Board

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Seneca � REB � Form � 1� – � September � 2014

Check the following options to see what documents apply to you:

Consent Materials: • Consent form• Assent form for minors

• Parental/3rd party consent• Transcribe confidentiality agreement

Recruitment Materials: • Letter of invitation• Verbal script

• Telephone script• Advertisements (newspapers, posters, Experimetrix, etc.) • Electronic correspondence guide

Data Gathering Instruments: • Questionnaires• Interview guides• Tests

Documents



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Seneca � REB � Form � 1� –� September � 2014


PART A: Researcher(s) Information Research Project:

Project title: Application date:

Estimated start date: Estimated end date:

Researcher(s) Information:

Principal Investigator: Co-Investigator:

Other Researcher(s): E-mail address(es):

Organization affiliated with (if not Seneca or in addition to Seneca):

Additional contact information:

Phone:


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Seneca� REB� Form� 1� –� September� 2014

Context of Study

1. Professional development?

Yes

No

2. Workload assignment?

Yes

No

3. Masters/Doctoral program?

Yes

No

4. Does the research involve another institution or site?

Yes

No 5. Has any other REB approved this project?

Yes – Provide a copy of the approved letter along with a copy of the original

submission.

No – Answer question A below.

a) Will any other REB be asked for approval?

Yes

No – Please explain:


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Conflicts of Interest

1. Will the researcher(s)/members of the research team/and/or their partners or immediate family members receive any personal benefits as a result of or in connection to this study? (e.g., financial benefit such as remuneration, intellectual property rights, rights of employment, consultancies, board membership, share ownership, stock options, etc.)

Yes No

PART B: Description of Study Methodology & Procedure

1. Purpose of the Study (include RESEARCH QUESTIONS, major goals, objectives or variables being studied) – this needs to be consistent with what is stated in the Information Letter and Consent Form:

2. Human participants being studied and sample selection:

a. Who are the participants from whom or about whom data will be collected?

b. How will they be selected and asked to participate? Be specific and attach Recruitment/ Invitation material(s) as appendices.


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c. Who will collect the data from the participants? How?

d. Is the researcher in a position where there is a potential for the participants to feel coerced to participate? E.g., real or perceived power differential between researcher(s) and participants?

Yes No Explain why or why not?

3. Treatments, interventions or manipulations (this includes, surveys, interviews etc.) to be used?

4. Significance of the study in the real world - this must be consistent with the what is stated in the Information Letter and Consent form:


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5. Compensation for participants

a)Will participants receive compensation for participation?Yes – Fill out the following information and answer the question below:

Financial Yes No In-Kind Yes No Other Yes No

Provide details and justification for the amount or the value of the compensation offered:

No – Explain why compensation is not possible or appropriate:

b) If participants choose to withdraw from the study, how will the compensation be affected?


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6. Dissemination of findings:

Do you plan to publish or present the findings outside the college?

Yes - REB approval is needed

No - I.e., the only use of the data will be for course/program decision making, you need to ensure all the ethics principles are met but REB approval is not required.

PART C: Ethical Implications & Protection

1. Possible risks to participants

a) Physical risks (including any bodily contact/administration of any substance)

Yes No

b) Psychological/emotional risks (feeling uncomfortable, embarrassed, etc.)

c)Social risks (including possible loss of status, privacy and/or reputation)

Yes No

d) Legal risks (potential of apprehension or arrest, being identified as a member of a legally-compromised group, potential need to report child abuse)

Yes No

e) Describe the risks involved in the study, and what steps will be taken to ensure that they will managed and/or minimized:

Yes No


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2. Protection of participant rights: for example...

a)Voluntary participation? Yes No

b) Freedom to not answer questions they do not wish to answer?

Yes No

c)Freedom to withdraw without explanation orconsequence?

Yes No

d) Non-identifiability in any reporting of the findings?

Yes No

e) Isolation of participants and researcher? Yes No

f) Participants to choose safe location for interview(s) if applicable?

Yes No

g) If questionnaire will be administered in class, will the researcher be present during the administration of the research tool?

Yes No

h) If so, what do you intend to do to minimize the potential perception ofcoercion?

i) Are all these rights clearly stated in the attached informed consent?

Yes No


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3. Data collection, storage and disposal (this includes both hard copies and access to electronic data, e.g., encryption of identifiable digital data):

a) How will they be kept secure and fully destroyed, and when?

b) Attach as appendices copies of data collection tools (e.g., interview guides or protocols to be used)

4. Informing participants of findings – how and when will a summary of findings be made available to participants?


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PART D: Implications for the Institution

1. Feasibility of study (e.g., time constraints, sample selection):

2. Potential use of college resources (e.g., college time, equipment and supplies to be used):

NOTE: Please ensure all consent forms, etc are attached with this REB submission.

Principal Investigator’s Signature Date


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Chair/Dean Approval

I am aware of and have approved this research to be conducted at Seneca College as outlined above.

Principal Investigator’s Signature Date

Internal Approval for Access to Institutional Date (If Applicable)

I have reviewed the research request to be conducted at Seneca College as outlined above and grant permission to access the information subject to any of the conditions outlined below.

Name and Title

Signature

Date

Conditions of Access (If Applicable):


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