ETHICAL CLEARANCE OF RESEARCH INVOLVING HUMAN PARTICIPANTS: APPLICATION FOR APPROVAL OF RESEARCH
1. Name of primary researcher
First Name
Last Name
Add names of any additional researchers
Email
example@example.com
Phone
Member Institution / Graduate Research School / Office of the Dean
Is your research being overseen by a supervisor?
Yes
No
Supervisor Name (1)
Email
example@example.com
Other contact details
Supervisor Name (2)
Email
example@example.com
Other contact details
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Project Title
2. Research Context - this research is to be carried out as a:
Please Select
PhD
DMin
DTh
MPhil
Honours thesis
Research Essay (postgraduate)
Undergraduate program
Academic research of a member of faculty
If relevant, please state the coursework unit
3. Outline the research and its place in the project (max. 500 words)
Research Question(s):
Population:
Methodology:
4. Nature of the research - approval is sought for the use of:
Questionnaires and surveys
Qualitative methodologies (interviews, recordings, notes from focus groups etc.)
Behavioural observation
Accessing data you, or another individual/organisation, have already collected for another purpose (e.g., from a database or archives)
Psychiatric or clinical psychological studies
Psychological experiments
Other
Provide further details here (note - you will be asked to upload all survey items, questionnaires etc. later in the application):
Will your research involve the use of deception or limited disclosure?
Yes
No
If you answered 'yes' to the use of deception, you will need to justify this to the committee and explain why deception is necessary to achieve the goals of the study. Also explain if the use of deception is likely to cause psychological discomfort (e.g., stress, anxiety, embarrassment, loss of self-esteem) and how you will debrief the participant, including a written script that will be read or provided to the participant. A debriefing statement will need to be included in the participant consent form.
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5. Has the collection of research data already taken place?
Yes
No
6. Time frame
Date for the commencement of research collection (Day/Month/Year)
Date for the conclusion of research collection (Day/Month/Year)
Period for which approval applies (Day/Month/Year to Day/Month/Year)
7. Merits of the research - taking into account the recent literature and previous studies, this research project is justified in that it:
8. Participants in the research
Do the participants of the research include children/young people under the age of 18?
Yes
No
If yes, upload a Working with Children Check
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Will your research involve any of the following (select all options that apply):
Wards of the state
Prison inmates and prison authorities
Members of the armed services
People who are mentally ill
People who are intellectually impaired
People with disabilities and/or their carers
People with chronic illness and/or their carers
People who are from a non-English speaking background
Aboriginal and/or Torres Strait Island people and/or communities
People from non-English speaking backgrounds
If you selected Aboriginal and/or Torres Strait Island people and/or communities, have you read the most recent guidelines of the National Health and Medical Research Council for Research Involving Aboriginal and Torres Strait Islander Peoples and Communities?
Yes
No
If participants include people who do not speak English as their primary language, provide details of how translation assistance will occur.
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Provide a copy of the information to be made available to participants. Select each item to confirm it includes the following:
The title of the project on each page
Pages numbered as page 1 of X, 2 of X, etc.
An assurance that participation is voluntary
An assurance that participants can withdraw at any time without penalty or prejudice
The name and contact details of the Sydney College of Divinity Dean should a participant wish to make a complaint about the conduct of the research project
First page is to be printed on Sydney College of Divinity Letterhead
The consent form includes information for storing data (e.g., recordings)?
The process to debrief participants (if applicable)
Note:
If interviews are used, participants should be informed of their right to read/edit the transcript before results are recorded – researcher must provide details of how this is to occur. Researchers must also provide details and assurances that any third party assisting in transcriptions will respect confidentiality and that all information gathered, unless separate and specific written permissions have been obtained, will be ‘de-identified’ to ensure confidentiality All of these assurances must be included in the cover letter sent to participants.
Will written consent be obtained?
Yes
No
Has a copy of the consent form been uploaded?
Yes
No
Has it been printed on the letterhead of the Sydney College of Divinity?
Yes
No
Upload the participant information and consent forms here:
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Give details of how participants will be recruited, including assurances that choosing not to participate will not affect participants in any way (especially relevant when recruitment is supported by service, government, or voluntary agencies; or with students recruited by their teachers). Upload a sample letter to such agencies if applicable.
If applicable, upload a sample letter to agencies you will seek to recruit participants from:
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Will participants receive any reimbursement, remuneration or financial incentive or 'rewards' as a result of participation?
Yes
No
If yes, give details here:
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9. Conflict of Interest
Are the participants:
In a teacher-student relationship with the researcher?
Yes
No
In an employer-employee relation with the researcher?
Yes
No
In a minister-parishioner relation with the researcher?
Yes
No
In any other dependent relationship with the researcher?
Yes
No
In a health carer-receiver relationship with the researcher?
Yes
No
In a doctor-patient relationship with the researcher?
Yes
No
Is the research being funded by an external organisation?
Yes
No
If yes to any conflicts, give details here:
Does the researcher or supervisor expect any direct or indirect financial gain or other benefit from conducting the research?
Yes
No
If yes, give details here:
Have others besides the researcher placed any restrictions on the use of the results?
Yes
No
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10. Risks, benefits and publication of results
Could participation in the research adversely affect the participants resulting in:
Physical harm?
Yes
No
Psychological harm?
Yes
No
Injury to reputation?
Yes
No
Invasion of privacy?
Yes
No
Breach of law?
Yes
No
If participants are recruited directly by the researcher show how the issues of coercion, real or perceived, is addressed:
How will the participants be informed of the purpose of the research?
Is the research expected to benefit the participants directly or indirectly?
How are the results of the research to be disseminated?
List the institutional location(s) where all data collected will be stored (minimum period = 5 yrs after publication)
List the media for storing data (E.g. audio/ video recordings, typed transcripts, etc.)
Upload all forms of data collection, e.g., questionnaires (in full), measures, outline of questions (for individual / focus group interviews), survey forms...
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All forms of data must be approved: the wording of questions or the approach of a survey design have significant ethical implications that need to be vetted in detail. An example: a survey that states ‘please answer all questions to the best of your ability’ violates the subjects’ rights to refuse to answer any question as they choose.
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11. Consent
Name the individuals and officials of organisations whose consent is required, and upload the documentation.
If this does not apply to your research, please indicate here:
Not Applicable
Upload all relevant documents here:
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12. Consultation
Name the particular church, ethnic or community groups involved. Name the individuals and officials who have been consulted, and upload the documentation. Show how you have responded to any concerns and issues raised.
If this does not apply to your research, please indicate here:
Not Applicable
Upload all relevant documents here:
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13. Reflections of the researcher
As the researcher give your understanding of the ethical issues involved in this research project (max 500 words).
14. Signature of the researcher
*
15. Approval of this ethics application has been provided by my supervisor(s) (where applicable)
Yes
Name of supervisor
First Name
Last Name
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