Research Ethic Application form-UK based

Please read the MU Code of Practice for Research: Principles and Procedures. The purpose of this
form is to help staff and students in their pursuit of ethical research methodologies and procedures.
Students should complete this form in consultation with their supervisors. The supervisor is
responsible for submission of this form and required accompanying documents. No fieldwork should
begin until your Research Ethics Committee (REC) has given approval.
Section 1: Applicant details
1.1 Details of Principal Investigator/Supervisor
Name: Email: Department:
Tel: Position:
1.2 Details of Student Researcher (if applicable)
Name: Email: Department:
Tel: Position:
1.3 Details of any co-investigators (if applicable)
Name: Email: Organisation:
Name Email: Organisation:

1.4 If this is a group student project please provide details of programme, module and student
group:

Section 2: Details of proposed study

2.1 Title of study
2.2 Proposed start date:
2.3 Proposed end date:
2.4 Aims of the study

2.5 Please provide summary details of the research study and rationale (max 1,000 words).
Include information, where relevant, about participants study design, data collection methods
(e.g., interviews, questionnaire, observation etc) and/or secondary data sources (e.g., UK
National Statistics) to be used in the research, data analysis and benefits of the research and
citations.

Section 3. Initial checklist

3.1 Is this non-empirical research? (i.e., does not involve data collection from Yes No
human participants or animals or use of animal parts)

3.2. Does the research already have ethical approval from another UK Ethics Yes No
Committee (e.g., a UK HEI or organisation e.g., NHS, IRAS)?
(Please submit evidence of ethical approval with your application)
3.2.1 Is liability insurance provided by the other ethics committee body/institution? Yes No

3.2.1 Does this research require approval from an external research ethics Yes No
committee? (e.g., NHS or other organisations, agencies and local authorities)

If ‘Yes’ please provide further details of the external ethics committee below:

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3.3 Will you be utilizing Secondary Data in your research? Yes No

3.3.1 Does the research involve secondary data analysis using a government archive Yes No
(e.g., UK Data Service / UK Data Archive), publication with ISBN or equivalent
identifier?
Please specify data set to be used and how it will be obtained.

You will need to submit evidence of approval to use the planned existing data.
Yes No
3.3.2 Do you need to contact the original researchers or data collectors to gain
permission to use the data or inform them of the purpose of your secondary analysis?

3.4 Will the use of the data/outputs from the research (e.g., products, guidelines, Yes No
publications etc) comply with UK legislation?
If ‘Yes’ please provide further details:

3.5 Does your research fit into any of the following Security-Sensitive Yes No
categories?
If so, please indicate which:
a) Commissioned by the military Yes No
b) Commissioned under an EU security call Yes No
c) Involve the acquisition of security clearances Yes No
d) Concerns terrorist or extreme groups Yes No
If you responded ‘Yes’ to any of the above, please complete the Security-Sensitive questions sheet which
can be found on Unihub and the staff intranet sections for Research Ethics.

If you responded “No” to all the questions in Section 3, please go to Section 7 and then complete the
relevant declaration in Section 9. Otherwise, please complete the remainder of this form UNLESS
your research involves Human Tissue (including blood) then please complete the Natural Sciences
REC form or involves psychological research and requires approval from the Psychology REC and
completion of the Psychology REC form.

Section 4 Research data

4.1 Secondary data research (e.g., published data, archives, court reports, hospital records, N/A
case notes, internet site etc.) Please specify data set to be used and how it will be obtained
and whether appropriate or required permission will be obtained:

4.2 Primary data from human participants: Please specify categories of human participants: N/A
(e.g., students; those in an unequal relationship (e.g., your own students): general public;
specific group(s) or team(s). (Note: NHS patients, and/or their relatives/carers, vulnerable
adults unable to give informed consent must be reviewed by NHS NRES via the IRAS system.
Collecting data from under-16yr olds and vulnerable adults will require DBS see 6.11)

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i) Categories and number of participants:

ii) How will participants be recruited and approached? (e.g., using email, social medie sites,
posters, letters of introduction etc), what contact/reply arrangements will be made (e.g., mdx
email or details a dedicated email account, or skype address for the research etc) or accessed
gained to groups of participants (e.g., through gatekeepers, e.g., organisations, managers,
parents, schools etc) Please provide details:

iii) Details of materials to be used/resources required for this study: (Please provide copies of
questionnaires, indicative interview questions, topic guide/prompts, visual images etc. to be
used in this research)

4.3 Animals or the use of animal by-products: If the research involves the participation N/A
and/or observation of animals or the use of animal by-products please refer to the MU
Statement on the Use of Animals in Research, Teaching and Practice and provide the
following details:
i) Type of animal/animal by-product
ii) Justification for use of animal/animal by-products(s)
iii) Where data collection is being undertaken
iv) Where animals/animal by-products are kept and care/storage facilities/disposal
v) Evidence of relevant licence/permissions (where applicable)

4.4 Other data sources to be collected/used not categorised above e.g., flora/foliage, N/A
minerals, precious artefacts etc. Please provide details:
i) Type of data
ii) Justification for use
iii) Where data collection is being undertaken
iv) Where the data will be kept and care/storage facilities
v) Evidence of required licence/permissions (where applicable)

Section 5: Anonymity, confidentiality and consent

5.1 Will the research involve collecting or analysing personal data or sensitive Yes No
personal data? (i.e., personal data refers to information that may identify
individuals e.g., name, address, date of birth, opinion, specifc event, set of
characteristics that would clearly identify individuals or very small groups.
Sensitive personal data refers to racial or ethnic origin, political opinion, religious
beliefs, trade union membership, sexual life, physical or mental health, criminal
matters.)

If ‘yes’, consider irreversibly anonymising data, if possible, by removing names

and other linked or identifying information which may still identify an individual
without their name. Alternatively, if personal or sensitive personal data is required
for the research, you must comply with the Data Protection Act (DPA)(1998) and
understand your responsibiities under the DPA and have received data protection
training. Please complete the Data Protection Act Checklist for Researchers
5.2 Will lists of identity numbers/codes or pseudonyms for individuals and/or Yes No
organisations (i.e., linking keys to personal identifiers) be stored securely and
separately from the research data and destroyed after the study to avoid any risk of

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confidentiality being compromised? If ‘no’ please provide details:

5.3 Will you tell participants that their data will be treated confidentially and the Yes No
limits of anonymity will be made clear in your Participant Information Sheet*?
(e.g., their identities as participants will be concealed unless prior consent is given
to include the name of the participant in any documents resulting from the
research. Consider how participants’ narratives, quotes or involvement in specific
events may make anonymity difficult to maintain.) Please provide details how you
will ensure this:

5.4 Will you obtain Written Informed Consent* directly from research Yes No
participants (if applicable)? If ‘no’ please provide details:
If ‘yes’ please specify how and when this will be achieved:

5.5 Will you obtain Written Informed Consent* directly from gatekeepers (if Yes No
applicable)? If ‘no’ please provide details:
If ‘yes’ please specify how and when this will be achieved:

5.6 Will you inform participants that their participation is voluntary and that they Yes No
have a right to withdraw from the research at any time without penalty? If ‘no’
please provide details:
5.7 Will you have a process for managing withdrawal of consent? Please provide Yes No
details:

5.8 Will it be necessary for participants to take part in the study without their Yes No
knowledge and consent at the time, or by deception e.g., covert observation?
If ‘yes’, please provide justification and details of how this will be managed to
respect the participants/third parties involved to respect their privacy, values and
to minimise any risk of harmful consequences:

5.9 Will you provide a Written Debriefing Sheet*? (if applicable) Yes No
5.10 Will you need consent from people who appear in visual data (e.g., photos Yes No
or films)? If ‘yes’ please provide details:

5.11 Will you audio or video record interviews and/or observations? Yes No
If ‘yes’ please provide details on how participants’ anonymity will be maintained:

5.12 Does the research involve participants engaged in internet activity (eg., Yes No
responding to internet surveys, emails, chatroom discussions, blogs,
interactive games, social media and networking sites etc, and have
i) gained their informed consent to be identified
ii) ensured anonymity
Explain how will you obtain permission from the website authors, or informed
consent from participants, and ensure anonymity and protect confidentiality in an
environment that generates significant amounts of background information e.g.,
data logs, IP addresses, cookies and caches and/or with low levels of system
security? Please provide details:

*Please submit copies of these forms with this application

Section 6: Avoiding harm: risk assessment and management, safety and legal issues
6.1 Will you use an experimental research design (ie., implement a specific plan Yes No
for assigning participants to conditions and noting consequent changes) involving
either i) drugs, placebos or other substances (e.g., food substances, vitamins) to be

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administered to the participants, or ii) invasive, intrusive or potentially harmful

procedures or any kind?
If ‘yes’, please provide details of treatment/intervention (and specify is these are
intrusive interventions e.g., hypnosis or physical exercise, or include the use of
drugs, placebos or other substances e.g., vitamins, food substances etc.) and provide
details of required resources for this study:

6.2 Will the research cover sensitive topics? (e.g., sexual activity, drug use etc) Yes No
If ‘yes’ please provide details of how possible adverse reactions will be avoided and
what support will be in place to manage any adverse consequences:

6.3 Is pain or more than mild discomfort likely to result from the study? Yes No
If ‘yes’ please provide details:

6.4 Could the study induce psychological stress or anxiety or cause harm or Yes No
negative consequences beyond the risks encountered in normal life?
If ‘yes’ please provide details and state how participants will be supported:

6.5 Will the study involve prolonged and repetitive testing? Yes No

If ‘yes’ please provide details, justification and state how participants will be
supported and length of each data collection session, number of sessions and
location of data collection:
6.6 Will this research be conducted off-site (i.e., not on MU premises) AND the Risk Yes No
Assessment Form does not indicate low risk?
If ‘yes’, - the research is off-site - please provide details of other locations and
complete a Risk Assessment Form for Fieldwork to be submitted with this form.

If the research is not off-site, a risk assessment form will need to be completed if the
research involves groups of participants and there is a need to control space risks or
to comply with relevant licence(s).

6.7 Will being alone with individual participants or group of participants place you Yes No
at risk?
If ‘yes’ please state how this can be avoided or managed?

6.8 Are there any adverse risks or safety issues (e.g., from potential hazards) that Yes No
your methodology raises for you and/or for your participants or others? If ‘yes’,
please specify and provide details of mitigating actions that will be taken (e.g.,
travelling alone, working in hazardous conditions, discussing illegal activities on-line
etc.) and how you, and your participants/third parties will be supported?
6.9 Is the research or outputs from the research likely to cause harm to others (e.g., Yes No
to their physical well-being, mental health, dignity or personal values) to an extent
greater than that encountered in ordinary life? Please provide details; e.g.,
dissemination plans and how an increased risk of harm will be avoided.
6.10 Is this research likely to have a damaging effect on the environment e.g., Yes No
damage to habitats, plants, or sites of archaeological or geological or cultural
significance? Or a negative impact on people living/working in the immediate
locality of the study?
If ‘yes’ please provide details and state how damage will be minimised:

6.11 Will this research require a current Disclosure and Barring Service (DBS) Yes No
Certificate*?

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*Needed when working with under-16yr olds and/or vulnerable adults for example,
in education or healthcare contexts.
If ‘Yes’, please provide details of DBS number and date of issue:

Section 7: Research funding, sponsorship and collaboration

7.1 Does the research have external funding? Yes No
Îf ‘Yes’, please provide further details:
7.2 Does the research have a sponsor (i.e., any person or organisation who Yes No
provides support for the research in the form of income, use of data, facilities,
materials, assistance with data collection etc) that may have ethical implications
for the research? If ‘yes’ please provide details of the role of the funder and
issues:
If ‘yes’, what ethical review procedures must this research comply with for that
country, and what steps have been taken to comply with these:
7.3 Does the research involve an international collaborator or research conducted Yes No
overseas?
If ‘yes’, what ethical review procedures must this research comply with for that
country, and what steps have been taken to comply with these: (e.g., Do you need
local permission/approval? Are there any country specific cultural social or legal
considerations that need to be taken into account? Who will be collecting the data
overseas? Have you considered intellectual property issues?)

7.4 Will this research or part of it be conducted in a language other than English? Yes No
If ‘yes’, full translations of all non-English materials will need to be submitted.

Section 8: Other issues - to be completed by ALL applicants

8.1 Does the research involve any ethical and/or legal issues not already covered Yes No
that should be taken into consideration? If ‘yes’ please give details:
8.2 Do you or your researchers require training on the requirements of the Data Yes No
Protection Act for researchers?
8.3 Does the research raise any other risks to safety for you or others that would Yes No
be greater than in normal life? If ‘yes’ please complete the MU Risk Assessment
Form for submission to the REC with this form.
8.4 Will participants receive any financial inducements/reimbursements (other Yes No
than reasonable expenses and compensation for time) will be offered to
participants?
If ‘yes’ please provide details and justification:

8.5 Are there any conflicts of interests to be declared in relation to this research?

Section 9: Declaration – to be completed by ALL applicants

As principal investigator/student researcher I confirm that:
1. I have read and agree to abide by the relevant Code(s) of Ethics appropriate to my research field and
topic.

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2. I have reviewed all the information submitted with this research ethics application and believe that it
accurately represents the proposed research.
3. I have read and agree to abide by the University’s Code of Practice for Research: Principles and
Procedures.
4. I agree to inform my Supervisor/Research Ethics Committee of any adverse effects or changes to the
research procedures.
5. I understand that the research/research data may be subject to inspection for audit purposes and I agree
to participate in any audit procedures required by the Research Ethics Committee (REC) if requested.
6. I understand that personal data about me contained in this form will be managed in accordance with the
Data Protection Act.
7. I have completed and signed a risk assessment for this research study (if applicable).

Principal Investigator Name……………………………Signature:……………………….….Date:

…………….

Student Name……………………………………………..Signature:……………………….….Date:
…………….

As supervisor I confirm that:

8. I have reviewed all the information submitted with this research ethics application and believe that it
accurately represents the proposed research.
9. I accept responsibility for guiding the applicant so as to ensure compliance with the terms of the
protocol with any applicable Code(s) of Ethics.
10. I understand that research/data may be subject to inspection for audit purposes and I agree to participate
in any audit procedures required by the Research Ethics Committee (REC) if required.
11. I confirm that it is my responsibility to ensure that students under my supervision undertake a risk
assessment to ensure that health and safety of themselves, participants and others is not jeopardised
during the course of this research.
12. I understand that personal data about me contained in this form will be managed in accordance with the
Data Protection Act.
13. I have seen and signed a risk assessment for this research study (if applicable).

Supervisor’s Name………………………………………Signature:…………………………….Date:
………….

Supervisor’s recommendation

This is a low risk project (i.e., none of the response given are in the shaded Yes No
box/column) and all ethical, legal and safety issues have been sufficiently
addressed

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I approve the project as supervisor (Please submit to the relevant REC Yes No
administrator).

This project will be submitted to the relevant REC for further consideration Yes No

If submitting to your Research Ethics Committee please use the documents checklist below:

Please check and attach the following documents where applicable:

1. Evidence of external approval – from external ethics body Yes No NA

2. Evidence of external approval – from external ethics body Yes No NA

3. Letter of permission (if required from organisation(s) where research is to be Yes No NA

conducted)

4. Participant information sheet Yes No NA

5. Written informed consent sheet Yes No NA

6. Written debriefing sheet Yes No NA

7. Completed risk assessment form Yes No NA

8. Copy of materials – questionnaires, interview guide, visual images etc. Yes No NA

9. Disclosure of conflict of interests (if applicable) Yes No NA

10. Evidence of relevant licence for research with animals/animal by products Yes No NA

Templates for Participant Information Sheets, Consent Forms and Debriefing Sheets can be
found on the MU Ethics intranet site and Unihub.

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FOR RESEARCH ETHICS COMMITTEE USE ONLY

REC NO:________________DATE:________________

Name of Principal Investigator or Student:

Name of Supervisor (if applicable):

Project Title:

First Reviewer’s decision: (Please avoid revealing the reviewer’s identity)

1. Approved Yes No

2. Approved subject to the following minor amendments: Yes No

3. Resubmission required and further information is needed on the following: Yes No

4. Not approved for the following reasons: Yes No

Second Reviewer’s decision: (Please avoid revealing the reviewer’s identity)

1. Approved Yes No

2. Approved subject to the following minor amendments: Yes No

3. Resubmission required and further information is needed on the following: Yes No

4. Not approved for the following reasons: Yes No

Name of REC …………………………………………Chair of REC Name:

……………………………………….
Signature:……………………….……………………………………….Date:
………………………………………..

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Faculty of Arts and Creative Industries

The Burroughs
Hendon
London NW4 4BT

Main Switchboard: 020 *************

Oct 11th ****

ETHICS REVIEW Group

Dear Salim

Re your application for ethical approval relating to your doctoral project

Thank you for submitting your application.

I can confirm that your application has been given approval from the date of this
letter. Please ensure that you contact the ethics committee via ****
*****@****** if there are any substantive changes to the project to consider
possible implications for ethics approval.

You should maintain participant consent forms and any related documentation
in a form that could be scrutinized by the ethics group if needed.

Good luck with your research.

Yours sincerely
Prof *******

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