St. Thomas More College, University of Saskatchewan Department ...
St. Thomas More College, University of Saskatchewan Department ...
St. Thomas More College, University of Saskatchewan Department ...
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Appendix B3 Pre-screen<br />
Psy-REC Screening Checklist<br />
<strong>St</strong>udent Researcher: ___________________ Faculty Supervisor: _____________________<br />
Application Form<br />
40<br />
Acceptable or Not or N/A<br />
Anticipated start date/end date <br />
Section 1 - Purpose <strong>of</strong> proposed research - described <br />
Section 2 – Abstract - described <br />
Section 3 – Participants – procedure for recruitment described <br />
Relationship between researcher and participants specified <br />
Compensation for participation is described <br />
Potential for loss <strong>of</strong> privacy or anonymity <br />
Does the protocol involve vulnerable population (inmates, children, elderly) <br />
Section 4 – Informed Consent<br />
<strong>St</strong>andard statement <strong>of</strong> process for obtaining consent <br />
Copy <strong>of</strong> consent form attached <br />
Copy <strong>of</strong> letter to relevant organizations (if applicable) attached <br />
Where children are under age <strong>of</strong> 18, have parental consent provisions been made <br />
Copy <strong>of</strong> parental consent/child assent form attached <br />
Section 5 – Procedure for Withdrawal – standard statement <br />
Section 6 – Methods/Procedures<br />
Description <strong>of</strong> the research methods/procedures and copies <strong>of</strong> instruments attached <br />
Section 7 – Dissemination <strong>of</strong> Results - standard statement <br />
Section 8 – Estimate <strong>of</strong> Risks<br />
Any potential risks (physical, psychological, deception, coercion) <br />
Section 9 – Confidentiality <strong>of</strong> Data<br />
<strong>St</strong>andard statement regarding confidentiality and storage <strong>of</strong> data <br />
Section 10 – Transcript Release<br />
Procedures for transcript release described and copy <strong>of</strong> release form attached <br />
Section 11 – Debriefing and Feedback<br />
<strong>St</strong>andard statement regarding debriefing; debriefing form attached <br />
Section 12 - <strong>St</strong>udent Training<br />
<br />
<strong>St</strong>andard statement regarding student training <br />
Section 13 – Contact names, information and signatures
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