St. Thomas More College, University of Saskatchewan Department ...

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Appendix B3 Pre-screen Psy-REC Screening Checklist Student Researcher: ___________________ Faculty Supervisor: _____________________ Application Form 40 Acceptable or Not or N/A Anticipated start date/end date Section 1 - Purpose of proposed research - described Section 2 – Abstract - described Section 3 – Participants – procedure for recruitment described Relationship between researcher and participants specified Compensation for participation is described Potential for loss of privacy or anonymity Does the protocol involve vulnerable population (inmates, children, elderly) Section 4 – Informed Consent Standard statement of process for obtaining consent Copy of consent form attached Copy of letter to relevant organizations (if applicable) attached Where children are under age of 18, have parental consent provisions been made Copy of parental consent/child assent form attached Section 5 – Procedure for Withdrawal – standard statement Section 6 – Methods/Procedures Description of the research methods/procedures and copies of instruments attached Section 7 – Dissemination of Results - standard statement Section 8 – Estimate of Risks Any potential risks (physical, psychological, deception, coercion) Section 9 – Confidentiality of Data Standard statement regarding confidentiality and storage of data Section 10 – Transcript Release Procedures for transcript release described and copy of release form attached Section 11 – Debriefing and Feedback Standard statement regarding debriefing; debriefing form attached Section 12 - Student Training Standard statement regarding student training Section 13 – Contact names, information and signatures
CONSENT FORM Title of study Name and contact information for student research and faculty supervisor Purpose and objectives of study Detail of procedures outlined Estimate of time commitment Potential risk/discomforts outlined Standard withdrawal statement Standard confidentiality statement Standard storage of data statement Standard dissemination statement Standard statement regarding approval by Psy-REC with date Standard statement regarding ORS with phone number Acknowledgement of understanding Acknowledgement of receiving copy of consent form Conforms to standard consent form Notes on necessary revisions: 41
Page 1 and 2: St. Thomas More College, University
Page 3 and 4: or http://www.usask.ca/university_s
Page 5 and 6: 3. Tentative: The lying game: How o
Page 7 and 8: Please note that your final grade w
Page 9 and 10: Psychology 316 Student Evaluation:
Page 11 and 12: Psychology 316.3 Student Presentati
Page 13 and 14: Psy. 316.3 Presentation Feedback fr
Page 15 and 16: Appendix A Instructions for Researc
Page 17 and 18: esponsible for notifying the experi
Page 19 and 20: Alternatively you may contact the r
Page 21 and 22: invalidated if a status report form
Page 23 and 24: that could be used to identify a pa
Page 25 and 26: esources. If you wish to design a p
Page 27 and 28: Section 5(b) When participants deci
Page 29 and 30: All data will be in the form of SPE
Page 31 and 32: DEBRIEFING FORM 1. Present yourself
Page 33 and 34: Anticipated Start Date of the Study
Page 35 and 36: How and when are participants to be
Page 37 and 38: ) If the data are not anonymous, wh
Page 39: 13. CONTACT NAME AND INFORMATION Pl
Page 43 and 44: 9. This is the screen where you ent
Page 45 and 46: When students have completed your s
Page 47 and 48: Class projects: Frequently, undergr
Page 49 and 50: The following criteria can be used
Page 51 and 52: If you have any questions, please c
Page 53: Appendix F Fact sheet: St. Thomas M

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