IRB Submission Form

Name *

First Name Last Name

E-mail *

Title of Study *

One Word Title for this Study *

Start Date of Study (estimate) *

- Month - Day Year

End Date of Study (estimate) *

- Month - Day Year

Your association with Knox College *

Student Faculty Staff

Before you submitted this proposal, did your adviser review ALL the submitted materials and answers, AND approve them? *

Yes No

Advisor Name *

First Name Last Name

Advisor E-mail *

Describe the sample to be used, including how you will recruit participants and any demographic information you will collect about them. *

Are the data collected from participants in this study confidential or anonymous, or will participants' real names be used? If the data are anonymous, that means that no one, including the researcher, would ever be able to connect the participant’s name with the data s/he provided. If the data are confidential, that means that the researcher could connect the participant’s name with the data s/he provides, but promises not to do so. *

Confidential Anonymous Participants' Real names will be used

Please describe the procedures that you will use to ensure the anonymity of the data. *

Please describe how consent to use their real names will be obtained from the subjects. *

Please describe the procedures that you will use to ensure the confidentiality of the data.

Subjects typically need to go through consent procedures before consenting to participate in a study. Click here to see the types of information that should be used in obtaining consent.

Will you be obtaining consent from your subjects before they participate? *

Yes, I will use a consent form Yes, but I will not use a consent form No

Explain why you believe it is ethical for you to collect data from the subjects without first obtaining their consent. *

Explain why you believe it is ethical for you to collect data from the subjects without using a consent form. Describe the procedures that you will use to obtain consent and to inform subjects about the project and their rights as subjects. *

Please Upload Participant Consent Form *

Will any participants in your study be under 18 years of age or have limited capacity to consent (due to low IQ, dementia, etc.)? *

Yes No

Describe the procedures you will use to obtain consent from a guardian of these participants and assent from the participants themselves. *

Please Upload Guardian Consent Form (if required) *

Is there deception in this study? Deception is present if the participant is actively told something by the researcher that is not true (e.g., participants are given false feedback about their personality, are video-taped when they were told they wouldn’t be video-taped, or are told that something will happen that doesn’t actually happen.). *

Yes No

Describe how and when you will debrief the subjects about the deception that occurred. *

Will any exogenous substances (e.g., pills, alcohol, topical applications, injections) be administered to the participants in this study? *

Yes No

Describe the nature of the substance and the risks the participant might experience from its use. Explain how you have worked to minimize these risks and how you will address the risks if they occur. *

Will the participants provide any biological materials as part of this study (e.g., saliva, blood, etc.)? *

Yes No

Describe the procedure for obtaining these materials and the risks the participant might experience from providing them. Explain how you have worked to minimize these risks and how you will address the risks if they occur. Explain also how the materials will be stored and disposed of eventually. *

Some studies run the risk of causing physical or psychological harm to subjects. Physical harm might occur due to certain procedures that induce pain, that involve exertion, or that expose subjects to adhesives, tape, or the like. Psychological harm might be due to exposure to certain stimuli that are disturbing (e.g., scenes of rape) or that lead the subject to experience disturbing memories or feelings (e.g., recalling traumatic experiences). Does this study pose any physical or psychological risks to subjects? *

Yes No

Please describe the nature of the risk(s) that subjects will be exposed to. Explain why exposing subjects to these risks is necessary for this project. Explain how you have worked to minimize these risks. Explain how you will respond if the subject experiences distress as a result of the procedures in this study. *

Will any mechanical devices and/or sensors be applied to the participants in this study? *

Yes No

Describe the nature of the mechanical devices and/or sensors and the risks the participant might experience from their use. Explain how you have worked to minimize these risks and how you will address these risks if they occur.

Do the procedures in this study involve asking any questions or engaging in any procedures by which the researcher is likely to learn that a participant: a) is at some risk for harming him/herself; or b) is engaging in some behavior, or plans to engage in a behavior, that will harm another person? *

Yes No

Describe the study’s protocol for: a) informing the participant that confidentiality must be broken in this case; and b) fulfilling the researcher’s responsibility to minimize the chances that the participant or anyone else is harmed. *

In order to determine whether the project meets ethical standards, the IRB needs to know about what will happen to participants in the study. Therefore, in the box below, describe in detail the procedures the participants will go through. For experimental or survey studies, it is usually best to explain the procedures chronologically from the point the participant begins the study to the point where s/he ends the study, describing each manipulation or measure, and supplementing that description by uploading materials below. For interview studies or participant observation studies, it is usually best to explain the range of settings in which data collection will take place and describe the nature of the interview and/or interaction with subjects, as well as uploading below the most complete interview protocol possible. To be clear, the IRB is NOT interested in receiving a literature review of background information regarding your hypotheses or a rationale for your procedures. We just want to know what is going to happen to participants. *

Provide any materials that the participant will experience as part of this research project. These might include survey instruments, interview protocols, auditory or visual stimuli, or any other thing that the subject will see, hear, or sense in some way.

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Uplooad Materials

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IRB Submission Form

You cannot proceed further until your adviser has approved your submisson.