phase i- quality control review of research requests checklist · phase i: quality control review...

Review of Research Applications PHASE I: Quality Control Review Checklist Yes No Not Applicable Documentation 1. Application to conduct research ⎕ ⎕ 2. Detailed research proposal ⎕ ⎕ 3. Abstract ⎕ ⎕ 4. IRB approval/exemption letter ⎕ ⎕ ⎕ 5. CITI/NIH human subjects in research training ⎕ ⎕ ⎕ 6. Instrumentation ⎕ ⎕ ⎕ 7. Informed consent/assent forms and checklists ⎕ ⎕ ⎕ 8. Letters from Principals/Department Directors ⎕ ⎕ ⎕ Proposed Research Activities 9. Surveys, interviews, and/or focus groups ⎕ ⎕ 10. Administration of assessments ⎕ ⎕ 11. Classroom observations ⎕ ⎕ 12. Implementation of an intervention ⎕ ⎕ 13. Audio or video recording of participants ⎕ ⎕ 14. Access to student records required ⎕ ⎕ 15. Access to employee records required ⎕ ⎕ 16. Special student populations involved ⎕ ⎕ Description of Research Protocols 17. Recruitment of participants ⎕ ⎕ ⎕ 18. Obtainment of informed consent/assent ⎕ ⎕ ⎕ 19. Quantitative and qualitative methods ⎕ ⎕ 20. Protection of participant confidentiality/anonymity ⎕ ⎕ ⎕ 21. Security for the storage of data ⎕ ⎕ ⎕ 22. Destruction of data ⎕ ⎕ ⎕ Polk County Public Schools Office of Assessment, Accountability and Evaluation 1915 South Floral Avenue Bartow, FL 33830 (863) 534‐0531 / Fax (863) 534‐0770 Principal Researcher: Research Study Title: Researcher Institution: Type of Research: ⎕ Academic ⎕ Evaluation ⎕ Publication ⎕ National Study PCPS Employee: ⎕ Yes ⎕ No Revised 06/2018 1

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Page 1: Phase I- Quality Control Review of Research Requests Checklist · PHASE I: Quality Control Review Checklist Yes No Not Applicable Documentation 1. Application to conduct research

ReviewofResearchApplicationsPHASEI:QualityControlReviewChecklist

Yes No NotApplicableDocumentation

1. Applicationtoconductresearch ⎕ ⎕2. Detailedresearchproposal ⎕ ⎕3. Abstract ⎕ ⎕4. IRBapproval/exemptionletter ⎕ ⎕ ⎕5. CITI/NIHhumansubjectsinresearchtraining ⎕ ⎕ ⎕6. Instrumentation ⎕ ⎕ ⎕7. Informedconsent/assentformsandchecklists ⎕ ⎕ ⎕8. LettersfromPrincipals/DepartmentDirectors ⎕ ⎕ ⎕

ProposedResearchActivities9. Surveys,interviews,and/orfocusgroups ⎕ ⎕10. Administrationofassessments ⎕ ⎕11. Classroomobservations ⎕ ⎕12. Implementationofanintervention ⎕ ⎕13. Audioorvideorecordingofparticipants ⎕ ⎕14. Accesstostudentrecordsrequired ⎕ ⎕15. Accesstoemployeerecordsrequired ⎕ ⎕16. Specialstudentpopulationsinvolved ⎕ ⎕

DescriptionofResearchProtocols17. Recruitmentofparticipants ⎕ ⎕ ⎕18. Obtainment ofinformedconsent/assent ⎕ ⎕ ⎕19. Quantitativeandqualitativemethods ⎕ ⎕20. Protectionofparticipantconfidentiality/anonymity⎕ ⎕ ⎕21. Securityforthestorageofdata ⎕ ⎕ ⎕22. Destructionofdata ⎕ ⎕ ⎕

PolkCountyPublicSchoolsOfficeofAssessment,AccountabilityandEvaluation 1915SouthFloralAvenueBartow,FL33830(863)534‐0531/Fax(863)534‐0770

PrincipalResearcher:

ResearchStudyTitle:

ResearcherInstitution:

TypeofResearch: ⎕Academic ⎕Evaluation ⎕Publication ⎕NationalStudy

PCPSEmployee: ⎕Yes ⎕No

Revised 06/2018 1

Page 2: Phase I- Quality Control Review of Research Requests Checklist · PHASE I: Quality Control Review Checklist Yes No Not Applicable Documentation 1. Application to conduct research

Yes No Ethics&LegalIssues

23. FERPAcompliant ⎕ ⎕24. PPRAcompliant ⎕ ⎕25. Datasharingagreementrequired ⎕ ⎕26. Informedconsent/assentrequired ⎕ ⎕27. Criminalbackgroundcheckrequired ⎕ ⎕

DistrictConsiderations28. PotentialbenefittotheDistrict ⎕ ⎕29. Useofinstructionaltime ⎕ ⎕30. Useofemployeetime ⎕ ⎕31. Applicationanddetailedproposalareconcordant⎕ ⎕

RECOMMENDATION

⎕ProceedtoIRB ⎕ModificationsRequired ⎕PermanentlyReject

Signature:___________________________________________ Date:_______________________

Revised 06/2018 2

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