STUDY COMPLETION REPORT (COURSE-BASED WORK)
- COURSE NUMBER AND TITLE
Protocol Reference #: Original Approval Date:
Previous Renewal Date:
Completion/Closure date:
- FACULTY / INSTRUCTOR INFORMATION
Faculty Instructor(s)
Title: / Name:Department (or organization if not affiliated with Algoma University):
Mailing address:
Phone: / Institutional E-mail:
- PROJECT INFORMATION
a)How many studentswere enrolled in this course?
b)How many of these students were involved in the research exercise(s) of the course?
c)Did any research participants actively withdraw from the study?
Yes No If Yes, how many?
Please describe circumstances:
d)How many research participants completed the study?
e)Please provide a brief summary of how effective the research exercise(s) were for the students (100-200 words):
f)Since receiving original ethics approval, have there been any adverse or unanticipated events?
Yes No
(If Yes, please submit an Adverse/Unanticipated Event Report Form)
g)Please give the reason and provide explanation for closing the study (i.e., end of study, accrual met, not enough participants, etc.):
- DATA AND CONFIDENTIALITY
a)Please describe how study-related documents will be stored and/or retained after the completion of the study, explaining privacy protection and supporting security:
b)Will this be different from what you described in your original submission to the REB?
My signature certifies that the above information is correct and that no unapproved procedures were used in study. Proper safeguards to confidentiality and security of data will be maintained until all data are destroyed. Please email your Study Completion Report to .
NOTE: We cannot process the report until all the signatures are in place. Please submit your report and supporting documents as a single attachment (if possible). Signatures should be included as an inserted image into the document, or the hard copy can be signed, then scanned and e-mailed to .
If neither method is possible, the REB will accept confirmation of Investigator or Supervisor representation, provided that an institutional email is used.
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