June 2022, Vol. 14, No. 2 AJHPE 47 Forum Ever-increasing pressure is being placed on faculty members and students to engage in research and produce publishable outputs.[1] Projectivised multisite research provides a possible avenue toward alleviating this pressure, but it is not without potential pitfalls.[2] The purpose of this document is to critically reflect on some of the most pervasive ethical dilemmas faced by postgraduate researchers when engaging in such projects. The Stellenbosch Institute for Advanced Studies (STIAS) hosted a visit by four scholars to engage in a project named ‘Using a projectivised approach towards advanced studies in mental health research and developing graduateness among mental health students’. The envisioned outcome of the STIAS endeavour was to develop one large and comprehensive research project to which numerous postgraduate students could contribute through smaller, independent studies. Following lengthy discussions and consultation, a project titled ‘COVID-19 as psychological trauma, and managing the consequences’ was conceptualised. In order to attract postgraduate students from various universities to participate in the study, the possible concerns of the relevant institutional review boards (IRBs) needed to be considered. These IRBs exist within the context of their own membership and policies, but also subscribe to the requirements set by universities for degrees, guidelines from the Department of Higher Education and Training and the publication guidelines of peer- reviewed journals, all of which relate to the dissemination of the research. The aim of this article is to assist prospective collaborators on multisite research projects to deal with the challenges they may face when dealing with IRBs, and to provide them with practical insights that might ease the journey to publication. Six prominent ethical dilemmas specific to projectivised research were identified: (i) The first dilemma foreseen with outputs from multiple sites was that stakeholders (university authorities and journal editors) may deem the outputs as not independent or as a strategy to increase the number of outputs. In our planning, we were aware of these concerns, and therefore conceptualised each subproject to contribute independently to a well-defined and evolving body of knowledge. In the write-up, we described all the planned subprojects in detail, and how they independently and cumulatively contribute to the larger project. Specifying these subprojects should ensure that reviewers appreciate the gravitas of each subproject, and that they will be assured that fragmentation or dilution does not occur. Doing so will also provide reassurance that the employment of the least- publishable-units[3] approach (salami-publishing) is avoided. (ii) Related to the aforementioned is the fact that many universities require students to publish as a prerequisite to graduation.[1] It was therefore important to design the projects in a manner conscious of the authorship requirements set by leading journals.[4] As the student contributors were not involved in the conceptualisation of this research, they needed to be involved in ‘the acquisition, analysis, or interpretation of data’, as this would grant them access to authorship. It will subsequently be required of all student collaborators to be involved in the execution of the study under consideration. Furthermore, with multiple sites and contributors involved, it is suggested that all collaborators agree early in the process to accept the guidelines of authorship allocation, as stipulated by the International Committee of Medical Journal Editors.[5] Students should make sure that the by-line conventions specified in their university policies are considered in these agreements. (iii) Another problem associated with projectivised research is that a large part of the conceptualisation, methodology and research ethics is addressed on behalf of the student collaborators. However, it is important for students to attain the required learning outcomes associated with the degrees for which they have enrolled.[6] Student collaborators are therefore encouraged to take ownership of their own study and to defend the theoretical and methodological choices made on their behalf.[2] To acquaint the students with the workings of ethics applications, supervisors are to recommend certified online ethics training programmes to students. Attaching these certificates should be a prerequisite for the completion of their studies and the awarding of degrees. (iv) Related projects (investigating X in areas A and B) may require similar literature reviews, which brings us to the fourth issue, namely plagiarism.[3] Although cross-site collaboration is encouraged, students are also advised to conduct literature reviews independently. It is also Projectivised multisite research is gaining popularity, but is not without its pitfalls. Presented are eight possible challenges that could be encountered, and strategies to manage them. This article presents valuable information to scholars planning projectivised multisite research endeavours. Afr J Health Professions Educ 2022;14(2):47-48. https://doi.org/10.7196/AJHPE.2022.v14i2.1444 Ethical dilemmas in projectivised multisite research R Steyn,1 MA, PhD; U Subramaney,2 MB ChB, PhD; E S Idemudia,3 MSc, PhD; J Becker,4 MComm, PhD 1 Graduate School of Business Leadership, University of South Africa, Pretoria, South Africa 2 Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa 3 Faculty of Humanities, North-West University, Potchefstroom, South Africa 4 Department of Industrial Psychology, Faculty of Economic and Management Sciences, University of the Western Cape, Cape Town, South Africa Corresponding author: R Steyn (steynr@unisa.ac.za) This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. https://doi.org/10.7196/AJHPE.2022.v14i2.1444 mailto:steynr@unisa.ac.za 48 June 2022, Vol. 14, No. 2 AJHPE Forum recommended that students who work on similar projects (X in areas A and B) should approach the studies from different theoretical perspectives. The unique literature reviews and subsequent tailored discussions of findings will combat plagiarism and, simultaneously, contribute to the richness of the bigger project. (v) Data pooling forms an integral part of multisite research projects. Ethical concerns on this matter can be dealt with in the consent form[3] by stating that data will be pooled, and also by providing examples of how this will be done. Linked to this issue is the quality of the data collected from different sites. This is primarily a technical issue, but will also be of interest to some IRBs. To ensure the integrity of the data collected, standardised instruments are prescribed and strict research protocols should be developed to ensure the uniform collection of data. (vi) Most of these projects are multidisciplinary, thereby involving different departments within the university. There is always the temptation to submit the application of ethical clearance to a specific IRB with a reputation for leniency. Students should, however, ensure that the authority of the IRB in question is recognised by the department from which they plan to graduate. To facilitate student applications to IRBs, a copy of the certificate approving the grand project at a well-established university should be attached. It is envisaged that such a letter will add authority and help to facilitate the approval of these applications. Four strategies to assist students in obtaining IRB approval for multisite projects were employed. The first involved a broad approach, in which it was demonstrated that the grand project could meaningfully be segmented into a number of smaller, independent studies. The second strategy involved engaging students in their research project, allowing them to take ownership and to defend the prescribed protocols. The third strategy involved the utilisation of standardised procedures, in which all projects follow a predetermined and standardised approach, assuring ethical adherence. The fourth strategy related to foreseeing the most pertinent ethical dilemmas related to multisite research. Declaration. None. Acknowledgements. The Stellenbosch Institute for Advanced Study (STIAS) hosted the authors during the period in which this text was conceptualised and written. Author contributions. All authors contributed equally to the conceptualisation and production of the text. Funding. None. Conflicts of interest. None. 1. Bateman EA, Teasell R. Publish or perish: Research productivity during residency training in physical medicine and rehabilitation. Am J Phys Med Rehab 2019;98(12):1142-1146. https://doi.org/10.1097/ phm.0000000000001299 2. Steyn R. Ethical dilemmas associated with hyper-structured student research projects. S Afr J Higher Educ 2020;34(1):231-248. https://doi.org/10.20853/34-1-3095 3. American Psychological Association. The Publication Manual of the American Psychological Association. 7th edition. Washington, DC: APA, 2020. 4. COPE discussion document. What constitutes authorship? COPE, 2015. http://publicationethics.org/news/what- constitutes-authorship-new-cope-discussion-document (accessed 10 August 2020). 5. International Committee of Medical Journal Editors (ICMJE). Defining the role of authors and contributors. ICMJE, 2016. http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of- authors-and-contributors.html (accessed 26 April 2020). 6. South African Qualifications Authority. The South African Qualifications Authority (SAQA). Level descriptors for the South African National Qualification Framework. SAQA, 2012. http://www.saqa.org.za/docs/misc/2012/ level_descriptors.pdf (accessed 15 August 2020). Accepted 1 June 2021. https://doi.org/10.1097/phm.0000000000001299 https://doi.org/10.1097/phm.0000000000001299 https://doi.org/10.20853/34-1-3095 http://publicationethics.org/news/what-constitutes-authorship-new-cope-discussion-document http://publicationethics.org/news/what-constitutes-authorship-new-cope-discussion-document http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html http://www.saqa.org.za/docs/misc/2012/level_descriptors.pdf http://www.saqa.org.za/docs/misc/2012/level_descriptors.pdf