By Fiona Wallace, director, FW Clinical Research Ltd.
“The single biggest problem in communication is the illusion that it has taken place.” – George Bernard Shaw.
There are some easy ways to improve communication on your clinical trial. But before we get into that, let’s consider how poor communication can derail your clinical trial.
How we communicate with each other affects the success of a clinical trial. Following are some examples of poor communication, when the message between the transmitter and the receiver has not been fully understood by one or both parties.
Drowning In Emails
The methods of communication are important. Let’s discuss e-mail. Is email a friend or foe? Both!
Email can help your study or hinder it, depending on how the study team uses it. The most common complaint I hear from colleagues is the sheer volume of emails they receive on a daily basis. Let me share this alarming statistic: 54 percent of American workers left vacation time unused in 2017. The top barrier to not using this vacation time was “fear of returning to a mountain of work” (43 percent).1 I think it is fair to assume the mountain of work includes opening, reading, and managing emails on that dreaded first day back to work.
The worst-case scenario could be that something urgent and important is hidden amongst the messages, e.g., a potential safety issue on your clinical trial. This is compounded if you have several highlighted urgent emails in your inbox. Which email is more urgent than the others?
Why Reliance On Email As The Main Communication Method Has Increased
For example, I used to review my Phase 4 clinical research associate (CRA) teams’ monitoring reports, and one CRA was extremely diligent. She documented everything she did at their monitoring visit, down to listing every monitoring and source data verification discrepancy. There was no need for this level of detail, as only significant issues needed to be documented. Reviewing her reports took me four times as long as that of another team member. This would affect the study timelines and budget.
How To Improve And Reduce Email Communication
Insiders’ Perspectives On Communication Issues
In my own informal survey with peers and colleagues, I received varied feedback about communication. One of my first project managers (PMs), who is now a pharma VP, had this to say:
“Every day we still make expensive mistakes because of poor communication, despite the available technology. My view is we expect people to do more, so people take shortcuts. Do I read every email I receive in detail? No. I read one word in four and fill in the gaps. I receive answers that miss the question because the person I wrote to is also reading one word in four.
Clinical research projects are always expected to start immediately, so PMs may not have time to plan properly. Team turnover is endemic, and the people joining the team are already overworked, so they don’t have the time to truly understand what is going on. As an industry we are breaking the work down into ever-smaller pieces. Startup and regulatory teams focus on one small section of multiple projects, so they often have limited knowledge of the project’s objective, and, of course, there is always, ‘It’s not my job.’
We work in an environment dominated by American English. The words and phrases used do not easily translate for a global audience. I was once on a global conference call when an American colleague said, ‘We need to get this train out of the station.' A colleague from Germany asked, 'Why are we catching the train? Where are we going?’
So, in short, my view is we need a little bit more time. We need to spend more time planning how we will manage project communication. We need to communicate in a way that works in a global environment, where people of different countries, ages, and background communicate in different ways.”
Another colleague, who is the global head of training at a CRO, offered this:
“I assisted with the setup of a virtual investigator meeting. Due to the nature of the details beforehand, attendance was low and there were some unexpected attendees, which made everyone nervous. Afterward I received an aggressive email from the PM about poor management and poor attendance and that the client was unhappy. So, I took a moment to type an email in response, rebuffing all the concerns. So, here I am, email written and ready to send, and I stopped. I had no concerns about the email contents; it was all accurate, but it didn’t add anything to the situation. It wasn’t going to help the PM at this moment. So I spoke to my line manager [LM] for advice, and subsequently set up a call early the next morning. As it turns out, the PM started by apologizing for the email and said she should have paused before sending it. Had I sent that email, we would have ended up in a war of words on emails and probably a broken internal relationship. As it happens, going back to basics, a good, old-fashioned chat, worked wonders.”
One of my previous LMs, who is now a senior director had this advice: “The sentence ‘I told you Mary did not steal the money,' when written, is not the same as when spoken, as emphasis on any one spoken word in the sentence will change its whole meaning, e.g., ‘I told you Mary did not steal the money,’ compared to ‘I told you Mary did not steal the money.’ Also, if you have to ask for or provide an explanation of the same thing twice in email, pick up the phone!”
Finally, consider the 1 percent rule: if you could improve your communication by one percent, what would that look like? Some examples may be walking to another office to speak to someone instead of using the telephone; calling your research nurse instead of emailing him; and communicating some good news, such as an important milestone that was met. Small changes make a difference.
About The Author:
Fiona Wallace, director at FW Clinical Research Ltd, has worked in global CRO and pharma for 18 years. Her experience spans many countries including India, South Africa, U.S., Europe, and Central and Eastern Europe in Phase 1–4 studies in oncology, ophthalmology, erectile dysfunction, and rheumatoid arthritis. She specializes in developing high value retention learning solutions by utilizing her breadth of experience in project and CRA management, global clinical regulatory training, inspection readiness management, and provision of client solutions to improve staff retention and engagement. Her latest project is to open up the discussion of mental health in the clinical research workplace, with the goal of improving the quality of life for everyone working in the spectrum of clinical research. Wallace can be reached at firstname.lastname@example.org.