Systems and Regulatory Issues
Guest Expert: Mr Walt Cronin, NSABP - Preaching to the Choir
Originally posted by: Rose Mary Padberg, AccrualNet Team Member, on the former AccrualNet site on Jan 31, 2012.
I am so pleased to introduce Walt Cronin as our January guest expert. Walt is know by many of us for his inspiring and humorous presentations at NSABP meeting. You should also know that for more than 30 years Walt has handled administrative, project management and research experience in all phases of clinical research including recruitment planning, proposal development, protocol development, information systems management, quality assurance, logistics planning, and the design of operating systems. I asked Walt to share some of his insight on clinical trial recruitment with our AccrualNet readers. Here is what he said:
Walt Cronin's Post:
You might be familiar with the phrase "preaching to the choir". It is an idiom that came into our lexicon in the early 1970's and is meant to describe the situation of "making believers out of people who already believe, convincing people who are already convinced, or teaching people who are already educated" on the subject at hand. By virtue of the fact that you have come to this website and are reading this diatribe, it says that you are ALREADY a person who is: probably well-versed in the trials and tribulations associated with clinical trial recruitment; undoubtedly experienced in the obstacles associated with accrual; and someone who has first-hand exasperation at mounting a recruitment program that has fallen short of its goals.
Have faith. You have come to the right place; there are other destinations within this website that will surely be of great value to you. This current "conversation" that you are reading will, at best, only confirm what you have suspected for a long time After all, it has been 63 years since the first published report of a randomized controlled trial; you would think that, by now, someone certainly would have worked out the bugs. Yet, all of us involved in this enterprise spend countless hours preaching and sermonizing about the benefits of clinical trial participation, only too often for our messages to reverberate in empty places.
Continuing with this "ecclesiastical" theme and, at the risk of sound too "preachy", successful recruitment requires the following:
- We need to increase the size of the congregation. Those who are responsible for conducting clinical trials (pharmaceutical companies and the government) need to expand beyond the conventional methods and the individuals who are already involved, and be inclusive of other "denominations". There needs to be broader recognition of the vital roles that nurses and coordinators play in the recruitment process, and that recognition needs to be important to those being recognized.
- We need to make it less difficult to come to "church". At a time when we strive to increase recruitment, it seems as if more and more administrative burdens and regulatory complexities are being placed in our paths. To make significant inroads in expanding clinical trial recruitment, there first needs to be a corresponding decrease in the associated hurdles of conducting those trials.
- We need to stop asking for free-will offerings. Most of the people I know who are doing well at "singing the hymns" (i.e., recruiting to trials) are volunteering their efforts, without adequate personal and professional recognition of their efforts. Thought needs to be given to recognizing those efforts in a meaningful way so that those who are recruiting are doing it for more than altruistic reasons and so that additional talented people will want to "join the fold".