To be a great CRA, one skill is needed: active listening.
What skill differentiates a good clinical research associate (CRA) from a great CRA?
The answer- none of the above.
Don't get me wrong, these skills are important and they are point of entry for a good CRA. These skills are expected as a minimum set of skills to be hired for the job of CRA but they are not the skills that differentiate a great CRA.
A great CRA knows how to spot a troubled site AND turn it around. Or better yet, spot a site headed for trouble and turn it around before it gets there. A great CRA is proactive, engaged and a partner with her/his sites. Let's face it; sites don't want to be in trouble. Sites want to do a good job, keep enrollment numbers up, and be successful on their own terms.
None of us enjoy dealing with a persistently troublesome site. It is uncomfortable, unproductive and exhausting. Troublesome sites take up much of our most precious resource as CRAs our time. Yet, too often we label sites as “troublesome” and apply the same tactics over and over again:
We all know (and could write volumes on) the downstream effects of poor site performance (delayed product approval, to name just one). So what's a CRA to do? You've explained to site staff countless times what is wrong and how to correct it (CAPA this, CAPA that) and yet the issues and problems remain. Can you really have an impact or should you write them off, because after all, in large studies, not every site is going to be a success?
The reality is – if you are a great CRA you can do a lot to help these sites. To be a great CRA one key skill is needed: active listening.
Active listening is a communication technique that fosters understanding and ultimately builds relationships. Active listening requires you to:
Active listening is a fancy set of words for genuinely trying to understand where the other person is coming from. In this case, the other person is the study coordinator or the site staff.
In your discussion with your “troubled sites,” who does most of the talking? If you responded with “I do,” then you are likely missing a huge opportunity to help your sites become successful.
By employing active listening, you will be able to better understand the root cause of the issue(s) and provide a better solution than a “standard” CAPA that lacks meaning or relevance to the site. And the bonus for you and the study is this: people like to feel heard. When you make a genuine attempt to hear the study coordinator or other site staff, they start to open up and a better relationship begins to form. Better relationships typically lead to better results.
You execute this 5 Step Active Listening Process.
Step 1: Open the dialog. Meaning create an environment for good communication to happen. You can do this by:
Step 2: Listen attentively. You can do this by:
Step 3: Interpret. Meaning make sure you understand what they said by:
Note: Step 3 is the most challenging step and most often forgotten. Practicing will help.
Step 4: Evaluate. Consider the information the speaker provided by:
Step 5: Act! You now did a great job of listening and understanding what the speaker was communicating. Continue to build the relationship by ensuring proper follow up. You can do this by:
Above all, when you employ active listening, be genuine – the site will know when you're not
This 5 Step Active Listening Process is not always easy. Our nature, at least in the United States, is to keep the focus of our conversations on ourselves rather than the speaker. To mitigate this tendency you need to practice this process. I teach a course called “The Highly Effective CRA: Soft Skills for Taking Your Work to the Next Level.” In this course we conduct a role play activity where a CRA needs to actively listen to better understand what is happening at the site. Almost every attendee who participates in this role play activity ultimately learns that s/he might have listened, but s/he did not actively listen. Bottom line – it takes practice, practice, practice to perfect your active listening skills. See if you can find a partner to practice active listening prior to performing your next site visit.
The next time you sit down with the staff at a troublesome site, break your old habit of pointing out the issues that need attention in the hopes that they will fix them. Most likely, the site knows what needs attention. Telling them again is only frustrating to them. Bottom line: they need a different approach.
Try a little active listening and see where the conversation leads. Let them vent and get it all out. You may find some valuable information comes to light as you actively listen to their airing of grievances.