CRA’s and communication. Is it a good marriage?

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Job description and job skills of a CRA: communicative skills

Communication…does it exist? Do CRAs have good communication skills? Can they be trained to be more communicative? Or is this a “talent” that one may be lucky to have?

Throughout the years as a CRA it came to my attention that communication from CRAs towards study site teams is lacking. Do CRAs understand that communication is not only talking but also listening and trying to find a solution for possible problems (how small or big they are, doesn’t matter) in that way that both parties are happy?

When we first have a look at site initiation visits. Why do CRAs use very detailed power point presentations to guide and train the Site Team on the study protocol and the study procedures? A presentation can be very boring when it is too long and not all CRAs have the talent to work with these kind of presentations, specially when these presentations are prepared by other team members. We shouldn’t forget that these kind of presentations only need to highlight certain points of the study protocol and/or study procedures. But still, why do we use them? In my own professional experience as a CRA, I remember my first site initiation visit very good, nervous, uncomfortable, and very much using a detailed power point presentation prepared by the project manager. It was so easy to only read from the presentation and not to interact with the Site Team. When we are being critical towards ourselves as a CRA: Is it really necessary to have so much information on our slides? A lot of CRAs find it very tempting to read these sentences fully without intonation, without eye contact and I think we can all agree that we mostly start talking with one tone and loosing the attention of the audience. CRAs have to learn to use these presentation as a supporting tool and not as a leading tool when communicating with and to the audience. Communication is telling, using body language, interacting and listening and this is what we need to do during the site initiation visits. When a CRA is familiar with the study protocol and study procedures, it should not be a problem to explain your knowledge to the Site Team and explain them what is expected from them. When you interact and make eye contact, you will notice that you get reactions and questions and confirmations. Eye contact is a very important aspect to find out if your audience is listening, and if they understand what you are saying and trying to explain. Clinical studies have become more complex over the years, more vendors are involved, more detailed knowledge of GCP is expected, more detailed and administrative work from the Site Team is expected but does all this mean that communication needs to be put at the end of the list of skills and expectations and obligations? What would you do as a patient when you hear that the study nurse doesn’t have the time to listen and talk to you because a lot of administration is waiting for her? Isn’t it that the patient safety and wellbeing is always highlighted in every clinical trial? Finding a way to communicate will also help the Site Team to be there for the patient but also to make sure that the other tasks are being performed.

When we look at the regular on site monitoring visits… what is happening? Everybody is so focused on the quality of the data, which is absolutely necessary to obtain the correct results at the end, but we must face the fact that we are loosing the soft skills as a CRA or we are not even capable of developping the soft skills of a CRA? Are there too many data related tasks expected from the CRA that there is no time to give attention to soft skills? For prioritizing tasks on site and to make sure that everything can be managed in a reasonable timeframe it is important to work together with the study team. Remember working together will produce the best quality of data. Your timelines and being able to manage those are relying for 80% on your relationship and communication mainly with the study nurse/coordinator and the PI.

As a CRA we need to be able to evaluate the importance of CRA tasks, communication, data, obligations and prioritize these important aspects of the CRA role. As a CRA we need to be communicative, use common sense, be reasonable, be critical and be honnest. Not easy nowadays ….