By Eleanor Houston, Senior CRA, Industry
Gain insight into the factors of CRA burnout in clinical research from the 2018 PharmaTimes Clinical Researcher of the Year New CRA.
It is no secret that CRA turnover is a huge issue in the clinical research industry. It is not uncommon for sponsors or CROs to spend thousands of dollars onboarding a CRA, only to have them leave within one to two years after starting. Recent reports from the ACRP1 show that CRA turnover rates were as high as 25% in 2016, and the trend only continues to move upwards. There are many factors involved in a CRA’s decision to leave a company, including the standard salary, workload, and benefits, but there are also more holistic issues within CROs that create turnover.
As a CRA, you are taught to find the root cause of an issue before developing an action plan to correct it, but CROs and Sponsors do not seem to heed this advice when it comes to what causes CRAs to leave their jobs. There are so many facets to the CRA position that are often overlooked by upper management, including: limiting autonomy for travel, technological systems that are not user-friendly, and the basic understanding that teams are made of people with personalities and feelings.
Part of having a workforce that is predominately remote-based means trusting your employees to make the right choices for their needs and the needs of the company. All good relationships are built on trust– the employee-employer relationship is no different.
Many large CROs and Sponsors require that their employees only use a certain hotel chain or airline, even when it means staying a hotel that is further away from the research site or taking flights that require layovers rather than flying direct. While these inconveniences may seem inconsequential in the grand scheme of things, these minor details can really affect the morale of the CRA. It is very difficult to be on the road three to four days a week, and even minor conveniences like staying at the hotel nearest a coffee shop, or where a right-hand turn can be made rather than a left turn, really add up at the end of the day. When an experienced CRA is required to seek approval for every move they make, it becomes a burden on their ability to fulfill their deliverables. There are only 24 hours in a day, allowing CRAs to select their own amenities is one way to ease the stress of travel.
Another major burden to a CRA’s workflow is outdated or ineffective computer systems and processes. In the ever-changing technological field, a program that may have been adequate 10 years ago is now an ancient dinosaur. Slow CTMS systems that do not provide features like spell check or autosave, eTMF systems that do not integrate with the CTMS system, requiring wet-ink signatures on site communications rather than electronic signatures, travel agencies that don’t have apps for scheduling, expense report programs that do not allow receipts to be imported as photos from a phone or email, timesheets that cannot be accessed without logging into your computer, and requiring CRAs to use a courier like FedEx or UPS to submit documents rather than emailing them are just a few of the many dated systems and processes that require extra time and effort on the CRA’s part to complete their job. Often the minute administrative tasks that CRAs must accomplish every day are overlooked both as billable time and in metrics used to gauge performance. If technology can work to alleviate some of the workload, CROs and Sponsors should be striving to utilize the most up-to-date and efficient products available.
Possibly the most important factor in why CRA turnover is so abundant is because CROs and Sponsors tend to forget that study teams are made up of real people, not robots. Each has their own personality, strengths and flaws, personal life outside of work, and their own personal expectations of what they want from their career. So many times large companies will ignore complaints about poor managers or personality conflicts amongst teams because they feel they have no way to predict these issues, and therefore no way to solve them. If they took the time to work with employees to place them in positions that met their needs, CRAs may not feel the need to jump ship so often.
Many times CRAs find themselves working on a team that is poorly run or working for a superior who they clash with, either due to their communication or working styles. Rather than giving the CRA the opportunity to move to a different study, or even to simply have them report to a different person, the CRA is stuck in a position that they cannot get away from without leaving the company entirely. Large CROs and Sponsors often decide to “restructure” or “improve” upon their current set up of the company and move large amounts of employees around, having them report to new managers or placed on new studies, without stopping to think about how that affects the employee’s day to day interactions at their job. A strong relationship with your direct manager is often what makes or breaks any position, and unfortunately that relationship is not always valued by the company.
There are so many reasons why a CRA may choose to leave their current position, leave the next position they go to, and even the one after that. Sometimes it really is all about the money or titles offered with a new company. But for a many CRAs, money and titles only go so far. Having a comfortable position where they are trusted to make their own choices, have systems in place to support their deliverables, and people around them that fit the culture they strive to obtain can mean all the world to most. In an industry frequently driven by profit and metrics, it can be hard to find a spot that feels like your “work home,” where you don’t just feel like a replaceable cog in the wheel. Many companies are starting to understand that these issues have a major impact on employee morale, but so many still have so far to come.
–Eleanor (Ellie) Houston has been a clinical research professional for 9 years. She has worked as a CCRC, a research site manager, a Quality Assurance Officer, and currently as a CRA. She was also named Clinical Researcher of the Year- New CRA at the 2018 CROY awards last spring.
*This article was originally published on Clinical Research IO’s blog
Prafulla Bhagat says
As a Coordinator working in Clinical Trials, your thoughts greatly resonate with my experience in terms of a burn out. Thank you for writing such a great piece of wisdom which I think every department running trials should read. The high CRA turnover is either way detrimental to staff and the institution. It affects the dynamics of processes that govern the trials as new staff will need training and it comprises data quality and site efficiency as a whole not to forget putting patients life at risk.
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