CATEGORIES: Application; Decision-making; Investigator Meeting; Virtual Interactive
One of the key challenges of running a meeting of multiple study sites is to keep the participants fully engaged to maximise their input. However, there are usually a number of conflicting personalities around the table so it’s unlikely that their contribution is going to be balanced. Furthermore, those who tend to dominate and take up the airtime may inhibit contributions from more introverted team members – it is not unusual for just 3 individuals to control 70% of the discussion. So, how does this dynamic subsequently impact on the decision-making process? It’s unlikely that all opinions have been robustly explored; there are inevitably hidden views which are not expressed due to the less confident nature of some participants. It takes courage for a less confident person to challenge the views of a highly dominant peer member.
Using a structured decision-making process the team may come to a radically different conclusion than they would using the conventional ‘free for all’ approach. If at the outset of each topic to be explored, the participants were asked to provide their opinion in a blinded fashion – and the range of opinions was then displayed – the discussion might take a different direction. Firstly, all opinions would have been provided (with even the silent members participating); secondly, their opinions would all have been given equal weighting (rather than one viewpoint being vociferously promoted by a dominant team member); and thirdly, the opinions would be ‘raw’ and uninfluenced by other views provided. From here, the relative balance of opinion becomes obvious – is the group split into two camps or several opinions? Or is there consensus on a topic? The outlying differences can then be explored by the moderator so that a robust assessment is made for all topics.
This process is often used as the basis for designing virtual investigator meetings. Sites can be brought together on camera and asked for their views on, say, recruitment challenges, using virtual interactive (Vi) software. All sites can then respond in further interactions to promote best practice sharing. The moderator can quickly see differences in opinion and explore further. There are many examples of where differences in hierarchy or levels of confidence are then balanced by giving participants an equal opportunity to provide their opinion through a combination of process and technology. Having experienced the virtual interactive process, it becomes hard to watch a traditional face-to-face meeting again and not become frustrated that the sponsor is unable to see the full range of opinions from the assembled participants. Interestingly, participants report greater satisfaction (presumably related to their increased input) with the Vi process; 100% of all sites taking part in a recent virtual interactive investigator meeting expressed a preference over a flat WebEx (non-interactive) equivalent event.