Guest Column | October 25, 2018

From Cowardly Lions To Courageous Decision Makers: What ClinOps Needs Now

By Beth Harper

Fall is in the air, and Halloween is just around the corner. I always associate Halloween with “The Wizard of Oz.” When I grew up, Halloween meant reruns of the movie and was a highly anticipated annual family viewing event. Dorothy, the Wicked Witch of the West, those creepy flying monkeys, and, of course, the Wizard. We all had our favorite characters, and my poor parents had to contend with my post-movie nightmares for days. But it’s the Cowardly Lion who's been on my mind recently. In case you’ve forgotten, what he yearns for is courage. We eventually learn he's not really a coward; rather, he thinks he is because he doesn't ​believe in himself.1 More on that in a moment.

Fall is also conference season, and I’m fresh off four solid weeks of making the conference rounds from site-focused operational conferences, to quality and oversight programs, to e-clinical and data management events, to executive forums, and more. I’ve had the great fortune of facilitating a number of workforce-related sessions and workshops and have been struck by the breadth and depth of personnel challenges in our industry. I’ll recap some highlights of these sessions in my next article, but without question, the number one issue that rose to the surface is the absence of courageous decision makers in the workforce. Stated differently, the biggest pain point for managers and executives is the lack of staff who are willing and able to make decisions. This is a prized skill all organizations look for and, according to some, the simple ability to make a decision is the most important of all leadership skills.2

There is no shortage of great articles on decision making3, 4 or nifty tools to check your (or your employees’) decision-making skills.5, 6 Creative problem solving, critical thinking, and decision making all go hand in hand, as eloquently noted in one of the articles:

“Critical thinking is the practice of methodically gathering, analyzing, and evaluating information. It is one of the most vital parts of the problem solving and decision-making process, as it is the act of clearly thinking through options that will lead to a final choice. While decision making is the process that leads to actionable conclusions, critical thinking is the element that defines whether the choice is sound. Think about it this way: If problem solving is the car that gets your business to its goals, critical thinking skills are the gas.”7

Some interesting research out of the Netherlands reinforces the notion that teaching critical-thinking skills can improve judgment and decision making.8 Given that critical-thinking and decision-making skills are learned, honed, and mastered, it’s not surprising that the go-to strategy for many managers to enhance their staffs’ decision-making abilities is to invest in courses that focus on these skills.

But what is striking in the literature is the observation from many experts that the key ingredient for decision making is courage. “Courage in decision-making comes from confidence; confidence comes from the process you use to make the decision. You will often see that people who struggle with making difficult decisions do not have a methodology for processing information about the decision; therefore, they lack confidence in making a decision.”9 And while critical-thinking, problem-solving, and decision-making skills can be taught, what about courage? Can it be taught and learned, or must it simply be inspired?10 Regrettably, the answer to that may be a little less clear. Following the “Wizard of Oz” metaphor, Dorothy and the Cowardly Lion needed to learn how strong and courageous they could be, or were, for themselves. However, they had the Wizard and Glinda, the Good Witch of the North, to help them on their journey. They had people who believed in them.

So our collective challenge and opportunity is how to amp up critical-thinking and decision-making skills within the workforce. And perhaps more importantly, to find ways to believe in the workforce so they can gain the courage needed to apply these skills and start making courageous decisions. While clear-cut answers evade me at the moment, I have been reflecting on those mentors who inspired me to be courageous and believed in me. Perhaps you can do the same.

Oh, and in case you were wondering … my favorite Oz character was the Scarecrow. I’ll leave that to you to analyze. Until next time, wishing you a wicked Halloween filled with lots of treats and no tricks!


  1.  Quotes About Courage From the Cowardly Lion.
  2. The Courage to Make a Decision.
  3. What the Best Decision Makers Do.
  4. Courage as a Skill.
  5. How Good Is Your Decision Making?
  6. Watson-Glaser™ Critical-Thinking Appraisal.
  7. How to Make Better Decisions.
  8. Critical Thinking in Decision Making.
  9. Courage in Decision-Making.
  10. Can Courage be Learned?

About The Author:

Beth Harper is the president of Clinical Performance Partners, Inc., a clinical research consulting firm specializing in enrollment and site performance management. Harper also is the workforce innovation officer for the Association of Clinical Research Professionals (ACRP). She has passionately pursued solutions for optimizing clinical trials and educating clinical research professionals for over three decades. Harper is an adjunct assistant professor at George Washington University who has published and presented extensively in the areas of protocol optimization, study feasibility, site selection, patient recruitment, and sponsor-site relationship management. She serves on the CISCRP Advisory Board and the Clinical Leader Editorial Advisory Board, among other industry volunteer activities.

Harper received her B.S. in occupational therapy from the University of Wisconsin and an M.B.A. from the University of Texas. She can be reached at 817-946-4728,, or