How Can We Influence Others For Better Outcomes In Clinical Research?

This article is not about influence in the way many think today. There will be no social media tips or tricks but, rather, a helpful look into the Delphi method, which aids decision makers in various organizations including regulated ones to gain consensus. Key advantages of this method include:

• Anonymity for the participants to express their opinion freely without fear of criticism or pressure from dominant members
• Iteration when the participants can reconsider their opinion over multiple rounds as they encounter new information and alternative perspectives
• Controlled feedback as the facilitator guides participants’ focus by sharing aggregated results.

This summer, we delivered a DIA DIRECT webinar titled, “The Power of Influence: How can we influence others for better outcomes?” We focused on situations we encounter in our daily lives, such as advancing initiatives in the workplace or motivating family members to do — or not do — something. The interest in this webinar, and the number of people who registered, exceeded our expectations. We, therefore, decided to summarize the key points and further explain the Delphi method — an easy, structured, and practical way to influence and reach consensus.

What Is Influence, And How Does It Work?

Influence is “the capacity to have an effect on the character, development, or behavior of someone or something, or the effect itself.”¹ To exercise influence, we need to overcome resistance and encourage people to reconsider their views.

We can imagine influence as an equation where influence equals persuasion divided by resistance. If resistance is high, even strong persuasion yields minimum results, while lower resistance increases influence.

To be persuasive, we need to be credible, build trust, understand reasons of resistance and address them, and use appropriate techniques. It all starts with active listening to people whose views differ from ours. They may have different experiences, interpret supportive data differently, have different interests or values, or simply view the issue from another perspective. Active listening helps understand their position and find common ground. It means listening for total meaning of both the content and underlying feelings, responding to feelings, i.e., validating and supporting the speaker’s emotional state, suspending judgement, and noting all cues including interpretation of nonverbal signals such as facial expressions, posture, and tone.²

Guiding a productive discussion rather than allowing it to become a destructive argument requires increasing the receptiveness of everyone involved. To achieve that, we can:

• Hedge: Present our views as a hypothesis or perspective to be considered rather than as the unquestionable truth.
• Emphasize common ground: Highlight shared values, interests, concerns, or problems.
• Acknowledge others’ perspectives: Demonstrate that we have heard and understood differing opinions, even if we do not agree with them.
• Reframe the proposed change in a positive way: Explain the change in terms of shared objectives and potential benefits.

When a group needs to move beyond discussion toward a collective judgment, a useful technique is the Delphi method. It can be applied with both onsite and remote teams.

The Delphi Method

The Delphi method is a structured communication technique that uses multiple rounds of anonymous questionnaires or polls to gather expert opinions and reach a group consensus. It was developed by the RAND Corporation in the 1950s.^3,4 By allowing participants to provide judgments independently and then reconsider them after receiving summarized group feedback, the method can relieve some of the social pressures and group dynamics associated with face-to-face decision-making.

The process has five main steps:

1. Select experts: Assemble participants, i.e., a panel of subject matter experts (SMEs) and key stakeholders with diverse views on the topic.
2. Conduct round 1: Ask the participants to answer, independently, initial open-ended or broad questions.
3. Summarize results and provide feedback: An appointed facilitator collects, analyzes, and anonymizes the responses into a statistical summary.
4. Conduct round 2 and beyond: Ask the participants to review the summary and re-confirm or revise their answers.
5. Stop at consensus: Repeat the survey loop until opinions stabilize or match a predefined threshold.

Like every decision-making method, the Delphi technique has its pros and cons. Strengths include minimum groupthink, reduction of egos, and enabling geographically dispersed participants to collaborate effectively. Its limitations comprise the time to reach the outcome (multiple rounds), risk of dropouts between rounds, and the quality of the outcome highly depending on the selection of appropriate experts and articulating the questions.

Practicing The Delphi Method

During our webinar, we practiced the method with volunteers from the audience. The practice case and outcomes are described below.

Participants were asked to imagine that they were advising an executive team:

If you could invest in only one AI initiative over the next three years, which would provide the greatest improvement in clinical trial quality? The poll offered five options:

• AI-assisted protocol design
• AI-assisted monitoring
• AI-assisted safety surveillance
• AI-assisted quality management
• AI-assisted study documentation

After the first poll, we displayed the aggregated results and asked participants to explain the rationale for their choice, assumptions that influenced their choice, and evidence or experience supporting their choice. The participants should not tell others what they chose. Then we repeated the poll. Results of both polls are displayed in Figure 1.

After the second poll, we asked our volunteers, again without disclosing their choices, whether they changed their vote and what information or reasoning persuaded them to do so.⁴