We Need Communication Beyond The "Blah, Blah, Blah"

By Maria P. Ladd, cofounder, Clinical Research Site Collective

The single biggest problem in communication is the illusion that it has taken place.

We’ve all heard it before. Communication matters. Entire conference panels, performance evaluations, and inevitable project debriefs have been devoted to it. Yet here we are, still circling the same topic, nodding at the same conclusions, and — if we’re lucky enough to rightly identify it — wondering why miscommunication continues to derail timelines, frustrate teams, and strain relationships.

So why talk about it again? Because the ecosystem of clinical research is changing, and with it comes an unprecedented opportunity — and willingness — to change how we behave.

The Landscape Has Shifted

Over the past few years, decentralization, technology integration, and workforce turnover have reshaped how studies operate. Sites are finding their voices, sponsors are recognizing that partnerships won’t thrive when the only fuel is pressure,and CROs are learning to balance metrics with more meaningful engagement. The shifts are only beginning and need to grow but the openness to change has created the environment to continue in that direction.

There’s a new openness in the air, with less command and control, more curiosity and collaboration. That shift gives us a real chance to reexamine how communication feels in our daily work.

Communication Isn’t Just Words

We often define communication as what we say or write. But in clinical research, it’s so much more subtle - and powerful - than that.

A delayed reply, a clipped tone in an email, a missed acknowledgment during a site visit — all send a message just as loudly as a conversation. Body language, perceived attitude, and even response time communicate value, respect, and urgency (or not).

Silence is communication, too, especially when answers are needed quickly.

When we forget that, small misunderstandings grow into big frustrations. And frustration slows everything: start-up, recruitment, data entry, monitoring, and with those, morale.

Where The Disconnects Live

Let’s be honest: every stakeholder group has its own pressures, and none of us operate in a vacuum. We see problems through the lens of what we’re accountable for, or what we’re feeling in the moment. The breakdown happens when we assume everyone else has the same visibility, bandwidth, and priorities. It happens when we don’t consider the other side of the call, email, or visit.

CRA And Site

The CRA may be under intense pressure to close queries and meet monitoring deliverables. The site coordinator, meanwhile, is juggling patients, data entry, and five competing study demands. When a CRA’s email tone sounds sharp, or when the site doesn’t respond promptly, the other side often perceives indifference or incompetence, when it’s really exhaustion and competing priorities.

Improved communication here means context sharing: “I’m under a tight deliverable, but I know you’re balancing patient visits. Can we find a time today to prioritize key queries?” That single acknowledgment shifts the tone from enforcement to partnership.

Sponsor And CRO

This dynamic is often defined by metrics, milestones, and budgets. Sponsors expect proactive problem-solving; CROs operate under contractual boundaries and hierarchical communication. What’s often missing is empathy for the middle-man fatigue that CRO teams experience — tasked with satisfying sponsor expectations while protecting relationships with sites.

A quick check-in that says, “We trust your judgment on site feedback — what do you recommend?” goes further than another escalation call. It restores autonomy and mutual respect

Acknowledging the pressure from board and shareholder expectations and working to prioritize critical milestones demonstrate an awareness of external pressures.

CRO And Site

Sites sometimes feel CROs are the gatekeepers to sponsor decisions. CROs, on the other hand, often feel trapped between rigid processes and real-world site constraints. Both sides want efficiency but speak different operational languages.

When a CRO project manager explains why a certain form or process exists and listens to how it’s landing at the site, it builds shared ownership instead of compliance fatigue; this is the start of working toward the same goals as partners.

Mutual understanding doesn’t slow progress; it prevents rework.

Site And Sponsor

Sites are often the least considered voice when timelines tighten or protocol changes appear. A sponsor’s decision that seems minor on paper — an added visit or a new data point — can translate into weeks of contract amendments, scheduling challenges, and staffing strain at the site level.

When sponsors proactively ask, “What does this change mean operationally for sites?” it signals partnership, not hierarchy. Sites, in turn, gain trust and confidence to surface issues early, avoiding the costly surprises that can come later.

The Ripple Effect Of Better Communication

When communication improves, everything downstream improves:

• Preparedness: Teams that share information clearly and early can anticipate issues before they escalate. When a CRA knows the site’s patient load or a site understands why a sponsor is pushing for a metric, planning becomes proactive instead of reactive.
• Issue Resolution: Problems are solved in days, not weeks, because the conversations move from defending positions to aligning goals. It’s not about who caused the issue, but how we can each do our part to resolve it.
• Efficiency: Clear expectations reduce duplication of effort, redundant documentation, and the dreaded email loops. The time saved on back-and-forth emails becomes time spent on patients, data, and delivery. A second email signals a potential need for a conversation; the third email confirms it.
• Morale: When people feel heard and respected, they respond in kind. Sites engage more readily, CRAs approach their work with empathy, and sponsor and CRO teams collaborate instead of clashing. That human element directly affects performance metrics on all sides.

Every communication exchange leaves a residue — positive or negative. The quality of that residue determines the strength of the partnerships.

In short, communication creates the conditions for efficiency, quality, and trust to coexist. It’s not a soft skill; it’s infrastructure.

Why The Moment Is Right

Right now, the industry is in transition. Decentralized models (still a work in progress), evolving regulations, and increased patient expectations have forced everyone to operate differently. The old top-down structure doesn’t fit a system that relies on both the digital and the human touchpoints.

Workforce turnover across functions has brought an influx into the current landscape. New professionals are entering the field with fresh ideas and fewer assumptions about how it’s always been done. At the same time, seasoned experts are more willing to question inefficiencies that have lingered for decades. That crossroad has opened a rare window: the cultural willingness to change.

Technology has democratized visibility. Sites have more insight into timelines, documents, and performance data that used to live behind sponsor firewalls. Transparency has its growing pains, but it builds shared accountability.

We’ve never had this much access to each other — or this much opportunity for misunderstanding each other.

The moment is right because we need to align by necessity. Studies are more complex, patients are more central, and margins for delay are razor-thin. The only sustainable way forward is to treat communication not as background noise but as a performance lever that deserves the same attention and care we apply to protocols and data.

A Call To All Of Us

So, where do we start? Not with another training module or slide deck but with small daily actions that change the tone of our interactions:

• Take an extra minute to acknowledge what someone else might be balancing.
• When you sense tension, ask, don’t assume.
• Follow up, even when you don’t have the full answer. Silence breeds anxiety.
• Replace blame with curiosity: Help me understand what’s driving that.
• Share context, not just conclusions.

While I’ve seen what a breakdown can bring, I’ve also seen goals realign and relationships mend when communication improves. Teams thrive simply because people take the art of communication seriously — not as a box to check but as a living part of the operational ecosystem.

Clinical research depends on trust. And trust depends on communication that goes beyond blah, blah, blah. It’s time we treat it as the vital sign and overall quality indicator that it truly is.

About The Author:

Maria Ladd has been in the clinical research industry for nearly 20 years. She is a passionate site advocate, a site operations consultant, founder of iLumaSite, and cofounder of the Clinical Research Site Collective. As a key collaborator and champion of change for site engagement, Maria can be found on LinkedIn, where she lends a strong voice to the clinical research community at large.