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International Clinical Trials

Train to Gain

In today’s economic climate many organisations are cutting their budgets. Often one of the first casualties is training. Another effect of the current climate is that many companies are operating with a reduced workforce after redundancies and job losses, resulting in increased time pressure on the remaining workers. Many managers are understandably reluctant to spend unnecessarily large sums of money and time training staff. Yet staff development is vital for any organisation involved in clinical research to survive, thrive and meet regulatory and legal requirements.


One method of learning which is often neglected and misunderstood is coaching. Coaching can be defined as using day-to-day work to provide planned opportunities for learning under guidance. Another term that is used interchangeably with coaching is mentoring. These two disciplines are ostensibly different, but there is some overlap of skills between a coach and a mentor.

Mentoring can be described as a nurturing process in which a more skilled or more experienced person, serving as a role model, teaches, encourages, counsels and befriends a less skilled or less experienced person for the purpose of promoting the latter’s professional and/or personal development. Often the mentor may be from another department and their role will be to provide guidance and support rather than carrying out learning activities with specific objectives.

If we examine the definition of coaching we see that it is a learning activity which involves using day-to-day work. In other words, real work is being carried out while a person is learning at the same time. This is one of the major advantages of coaching over learning methods that may focus on theory, simulations and exercises. While these resemble work situations, they are not real. Viewed another way, learning while being coached reduces work ‘down time’. Staff don’t need to leave the work place to learn, making cost and time savings on travel. For contract research organisations (CROs) who are selling their staff ’s billable time, this can be a real bonus. Less billable time is lost and, depending on their agreement with their respective clients, they may be able to bill some of time the learner is being coached.

The ultimate goal of coaching is to bring about a permanent improvement in performance so that a manager can delegate work with confidence to the person being coached. Coaching is one step in a series of controlled stages. This is sometimes known as the control continuum (see Figure 1). Initially the manager has to provide direction. As the person acquires some skills and knowledge, the manager moves into a coaching style and then penultimately adopts a supporting role with periodic guidance. The final objective is achieved when the manager is able to delegate work to competent and confident people.

Coaching is vital when used as part of a blended approach with other training methods, and is often essential to ensure that learning is embedded and reapplied. Opportunities to use coaching may include:

  • A change in a person’s role or someone moving into a new role
  • Learning how to use standard operating procedures (SOPs)
  • Part of a career development programme or preparing a team member for promotion
  • Organisational changes which may require adjustments to the mindset of the workforce or adoption of new approaches to work
  • Where there are skills deficiencies or the introduction of multi-skilling
  • Performance improvement programmes
  • Introduction of new technology, processes, services or standard operating procedures
  • Changes in legislation or regulations
  • When someone’s confidence needs boosting


Coaching is a cyclical activity and can be imagined as a continuous wheel of learning. The first step in the cycle is sometimes the most challenging for both the coach and the learner (see Figure 2). It involves trying to get an objective measure of the gap between the learner’s current performance and the standards required by their job role or procedure. This is easier in organisations which have competencies in place and well defined procedures. The coach and trainee need to agree on what these gaps are before the next step can occur. This may involve questioning by the coach on the learner’s past experience and the perception of their own ability. Some people may be over- or under-confident of their own skills and the role of the coach is to help them understand how they are performing with respect to the required standards. This concept of selfawareness is the start of the learning process.

The next stage is to decide what learning objectives need to be achieved. These should be agreed upon, not imposed, and prioritised in line with business needs and the individual’s personal development requirements. Objectives should be expressed so that they are specific, can be measured and will stretch the person sufficiently so that they have a realistic chance of achieving them. At the same time, a suitable work opportunity should be identified. Depending on the learner’s ability and confidence, the coach may need to show what needs to be done through a short demonstration. The coach should keep this phase to a minimum and avoid taking over the session; the learner will gain little if all they do is observe the coach demonstrating their own proficiency.

At the earliest opportunity the learner should be given the opportunity to have a go, giving the coach the opportunity to observe the learner’s performance without being intrusive. Three dimensions of performance should be observed: the knowledge the learner applies; the skills they demonstrate; and the attitude they adopt. Knowledge may include familiarity with regulations, the relevant SOPs and project-specific procedures. Skills could include an eye for detail and an ability to carry out error-free work; and their attitude might be demonstrated by their thoroughness, tenacity to solve problems or their relationship with other members of staff. The learner may develop their own style and, provided they are performing as required and achieving the objectives in an effective and efficient way, the coach should not interfere. Clearly, if the learner is going badly off-track or is in danger of making a mistake which would affect subject safety or data integrity, the coach should step in. A very useful technique is for the coach to discuss the consequences of the course of action the learner may be deciding to take. If people understand the context of what they are doing, there is more chance that they will deliver work at the required standards, take ownership and make the right decisions.

Once the learner has had an opportunity to perform for a sustained period of time, the coach needs to provide feedback. A skilled coach will get the learner to reflect on their own performance by asking general questions about how the learner felt, and to consider what went well and what could have been performed better. Good performance should be reinforced using positive feedback, praising specific elements. Underperformance should be clearly pointed out to the learner so that lessons are learned, mistakes are corrected, and the learner adopts a strategy to avoid the repetition of errors in the future. The coach and learner then decide what gaps are still apparent and the cycle of learning begins again.

Coaching need not be confined to one-to-one learning. Small teams can be coached when a task needs a collective approach and can be readily divided up into component parts. I once took part in a very effective session where a senior manager coached and facilitated the review of a clinical trial report by giving us various sections to evaluate and coaching us in the relevant techniques. We all had a great sense of collective achievement afterwards, as well as a good feeling that comes of being part of a cohesive and well-coordinated team.


For a coaching scheme to work well for any organisation, the right people need to be selected as coaches. Not everyone makes a good coach. In sport, for example, the best players don’t necessarily make the best coaches – very few of the greatest tennis and football players seem to be able to move successfully into coaching when their playing careers are over. It is often less prominent players who are the most successful at developing others. Whether this situation translates into the workplace is debatable. However, we should not assume that star performers are necessarily going to make the best coaches. When managers are selecting coaches they should look for certain qualities.

To be a great coach it helps to be interested in, and derive satisfaction from, helping staff develop and acquire new skills. Good coaches are skilled at listening, observing and encouraging others to talk and express themselves without being judgemental or jumping to conclusions. Sometimes coaches need to be prepared to challenge learners, but in a constructive and positive way. A good coach must be honest and be prepared to have difficult conversations when necessary.


An organisation that has a strong coaching culture will benefit in many ways. Some jobs by their nature can involve working in a certain amount of isolation – particularly CRAs – if they are field-based. Having coaches available can mitigate the sense of detachment that sometimes occurs in these roles. Being a coach is great for a person’s individual development. Coaches themselves learn, and sometimes pick up new ideas from their students. People who become coaches find that this can be helpful from a career development perspective and is a good stepping stone into management. Having a coaching culture means that people understand the context of their work and can appreciate the consequences of their actions. There is a greater feeling of teamwork and an environment of mutual support. Selfdevelopment is encouraged and a learning culture is established. People begin to realise that attending a training course is not always the answer to fulfil a learning need. Coaching is a major tool for managers delegating work in the confidence that their teams are well equipped to meet the increasingly challenging environment of clinical research.

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Martin Robinson is a Director of Dovetail Clinical where he leads a team providing learning and organisational development services tailored for the clinical research community, including project management coaching and training, and process improvement facilitation. He has over 15 years of international experience in training and organisational development in clinical research. He joined Dovetail from the Institute of Clinical Research, where he managed their public and in-company training programmes. Previously, he worked for Covance where he had a number of roles in training, development and project management. Email:
Martin Robinson
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