IRB officials share ideas for bridging the gap with PIs
Robert Klitzman's survey of IRB chairs, members and administrators revealed a number of ideas that can be adopted by other institutions that want to improve relations with their investigators.
Klitzman, MD, an associate professor of clinical psychiatry and director of the masters in bioethics program at Columbia University in New York City, says most of these ideas are inexpensive to implement, but require changing attitudes about dealing with investigators.
- Opening the door — Several IRBs spoke of "open door" policies, making administrators, staff, and even chairs easily available to investigators via phone or email. Some also open the doors to the IRB board room itself, inviting investigators to come to meetings. However, at some institutions, interviewees complained that investigators wouldn't attend when invited.
- Rethinking anonymity — IRB officials interviewed showed nuances in the ways they deal with the difficult issue of whether an investigator should know who reviewed his or her study. An IRB may allow a reviewer to remain anonymous in specific situations, but encourage reviewers to reach out to investigators more generally when they see an opportunity to help.
One IRB director asked several members of the IRB to leave the board because they were adamantly opposed to communicating with investigators prior to meetings.
- Reaching out to educate — Many IRBs use newsletters and workshops to address continuing problems with studies that they see. Many note that their institutional human subjects protection training isn't extensive and may only consist of short online courses.
- Hauling out the charm offensive — IRB officials say they try to use tone, language, even humor, to ease the bite of an unpopular decision or request. One chair describes taking the blame for losing paperwork that she knows the investigator didn't turn in, in order to ask him to submit it "again."
- The goal, they say, is to be seen as facilitators and allies. They try to impress this on staff as well.
- Choosing where to put the effort — However, even the most helpful IRB officials have their limits. Some officials note that they work with principal investigators who frequently turn in poorly written proposals or complain about changes. With these PIs, they say, they are less likely to put in extra effort.
- Showing the basis for decisions — Not just the regulations, but the ethical principles that underlie them. If PIs understand how institutional rules tie back to ethics, they may be less resistant to them.
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