Leadership and Line Management in Clinical Research

Abstract: Line management is generic, utilizing the same approaches throughout all industries; line management brings together company needs and its workforce to deliver company objectives. This article provides an overview of line management styles and line-management-through-leadership approaches in the clinical research environment. The line management cycle – team building, support, motivation, and development—is described. Real-life examples illustrate how line management can support clinical research deliverables.

Introduction to Line Management

Line management brings together both the company needs and its workforce to deliver company objectives. Also, line management is not an exact science. The management style used needs to be adapted to reflect the needs of the direct reports. While the goal of line management is to deliver company objectives, it is important to support direct reports so that they can develop and grow in their roles.

Both line managers and direct reports have expectations. Based on an internal survey, line managers expect the following from their direct reports:

• Reliability
• Dependability
• Accountability
• Business mindset
• Flexibility
• Dedication
• Smart working
• Delivery of metrics
• Integrity
• Positivity

Direct reports responded to the survey saying that they expected the following from their line managers:

• Support
• Motivation
• Engagement
• Trust
• Work-life balance
• Feedback
• Solutions
• Development
• Honesty
• Fairness
• Empathy
• Transparency
• Listening
• Knowledge and guidance

Management Styles

Application of appropriate management styles result in a happy and productive work environment.

The authors use a variety of management styles, adjusting the style that they use to reflect the needs of the individuals being managed. There are six main management styles described in the literature ¹:

• Directive
• Authoritative
• Affiliative
• Participative
• Pacesetting
• Coaching

Each management style has its own strengths and weaknesses and works best in certain situations.

A directive (coercive) management style (“do it the way I tell you”) may be the best during emergencies or when the person doing the job is less experienced.

An authoritative management style (visionary) shares the manager’s vision and provides long-term direction.

An affiliative management style puts “people first, task second.” As an example, a CRA started the first 1:1 meeting with his line manager saying, “I know all managers are interested in metrics, so I am ready to start with that.” Instead, the manager suggested that the CRA start talking about himself first: how happy he was doing his job, any challenges and successes he experienced, if he was achieving his own goals for career growth. Turning the conversation towards himself helped to develop a better rapport between manager and CRA. An affiliative management style works because it is people who deliver the metrics. If the line manager takes care of the individual, the individual will try harder to deliver on their metrics.

In a participative or democratic management style, “everyone has input.” The participative management style especially works with the direct reports who are experienced enough and may not appreciate the directive (coercive) approach. Brainstorming with the team or asking team members for their input on how to complete a task are ways to use the participative management technique, engaging team members and giving them a sense of ownership.

Pacesetting (“do it myself”) and coaching (“developmental manager”) management styles are also necessary and very important.

Rosalind Cardinal, author of The Resilient Employee, said, “The key to being an effective leader is to have a broad repertoire of styles and to use them appropriately.” ³      

Managing through Leadership

A manager is the person who is responsible for controlling or administering an organization or a group of staff. Some managers achieve this by technical administering, telling their direct reports what to do and following up with reminders to have the work done. The opposite of technical administering and controlling is managing through leadership; a leader is a person who:

• Has and shares their vision
• Provides support
• Has empathy
• Is creative
• Achieves objectives through motivation
• Builds the team
• Listens and hears
• Provides continuous improvement
• Takes risks

The cycle of managing through leadership has four main components: Team building, support, motivation, and development.

Team Building and Continuous Improvement

A group of people is not necessarily a team. Table 1 provides an overview of team building and continuous improvement. Continuous improvement is necessary because the team is a living organism that changes over time. Building and maintaining the team is important because a happy and professional team is a productive team.

Recruiting the right people is a key to forming a productive team. A good job description is necessary. The individual being considered must have the right qualifications and experience as well as enthusiasm and the right attitude. The line manager must also determine whether the individual will be a good fit for the team and must assess his/her decision-making and critical thinking abilities.

Expectations can be set beginning with the job interview and/or the introductory meeting. Together with asking questions during an interview, it might be a good idea to share the company’s expectations. It’s also important to remind team members about company expectations when appropriate, the benefits of exceeding expectations, and the consequences of not meeting expectations. The authors find it important to praise team members and the team as a whole for their achievements as well as to make high achievement the norm.

Creating a transparent and friendly environment is another part of the team building technique. Ways to do this include hiring the right people, sharing values and expectations, and explaining the purpose of tasks and goals. Line managers provide or arrange for coaching as necessary for the team members.

Team building also requires being able to manage both conflicts and difficult team members. Even when the line manager hires the right people, there is no guarantee that people will not change over time. The line manager needs to try to understand whether any team members are unhappy and manage complaints proactively, have open dialogue with team members, take actions to resolve conflict, and handle difficult team members quickly. Balancing strengths and weaknesses is another approach to team building. The line manager should get to know team members in order to understand their likes and dislikes, their technical knowledge, their strengths, and the opportunities that need to be developed. Tasks need to be allocated to the appropriate people, and the management style should reflect the way in which each individual is going to be managed in the best way.

If a team member under performs, the line manager should step in to manage poor performance as soon as possible. Most people do not come to work to do a bad job; however, if someone on the team isn’t performing, this affects the other team members. Once the line manager identifies under performance, the manager should perform a root cause analysis to determine the problem. There are many reasons for poor performance, which include personal or professional issues. After identifying the root cause, the line manager should take immediate action to resolve the problem.

Team Support

Supporting the team (Table 2) gives the team members confidence. It works better when line managers are approachable, listen to their team members, and act upon information received.

The line manager should be patient, open, and fair, while remembering that patience is rewarded. As an example, a manager once asked one of his direct reports if she would like to deliver a presentation at an investigators’ meeting. She said “no” because she had never done it before. The manager decided to wait. She came back in a few days asking if the presentation was still available. They thoroughly worked together to prepare. The presentation appeared to be a great success, being a very strong further motivator for this individual.

Supporting the team also includes:

• A fair distribution of the workload
• Sharing expectations including those aligned with the end of the year performance review meeting
• Fair promotion, salary increases, and bonuses
• Not showing favoritism to any team members

Line managers should show their commitment to the team and be positive, serving as an example.

Protecting team members from unreasonable demands and serving as a buffer is also part of motivating the team. Nowadays at most international companies, people work in virtual teams, so they need to be culturally savvy to work effectively and efficiently while understanding different cultures, otherwise communication issues may occur. There may be situations regarding cultural misinterpretations where the line manager may need to step in to help.   

For example, a newly hired in-house CRA had great credentials and was a very nice individual to work with; however, there were issues with two sites where the standards of communication were different. In this case, the CRA’s manager had an open and fair conversation with the CRA discussing the issue. Together, they developed a plan to overcome the problem. The CRA’s communication style was adjusted, and the issue was successfully resolved.

Team Motivation

Motivating the team is another important part ofmanaging through leadership (Table 3). Leading, not ordering, and setting up clear achievable goals are parts of motivating the team while eliminating distractions. In the case of changes at an organizational level, such as a restructuring or an acquisition, the line manager may not be able to do much. However, the manager can help to explain and support team members. Distractions at the team level should be identified and managed quickly.

Line managers empower and encourage team members. Ways to do this include:

• Demonstrating trust
• Communicating vision and expectations
• Encouraging development and improvement
• Delegating tasks
• Encouraging team members to go above and beyond
• Accepting flexibility (there are many ways of doing things)
• Inspiring creative and critical thinking
• Showing appreciation

Several years ago, one of the authors hired a research administrator. The administrator had a scientific degree and was brilliant in that role; however, this person had low self-confidence. It was thought that the administrator was a great candidate to become a clinical research associate (CRA); however, when approached about this, this person was afraid to make the move. The author continued encouraging and motivating the administrator, and at some point that person gained the confidence to become a CRA, followed by a clinical trial manager. Now that person is a very successful global project manager. Without such manager’s support, that successful project manager might still be working at an administrative level.

Line managers should not refrain from praising their direct reports, as this motivates and encourages them, thus often boosting their confidence. In turn, it helps to set higher expectations. As an example, one of the authors maintains an Achievement Board for all of his direct reports using OneNote. All of the achievements are posted on the board – nothing is missed and no one is forgotten. The achievements are reviewed on a monthly basis at planned 1:1 meetings, and at the end of the year the Achievement Board serves as a very useful tool for the end-of-year performance review and possible rationale for promotions.

Recognizing achievements is a way to raise the bar and help team members to develop. Other ways to stretch individuals is to continue to challenge and support them while sharing successes with the broader team.

Team development

Team development (Table 4) can start with determining the aspirations, likes, and dislikes of the team members. Line managers should try to take these preferences into account when possible. However, development can be achieved by challenging them as well. There was an interesting real-life example where a very experienced Principal CRA joined the company. The CRA’s experience was primarily in oncology, and there was the agreement that this person would be allocated to work on oncology studies. However, it happened that there was no need for a CRA for an oncology study but there was a need for a CRA on a HIV trial. The CRA kindly agreed to take on the challenge, and we were going to review the allocation in six months. When the time came, the CRA requested to remain on the HIV study until the trial ended. The CRA has now been working on the HIV study for nearly three years, saying that some very valuable experience was gained and personal horizons were extended. So, this example suggests that it might be a great development exercise to take team members out of their comfort zone in order to promote their development.

Managing through leadership includes identifying development needs. We do this by reviewing career-building plans at different management levels by reviewing the plans with direct reports from time to time to implement changes, if needed. Providing reasonable flexibility can be very useful in facilitating staff retention. There are several ways to provide flexibility including allowing employees to work from home occasionally, perhaps start work later sometimes, or take on additional responsibilities or a specific study. A flexible approach should be used when it benefits both the team member and the company. At the same time, it is important to ensure that team members remember standard expectations so that flexibility is not abused.

Training is also an important element in managing through leadership. The global trend is to deliver training online, thereby giving up classroom-style training. However, line managers can still support their reports by:

• Providing suitable opportunities to learn by doing
• Conducting cross-functional team calls
• Delegating new tasks or allocating studies with new indications to team members
• Learning from others, including systems and processes
• Sharing best practices
• Adopting Q&A sessions and discussions

Coaching by the line manager and mentoring by more experienced colleagues are also ways to support team development.

Managing through leadership also includes boosting the confidence of team members. This is done through training and supporting a “you can do it” approach. Line managers identify the subject matter experts who can provide help when needed and be available to provide advice themselves. Other ways to boost confidence include appointing a mentor, providing the opportunity to suggest possible solutions, praising achievements, and encouraging colleagues and managers to acknowledge a job well done.

Learning Line Management

In line management, it is important to realize that you never stop learning. We can learn from both positive and negative real-life examples, learning by doing, shadowing, self-learning, training courses, and experimenting.

Conclusion

We, the line managers, should remember that our goal is to bring together the company needs and its workforce to deliver company objectives. We achieve it by building, supporting, motivating and developing happy and productive teams. There are mutual expectations between line managers and their direct reports. Line managers should be creative in identifying the management style that works in each particular situation. The successful manager develops a culture of leading by example, moving forward through a non-stop and ongoing cycle.

Table 5 details resources related to line management in clinical research.

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TABLE 1

Team Building and Continuous Improvement

• Recruit the right people
• Set up expectations
• Create a transparent and friendly environment
• Manage conflict and difficult team members
• Balance strengths and weaknesses
• Manage underperformance

TABLE 2

Team Support

• Be approachable and listen
• Be patient, open, and fair
• Show commitment and positivity
• Direct and delegate
• Protect team members

TABLE 3

Team Motivation

• Leading, not ordering
• Setting up clear goals to achieve
• Eliminating distractions
• Empowering, encouraging, and praising
• Raising the bar

TABLE 4

Team Development

• Knowing likes and dislikes
• Identifying development needs
• Providing reasonable flexibility
• Training, coaching, and mentoring
• Boosting confidence

TABLE 5

Resource on Line Management in Clinical Research

What is Leadership? 10 Ways To Define It. https://www.game-learn.com/what-is-leadership-ways-to-define. Accessed 12/18/19.

6 Management Styles and When Best to Use Them – The Leaders Tool Kit.

https://leadersinheels.com/career/6-management-styles-and-when-best-to-use-them-the-leaders-tool-kit/. Accessed 12/18/19.

Sean McFeat. A 20 Point Checklist For Effective Leadership

https://www.linkedin.com/pulse/20-point-checklist-effective-leadership-sean-mcpheat. Accessed 12/18/19.

Training Line Managers, CIPD Podcast. June 2016. https://www.cipd.co.uk/podcasts/training-line-managers. Accessed 12/18/19.

Line managers play crucial role in supporting employee well-being and engagement. CIPD. February 2017. http://www.cipd.co.uk/news-views/news-articles/line-managers-support-wellbeing-engagement. Accessed 12/18/19.

Trust the Process: 10 Tips to Empower and Encourage Your Staff

https://www.business.com/articles/trust-the-process-10-tips-to-empower-and-encourage-your-staff/

Accessed 12/18/19.

Conger JA. The necessary art of persuasion. Harvard Business Review, May–June 1998. https://hbr.org/1998/05/the-necessary-art-of-persuasion. Accessed 12/18/19.

References

[1] Ros Cardinal. 6 Management styles and when to use them – the leaders toolkit, April 2013

https://leadersinheels.com/career/6-management-styles-and-when-best-to-use-them-the-leaders-tool-kit/

² Sean McFeat. A 20 Point Checklist For Effective Leadership.

https://www.linkedin.com/pulse/20-point-checklist-effective-leadership-sean-mcpheat. Accessed 12/18/19.

³ Rosalind Cardinal. The Resilient Employee: The essential guide to coping with change and thriving in today’s workplace