On Research Podcast – Improving Access to Research Studies

Jessica Rowe: I think we need to get into those communities and we really need to just sit down over a cup of coffee and have a conversation. It’s not that hard. And we need to do it with compassion and we need to understand what the needs of these individuals are.

Justin Osborne: Welcome to On Research with CITI Program, your favorite podcast about the research world where we dive into different aspects of the industry with top experts in our field. I’m your host, Justin Osborne, and I appreciate you joining.

Before we jump in, as a reminder, this podcast is for educational purposes only. It is not designed to provide legal advice or legal guidance. You should consult with your organization’s attorneys if you have questions or concerns about the relevant laws and regulations that may be discussed in this podcast. In addition, the views expressed in this podcast are solely those of our guest.

At the top, you heard a clip from Jessica Rowe, my guest this episode. Jessica is the quality and education director at the Yale Cancer Center. She’s also the current president of SOCRA, the Society of Clinical Research Associates.

Today, Jessica and I focus on the topic of access to research. There are many reasons why improving people’s access to research is important, and just as many reasons that complicate the issue. We talk about the barrier from all sides, including some ideas and suggestions to consider in addressing this important issue. So without further ado, I hope you enjoy my discussion with Jessica.

I’m with Jessica here. Thank you so much for taking the time to speak with me. Thanks for joining the podcast.

Jessica Rowe: Of course. Delighted.

Justin Osborne: So just to jump in, can you tell us how you got started in the research industry, and then what your role or roles are now?

Jessica Rowe: Sure. So I think much like most clinical research professionals, this was not a planned career pathway for me. I fell into it. I started as a research assistant in a neuropsychology department, and from there I moved over to doing some research coordination with an anesthesiology group. And then I found my true passion when I jumped into working with the Institutional Review Board at University of Maryland. And that’s when I really found my passion in research ethics, compliance, and quality.

From there, I’ve held different roles in the quality space, in the compliance space, and in the education and training space. I like to say I’m a little bit of a jack of all trades in clinical research because I’ve never stuck to one path. I have been in the IRB space, I have been in the research coordination and operation space. I’ve even done financials and budgeting. But I really think that that gives me a really nice big picture of how we all kind of integrate to achieve an objective.

Justin Osborne: I like that. Yeah, that’s a good point. So then where are you at now? What are you doing now?

Jessica Rowe: Sure. So now I am currently the director of quality and education at the Yale Cancer Center in the Clinical Trials Office. I’m also an adjunct instructor at University of Maryland, Baltimore. So I do some teaching in their ethics and research administration courses. And I am currently the president for the Society of Clinical Research Associates.

Justin Osborne: Very nice. Okay. Very busy. A lot of hats.

Jessica Rowe: Very busy.

Justin Osborne: That’s great. Well, thank you for the background. And that actually helps because our topic today, talking about access to research studies. I want to let you sort of talk about that, define that, and kind of guide us through this topic. But it does, based on your background, it sounds like you do have a pretty broad range of experiences that you’re coming at this with, so this should be interesting.

So let’s talk about access to research studies. Can you kind of give us your, I guess, definition or parameters around this, and then we can kind of dive in?

Jessica Rowe: Sure. So I’m a little bit of a storyteller, so I’m going to start there.

Justin Osborne: Perfect.

Jessica Rowe: The reason I’m so interested, particularly in research access or access to research, is I myself grew up in a very small rural town where access to healthcare in general was very limited. If you had to have a surgery or you needed chemotherapy, you often had to travel hours to get to a location where you could have access to those services, or even go to another state.

As I got into the research space, what I started to realize is that this is also true for research. We have these populations that have no access or even awareness about clinical research. And we know that in many cases, particularly in the oncology space, the only access to potential treatment options can be through clinical trials.

In addition, by ignoring these populations, we’re not allowing them to contribute to science. We’re not allowing them the autonomy to make that decision. We think about justice from the Belmont Report, that we need to make sure everyone has equal access. We are not achieving that goal because we aren’t making sure that everyone has the ability to make a decision to participate in a clinical trial or not.

Justin Osborne: That’s interesting. And so to jump off of that definition I guess, it sounds like… Because I remember years ago, the industry sort of talking about how sponsors even were focusing more on community hospitals and trying to get to the rural areas rather than just the academic medical centers that are always in the downtown area. And you get the same patients over and over again in these areas.

So how do you think that we combat this? What are some of your suggestions or thoughts about where do we go from here?

Jessica Rowe: Sure. So unfortunately, even though I think we’ve been talking about this for years, as you’ve pointed out, I don’t think we’re doing it very well. I think that we haven’t quite figured out how to meet people where they are and recognize that many of these people, they can’t drive to a site. The community hospitals or the community physician’s office that you talked about, they aren’t equipped. They don’t have the knowledge to fully function as investigators and study team members. They haven’t been trained.

And honestly, I think one of the biggest challenges is that as a research industry, we aren’t coming together to tackle this problem. As you mentioned, the sites and the sponsors, they are trying to tackle it from their viewpoint. The study teams are trying to tackle it from their viewpoint. The IRBs don’t quite know how to handle this because all of a sudden you have these people who are not typically involved in research being involved in research, and what role do they play? And it’s the same conversation that we are having around decentralized clinical trials as well.

But I think there’s a couple of pieces here. One, we need to work with these populations. We need to engage them in the actual process. We talk about patient engagement. We talk about community engagement. But I think we can do better. We need to be going out to them and saying, “How can we help you? What do you need from us so that you can have the opportunity to participate in clinical trials?” We need to be providing training and education.

So when I go back home to my rural area and somebody asks me what do I do for a living, I get a deer in a headlights look. Many of these groups don’t even know what clinical research is. So just providing that basic knowledge. And doing that earlier, so starting to do that maybe in high schools to start really getting people thinking about that.

Ideally, we want people who are in these rural areas to be the ones contributing to the research, not only as participants, but having other contributions as well.

Justin Osborne: Yeah, that’s good. I mean, I think to your point, when we fell into this industry, like you were saying at the beginning, we just sort of fall into it, because there was really no track for it. Nobody talked about this growing up. I didn’t know this was an industry. That is sort of starting to change. You had mentioned education, and I know there’s programs now. You can get certifications now. There’s entire coursework, all this stuff. You can get knowledge of clinical research earlier, I guess. But I still think that it feels siloed, kind of to your point. Sure, we’re educating people on how to enter the industry. I don’t see a whole lot of education to the general public about what research is though.

Jessica Rowe: Exactly. And just to even be able to go into your physician’s office and ask about clinical research options. So I don’t think most people are aware that they can do that. That they can go in and they can say, “Hey, are there any clinical research options for me?” So I take my son to the pediatrician here, and all over their walls are flyers for clinical research studies. But I live in an area where there’s lots of academic centers near me. If I go back home and I take my mom to the doctors there, there’s no mention of clinical research. There’s not a poster. There’s not a flyer. There’s not a discussion. It’s not even considered an option on the table.

Justin Osborne: Yeah. No, that’s true. And so to get back to some of the root causes, I mean, you had kind of mentioned this earlier, but it seems like some of the problems with these smaller clinics or smaller practices, it becomes the complicated nature of research. So I mean, I would love for them to participate. I think people see them in general and say, “Hey. If they have patients, why don’t they just jump on board?” But it’s so complicated to start research at a small community clinic.

Jessica Rowe: It is. It is so complicated. It’s not as easy as just enrolling the patient and doing the study procedures. There’s financial implications. There’s contractual implications. There’s regulatory implications. And I could continue down this pathway. There’s technology implications.

And so I think we need to find a way to help support in these private practices, in these rural areas. And I’m focusing on rural areas, but it’s not just rural areas. It’s other places where people just don’t have access. But we need to find a way to support them to…

But part of the thing is I don’t think we’re asking. I don’t think we’re asking the question, “How can we help you? What do you need from us?” And we need to be willing to do that upfront. One of the challenges, I know, and it seems like a silly challenge, but one of the challenges that a small community hospital that I’m familiar with that’s been trying to do some research in a rural area, that they face is, sponsors just don’t want to work with them because it’s too hard to get a monitor there.

Justin Osborne: Oh, interesting. Even with all the technology advancements that we get?

Jessica Rowe: Even with all the technology, the remote options are just not quite as available because the site doesn’t have a CTMS. The site doesn’t necessarily have Epic, which a lot of places do. But just the travel itself of getting a monitor physically there was a barrier.

Justin Osborne: That is interesting. Can you name the sponsor? I’m just kidding. Okay. So no, that’s an interesting challenge.

So I guess let’s kind of shift back to why this is important. So thinking about access, everything we just kind of ran through, why do you think it is important that not only are we talking about this topic, but we actually change something? What are we going to miss out on if people continue to just not have access to research?

Jessica Rowe: So I think there’s a lot of things we’re going to miss out on, quite honestly. There’s the obvious. The purpose of clinical research is to improve health outcomes for all of us, whether it’s behavioral research or biomedical research. And then when we think about biomedical research and we think about studying new drugs or new devices that we hope are going to benefit the people in our own communities, our friends, our families, our kiddos, we want to make sure that that product has been tested for safety and efficacy in the populations are going to use them. We’re physiologically different. People from one region are different from people from another region. So essentially we don’t have that data for these pockets of people that aren’t getting access to research. So there’s that concern.

From my perspective, and this is more of a personal opinion, but it’s an ethical issue. And I truly believe that everyone should have the opportunity to participate in research. There’s benefits to participating in research. We know this. I’ve also already said, in some cases it is sometimes the only option is enrolling in a clinical trial. And I think ethically, we have a duty to allow people this opportunity and we aren’t doing that. I think if we’re really adhering to those ethical principles in the Belmont Report, like justice, we need to make sure that we are engaging the broader community. We need to make sure that everyone’s having this opportunity, no matter where you live or what you do for a living.

And so I think also by excluding those people, and I don’t think it’s active exclusion, but by not finding ways to include them, the other problem we’re having is we’re continuing to promote distrust amongst certain communities. We know that public trust in clinical research isn’t always the greatest. We don’t have the best historical reputation. But if we’re not working with those communities, if we’re not having the conversations, if we’re not bringing research to them, they have no reason to trust us. They have no reason to trust the work we do because they don’t know it.

Justin Osborne: Yeah. No, that’s true. And I feel like it’s interesting because, like you said, a lot of people don’t know about research. You would feel like the impetus would really be on our industry to want to promote the positive aspects of clinical research. Even if people have a very, I don’t know, basic level of understanding of research, a lot of it is negative. Like you said, we don’t have a great history. So you would think that we would try a little bit harder to push some of the positive aspects of this and helpful aspects.

Jessica Rowe: Yes.

Justin Osborne: So thinking about the different roles, in our industry we have all these different segments of groups working on research. You have the sites, you have the sponsors, you have academic centers, and then you have the community centers.

But I guess can you kind of talk through those different segments and what you think their responsibilities are or should be, and what role do they play in this?

Jessica Rowe: Sure. And one group that we haven’t mentioned is the regulators too. They have a piece in this too.

Justin Osborne: Yes, absolutely.

Jessica Rowe: So from the sponsor perspective, I think that the sponsors need to be more willing to take a chance and to take a risk and engage these rural areas and have these conversations. I told the story about the monitor earlier, and part of that is just they’re not willing to take that risk. They weren’t willing to take on that financial risk or that burden.

I know another challenge has been sites that haven’t proven themselves yet, so to speak, sponsors don’t want to engage with them. So sponsors need to be willing to have the conversation and take on those risk, and provide maybe funding for training.

So they need to be able to support sites in new and novel ways that they haven’t thought about before. It’s not just about your standard clinical research budget. How else can we support sites? Can we build into the budget funding to help get people to the location? Can we build in funding for the staff themselves? That’s a big one. You get folks…

I fell into clinical research, but eventually I got training because I was at a large academic center. I had lots of opportunities. In these smaller rural places, they don’t have those opportunities. So you get folks who maybe went to school for nursing or psychology. And that’s great. I went to school for psychology. But then they don’t have the opportunity to supplement that with clinical research training. So sponsors can find a way to support that, to help support the pipeline of just the workforce itself in those areas. I think that that would be huge.

I think that the academic centers should be looking at where they can partner with these smaller sites and where they can provide the support. Maybe they can provide that educational support. Maybe they can provide some shadowing support or some technology support. So being able to partner with these smaller sites. And not necessarily sites that you already have some arrangement with. So maybe being able to reach beyond that a little bit.

So I think we kind of all play a role in that. And we need to figure out how can we work together to do this?

Justin Osborne: Yeah. And even to that point with the academic centers, the infrastructure itself is one of the harder things, I think, for the smaller rural areas to tap into. Because I mean, they just don’t have the funding for it anyway, and so when you just get to the financial conversation of research, that’s sort of a deal breaker for them a lot of times. So that’s, like you said-

Jessica Rowe: It’s a huge deal breaker. And it’s more expensive, quite honestly, to conduct research in these smaller areas because they don’t have that infrastructure built out. So they’re having to either build it out or they’re having to supplement in some way or contract out. It’s more expensive.

Justin Osborne: Yeah. Well, okay. So to me, it seems like there’s sort of two buckets to think about this access to research studies. And one is the industry side of taking the chances, like you were saying, and having resources sort of developed to help bring patients in. The other side, the other bucket, is educating the community itself about research. We’ve touched on that.

But let’s dive into that bucket for a few minutes. What I’m thinking about here is exception from informed consent, on the IRB side, the regulatory side, you mentioned IRB stuff. To have a study be approved in that method, you have to have a community plan, a community education plan, which involves going into the community where you’re doing that study and educating people on the study, which includes educating them about research. That’s not a requirement of a standard clinical trial study.

Jessica Rowe: And my question is why?

Justin Osborne: Right.

Jessica Rowe: Why shouldn’t this… I am not saying that every study… Oh, geez. I’m going to get… People are going to completely argue with me about… I’m not saying every research study has a responsibility to go out and do that, that it needs to be built into the regulations or requirement.

But I do think that as clinical research professionals, as investigators in studies, as academic institutions who engage in this research, I do think there is that responsibility there. And I do think that we need to put some thought into how do we make that kind of a standard practice that we are having these conversations with our communities?

The other piece to that that I meant to mention earlier too was just, and I alluded to it, was the workforce. So in these smaller, more rural areas, you don’t have access to the same type of workforce. And in terms of being able to develop a workforce, part of that is just the education. Because like you said, you didn’t know clinical research was an option. And so I think working with the local schools and providing some education in that space would also be beneficial.

Justin Osborne: I agree. That is helping, and I think that’s something that you can sort of see looking back 15, 20 years, you can really see efforts made and some progress in that area of the formal education part of clinical research, which is good.

I also, I have to go back to the Covid times. I feel like in that moment, the research was talked about more on a broad level out in the community because it was on the news every day, and research all of a sudden became popular. And it was like, “Oh, people know what we do now.” And I don’t know if that was just simply because it was on the news and people were interested in talking about it, or if there was more at play there, but it went away pretty quick right. After things kind of calmed down, we don’t have that… We’re back to the normal. You know what I mean?

So what could we tap into from that experience?

Jessica Rowe: So I think with Covid, we actually had a missed opportunity. We had some momentum there, and then we lost it. And it was unexpected momentum so we weren’t prepared for it. We weren’t prepared to build off that. And unfortunately, I think with Covid, it was a little bit of good press and a little bit of bad press. And unfortunately, I think the bad press outweighed, or held more weight with the public, than the good press did. And we as an industry probably didn’t do our due diligence there.

But you bring up a good point. I think that we know we can do it. We know we can get the words out, we can communicate to the public. But we need to make sure we’re doing it responsibly too. I think that was one of my fears during Covid was are we communicating about clinical research in a responsible way to the public? Are we having meaningful conversations about it?

I do a course on research misconduct, and one of the pieces I talk about is just what happened during Covid in terms of publications getting out there before there peer reviewed, and having no real conversation around what clinical research actually means, what the results actually mean, what it actually means to be collecting this data, and how it’s used.

Justin Osborne: Yeah. No, that’s interesting. And I do, I agree. I think there was probably a missed opportunity. It doesn’t mean we can’t go back and relook at it.

Okay, so to jump back to the other bucket a little bit, because I did want to touch more on some of the methods that the industry is attempting, including decentralized clinical trials, which you mentioned. Let’s talk through that, because I feel like that was a really popular, everybody’s pushing it, and then it’s kind of dialed back a little bit after people realize that it’s not as practical as maybe people were talking about it initially.

So talk through that, and let’s talk about how that could help this problem, and then some of the holdbacks.

Jessica Rowe: So I am still very optimistic personally about decentralized trials. I know there’s a lot of hurdles. I know the conversation has lost a bit of energy over time. But I fear that if we don’t continue exploring the option, it’s going to go away, and it is possibly a way to tackle this access issue.

And I think unfortunately what has happened is, like any other time in clinical research, we got ahead of ourselves a little bit. We came up with this great idea, decentralized clinical trials, but the regulations didn’t keep up with us. The operational piece didn’t keep up with us. The financial piece didn’t keep up with us. And so we’re trying to figure out how to operationalize decentralized clinical trials without really having the knowledge or having the guidance out there that we need to do it.

But I think we can do it. We’re getting there. And I think as a community, again, this is where we need to work together. Sponsors need to work with sites. Sites need to work collaboratively with their HRPP, so their human research protection programs, with their legal counsel. All of these people have a piece in it. And we need to work with our regulator. So when the FDA released their guidance about decentralized clinical trials, that was really our opportunity to weigh in, how do we operationalize this?

So there was a lot of talk about, I’m going a little bit off here, but it relates, there was a little bit of talk about the delegation task list, I think they were calling it, or the DTL, that was going to be required as part of decentralized trials. Well, then the question came up, if we work with this physician’s office in this rural area, do they need to go on that log? Who goes on that log? When do they go on the log? Does the third party vendor go on the log? And it seems like this really small point, but it’s a barrier. It’s a barrier to us implementing the decentralized clinical trials. And so that’s where we need to work together across the board, from sites to sponsors to regulators, and talk through these processes, and really think about what is the intent?

I think decentralized clinical trials really do have the ability, we talk about a lot in terms of increasing diversity, but I like to think about it more in terms of increasing access just across the board. And I think decentralized trials can do it, we just need to figure out how to get over these hurdles that are coming up, and we’re not going to be able to do it if we work in our silos.

Justin Osborne: Yeah. No, that’s true. That’s a good point. And I mean, yeah, people are still obviously talking about DCTs a lot and how to sort of make that work. I think that that’s a good reminder that this all comes down to let’s figure it out. Let’s work together and figure this out.

So to jump to something else that you mentioned at the beginning about some of the hurdles and drawbacks. With access, I’m thinking about technology. And so the fact that this industry has moved very quickly… I mean, if you go to a conference now, they’re not research conferences, they’re technology conferences that just happen to be talking about research, is what it feels like. But if you don’t have the technology, if you don’t have the systems that the sponsors require, or a CTMS at the site level like you’d mentioned, how can you do research?

So how do we get over that barrier where… And I get it, the efficiencies gained by the technology are great, but it feels like it’s creating a pretty big chasm.

Jessica Rowe: So you’re opening up a can of worms for me, because it’s not just related to access, but from the site perspective I have a lot to say on this topic.

I think one of the things that we need to do is maybe come to an agreement on some core systems. So working with sponsors, every sponsor has their own EDC and they have their own guidelines for using that EDC and they have their own technology they want used. Well, as a large academic site, we can kind of handle that, although it’s still challenging. But can you imagine handling that at a small one or two person site? No, it’s impossible. You can’t do it.

So I think there needs to be some kind of, and I have no idea how to do it, but there needs to be some kind of agreement or consistency across the systems that are being asked to be used.

Justin Osborne: That’s interesting. Almost like a smart IRB approach to technology for research.

Jessica Rowe: Yes, exactly. Exactly. And we’re starting to see this too with this idea of direct data entry, so the direct data entry from an EHR, or electronic health record, into an electronic data capture system. Well, every sponsor has a different system. And so if you’re asking the sites to figure out how to make those connections, they’re having to redo it every single time. And so, like you said, really we need almost like a smart IRB approach to this, and that will inevitably help these smaller sites because they just don’t have the bandwidth to be able to constantly support all the technology changes.

But I also think that, and I don’t want to put all the blame on sponsors by any means, but I do think sponsors need to provide a little bit more support there as well when it comes to these smaller sites. Maybe they can help them get access to some of the technology that they don’t have access to right now. Maybe they can provide them some technology support. So I know at the larger sites, like at our institution, on my own team, I have technology support because it’s so integral in research right now, and it’s going to continue to be that. We really do need that additional support.

But then when you think about working with these rural sites, you also have to think about not just the site, but the patient population. Is the patient population efficient in using that technology? Do they have access to it? It seems silly, and I keep going back to where I grew up because that’s what I know, when I go home to visit, I sometimes don’t even have cell service. So thinking about how do we support those pieces as well?

Justin Osborne: Yeah. That’s interesting. That is a challenge. It’s a challenge because, thinking about the industry side, because somebody could create solutions for this, but then you’re not going to make a profit on… You can’t make money with this, so there’s no business there. So yeah, that’s interesting to see. It’ll be interesting to see how that plays out.

Jessica Rowe: So my least favorite part of the clinical research space is finances, so I tend to stay away from that.

Justin Osborne: Yeah, yeah. No, it gets complicated pretty quickly. Okay. So far, we’ve really talked a lot about system level, broader issues and barriers to access to research, from both the community not knowing about it to the industry side not being able to operationalize it.

But let’s get into the weeds a little bit more. There’s a lot of logistical issues that come up when you’re talking about access, especially in those rural areas. So let’s talk through that. The system level needs to be fixed, but do people understand what they’re trying to fix when it comes down to the actual details of it?

Jessica Rowe: Yeah, I think that’s a really good question. In my opinion, I don’t think we do because I don’t think we’re asking the right questions and I don’t think we’re paying attention. We’re making a lot of assumptions about what people need to be able to have access. And yes, someone might need transportation or they might need child care, but we need to have those conversations and we need to have it with some compassion and understand where this need is coming from. And maybe even understand that it’s hard to express that need or to ask for that need. People don’t like asking for help.

Justin Osborne: That’s true.

Jessica Rowe: So sometimes I worry that we really don’t understand, that we don’t have the right conversations, that we’re almost being paternalistic and assuming that we know. And I think it’s important for us… That’s why I think we need to get into those communities, and we really need to just sit down over a cup of coffee and have a conversation. It’s not that hard. And we need to do it with compassion, and we need to understand what the needs of these individuals are.

Justin Osborne: Yeah. No, that’s really good. That’s important. Well, hopefully we can get there. I mean, I feel like you’ve outlined some really good ideas and thoughts about how we can improve this area. Because it does, it benefits everybody. It’s not like this is just benefiting the rural areas. This is benefiting medicine and healthcare.

Jessica Rowe: Yes. It is.

Justin Osborne: Any other final, just to put it to you, any other final advice, thoughts, wisdom, anything that you want to share on this topic?

Jessica Rowe: Yeah. I think at the end of the day, I like to remind people, we need to remember who we’re doing this for. Clinical research is not glamorous, really. When we’re down in the weeds, it’s not. It’s high burnout. It’s exhausting. It’s a highly regulated space. It’s not an easy space to be in all the time. But at the end of the day, we’re all here for a reason. And I can only assume for everyone, much like me, that reason is I want to do something that will benefit the people. I love the people that I am friends with, my family, my community. And that’s the ultimate goal. That’s the ultimate goal.

We talked about finances earlier, and I understand that plays a piece in all this, but I think we need to make sure we’re not losing sight of the real why behind everything we’re doing.

Justin Osborne: That’s great. That’s great. Couldn’t agree more, and I really appreciate your time. Thank you, Jessica, for coming on here and talking to us about this important topic.

Jessica Rowe: Absolutely. Thanks for the opportunity.

Justin Osborne: Welcome back to our segment, Same Team. I am sitting down with Jessica here still. And Jessica, it’s easy to get bogged down in our day-to-day job responsibilities. We kind of talked about this earlier, but I do believe, I agree with you, that those of us in this industry stay because we actually care about the impact that we’re making and we want to make a difference.

So can you share an experience or an example or a story from your career that connects you back with this idea that we’re all on the same team?

Jessica Rowe: Yeah, absolutely. So about a little over a year ago, I started a new position in this director of quality and education. And as part of this role, I built a new team. And my team does a little bit of everything. And they’re down in the weeds. They’re boots on the ground. And it can be really easy to lose sight of the bigger picture when you’re in that grind day-to-day, just as you said.

Shortly after I started this position, we had a inspection for a study that was looking at a new drug for melanoma. And even myself, I was losing sight of the bigger picture. I was stressed out. My team was stressed out. We were in the weeds trying to make sure that we were ready for this inspection, that our data was ready, that everything was good to go.

And at the same time that this inspection was happening, my aunt, who I was very, very close to, was seeking treatment for melanoma. And unfortunately, her options were very limited. And I remember sitting there during the middle of all of this kind of inspection readiness chaos, and having a moment of… Kind of an aha moment. A reminder that I am doing this, we are doing this, for someone like my aunt. We’re doing this so that we can try to bring new treatment options to the people that we care about, to our communities.

And shortly after that, I sat down with my team and we talked about our why. And I shared that story, and I shared that’s one of my whys. And so I asked each of them to think about what their why is, and we talked through how each piece of their day-to-day job was helping to meet that why.

Justin Osborne: That’s great. That’s awesome. I mean, I’m sure that that was very motivating and kind of reassuring, right? I mean, people don’t often get the opportunity to think through how their role impacts the bigger picture, you know?

Jessica Rowe: Yes. Yes.

Justin Osborne: Well, that’s fantastic. I really appreciate you sharing. And thanks again for hopping on the podcast and talking with us today.

Jessica Rowe: Yeah, absolutely. Thank you.

Justin Osborne: Be sure to follow, like, and subscribe to On Research with CITI Program. If you enjoyed this episode, you may be interested in other podcasts in the CITI Program universe, including On Campus and On Tech Ethics. You can listen to all our podcasts on Apple Podcasts, Spotify, and other streaming services. You should also review our content offerings regularly as we continually add new courses, subscriptions, and webinars.

Thanks for listening.