Be creative in seeking out unaffiliated members
Be creative in seeking out unaffiliated members
Once you've found them, provide special training and make them feel like part of the group
Want to attract and retain good nonscientific, unaffiliated IRB members? Cast your net wider for interested people, train them well and nurture them carefully.
Emily E. Anderson, MPH, a PhD candidate in healthcare ethics at St. Louis University, Missouri, says that after interviewing more than a dozen lay IRB members, she thinks IRBs should do a better job of choosing and preparing nonscientist and unaffiliated members for their roles.
Her findings were published earlier this year in the journal Accountability in Research.
Anderson says her own experiences serving on one IRB, and watching others, showed her that every board has a unique personality, which can make it harder or easier for a lay member to contribute.
"Having a different set of personalities, having a different chair, different levels of administrative support, different ways of running meetings — all of those things contribute to an outsider's ability to raise concerns," she says.
Anderson says her focus on IRBs was an outgrowth of a larger interest in community participation in research. As part of her PhD program, she participated on an IRB as an outside member. That experience got her thinking about the challenge of selecting nonscientist and unaffiliated members who can contribute to an IRB.
"People identified it as a problem, but in terms of really doing any kind of searching into what kinds of people are serving in these roles or how IRBs can identify them, there was very little on that," she says.
Anderson identified IRBs in two Midwestern cities and sent word to the IRBs that she was interested in speaking with lay members. She says she very quickly was contacted by the 16 people she ended up using in her qualitative study.
"People were very willing to talk to me — very eager to talk and very accommodating," she says. "The people I interviewed were probably the more participatory members. Someone who just shows up at meetings and doesn't do anything is probably not going to contact me to talk about their experiences."
The group of 16 represented eleven institutions, including universities, hospitals, a Veterans Administration facility and one research organization. Some were members of more than one IRB.
Most recruited personally
Anderson chose to interview only members who were both nonscientists and unaffiliated - not always easy to find on an IRB, she says. In many cases, she notes, IRBs have "nonscientist" members who are affiliated with the institution, and "unaffiliated" members who are scientists.
Among her sample, one member was a pharmacist, but she included him because he was not a researcher and served on a social-behavioral IRB, which she felt made his experiences more pertinent.
Anderson asked them about their experiences of being selected and trained for the IRB, as well as their attitudes about how they were treated.
From their answers, and from her own observations of various IRBs, Anderson suggests that institutions can do a better job of recruiting, training and nurturing lay members:
- Recruitment - Most nonscientist, unaffiliated members interviewed by Anderson were initially asked to serve on an IRB by someone they knew. In one case, a woman met an IRB member because their children went to school together. Many were asked to become lay members after having previously worked for the university or actually serving on or being employed by the IRB.
Three of the members surveyed said they approached the IRB after hearing about a need for community members. One woman, recently retired, says she was looking for a chance to volunteer "where I didn't have to stuff envelopes … and I might be able to use my brain."
The members themselves suggested that a bachelor's degree was an important asset, and others suggested backgrounds in professions such as law, science or the ministry. A few members who are lawyers say they were recruited not for their legal qualifications but because their IRBs thought they'd bring analytical skills to the table, Anderson says.
But Anderson herself would like to see IRBs become more creative in seeking out lay members, in order to achieve more diversity on the board. She notes that her sample, like others of lay IRB members, was overwhelmingly white, educated and professional.
"[IRBs] really need to avoid selecting them just based on convenience," she says. "Try to find people who are going to be good because of their personal qualities and skills and not just because they happen to already be known and easy to find. Are they going to contribute anything, or are they just the neighbor of the provost and doing somebody a favor?"
Anderson says she believes having only one or two lay members on a board makes it even harder to achieve diversity.
"You can't expect one person to be reading the protocol wearing multiple hats at the same time," she says. "Having more than one person to fill these roles or having different combinations of people who are nonaffiliated and/or nonscientist, is one way to bring diversity to an IRB."
Anderson notes that as IRBs have gotten larger, the number of lay members has stayed about the same. She sees that as a missed opportunity for IRBs to diversify
"There are IRBs who will have 25 members and they'll still only have one or two nonaffiliated/nonscientist members."
- Training — Once lay members were selected, the training they received varied greatly from one institution to another. Some reported no formal training at all, while others took Web-based programs or attended one-on-one sessions with an IRB staff member.
Most said they were faced with an overwhelming amount of material, and that their real education came on the job. They complained that material was presented in a disorganized way, making it hard to know what was most important in reviewing a protocol.
Anderson notes that lay members reported that they often received exactly the same training as scientific members, who come to the IRB with much more research experience.
"People who are nonaffiliated, nonscientist members need special training," she says. "It's not impossible to bring them up to speed, but you can't just throw them in. Common sense tells you that training for someone who's been a researcher for 15 years and training for someone who doesn't know anything about research should be different."
She says members benefited from being able to observe actual IRB meetings before joining the board, so that they could observe protocols being reviewed without the pressure of having to participate.
Observing 'social graces'
Nurturing — While most of the lay members told Anderson they were treated well and respected by other members, many did feel intimidated sharing the IRB table with professors and scientists.
Anderson says it's possible to ease that discomfort by taking small steps to make the new members feel like a part of the group.
"Some people mentioned that they weren't even introduced to the committee and that the other members were not introduced to them," she says. "So there were people who'd been serving for a year and they weren't even sure who everyone was. They weren't sure that everyone knew who they were.
"That just seems like basic Social Graces 101. If you're having a committee of people and you have a new member, you introduce them. Especially if it's someone from the outside, who will perceive that they're on a different level from everyone else."
She says members told her they really appreciated small gestures like being complimented when they made a good point, or being contacted by the administrator after the meeting to see if the member had questions.
"Things like that can help people feel more comfortable expressing any concerns that they have, which is sort of the point of having those people there," she says.
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