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WCG Survey Suggests that Entrenched Leaders Are Stalling Clinical Trial Diversity

Diversity, equity, and inclusion (DEI) remains a topic of considerable discussion across the industry. But too often, it remains little more than talk.

The dissonance between the perceived importance of DEI among clinical research professionals and the reality of clinical trials is stark.1,2 They acknowledge the critical role of diversity among clinical trial participants, but their sentiments do not translate into meaningful change.

The annual WCG Avoca Industry Survey found that professional entrenchment, rather than any philosophical objection to DEI, contributes to the problem.

Stagnation Among Leadership

The survey results revealed a concerning pattern: The longer site and sponsor professionals stay in their roles, the less importance they tend to assign to various types of diversity. This suggests that entrenched viewpoints and resistance to change among senior leaders are at least partly responsible for the lack of progress in DEI initiatives.

Some senior managers may perceive DEI initiatives as ineffective and not relevant to regulatory approvals. Others may harbor an “old school” mentality, clinging to established practices that have proven successful in the past.

A few of the survey respondents were quite candid, mentioning “upper management stagnation” and an “old school sponsor mentality that insists on using proven methods.” They may simplyview DEI initiatives as “nice to have” rather than a critical component of clinical trial success. As a result, they see DEI process as a series of hoops to jump through. From their perspective, DEI is unnecessary – even disruptive – and they may be hesitant to invest time and resources into implementing DEI initiatives. And of course, they are concerned with the potential costs.

This relates to another survey finding: These leaders might not fully grasp the scientific and financial imperatives of these initiatives. Survey respondents who saw DEI as more than merely checking a box were more committed to it. Specifically, respondents who saw the pursuit of diversity as a scientific or ethical imperative were more passionate about its importance than those who valued diversity for regulatory or marketing reasons.

It follows, then, that educational initiatives highlighting the scientific and ethical rationale for diversity can help shift perspectives and promote DEI-oriented decisions.

Show Them the Evidence

Providing clear evidence of the clinical benefits of diversity can help shift attitudes and practices. There’s also a need for education around regulatory issues.

Given that individuals who have spent more time in their roles are more likely than junior staff to make decisions regarding clinical trial execution and the funding of any new initiatives, their attitude toward change can have an outsized impact on the successful implementation of DEI programs.

By prioritizing education surrounding the scientific and ethical rationales for diversity, promoting leadership that embrace evidence-based decision-making, and fostering greater collaboration and communication across the industry, we can make progress towards a more diverse and inclusive clinical research landscape.

To learn more and take action on Diversity, Equity, & Inclusion initiatives, schedule a consultation with our DEI experts today.


  1. FDA guidance “Enhancing the Diversity of Clinical Trial Populations — Eligibility Criteria, Enrollment Practices, and Trial Designs Guidance for Industry” – November 2020
  2. Clark LT, Watkins L, Piña IL, et al. Increasing Diversity in Clinical Trials: Overcoming Critical Barriers. Current Problems in Cardiology. 2019;44(5):148-172. doi:

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