In clinical research projects, one underperforming team member can affect not just productivity, but also team morale. This is especially critical when the timeline is tight and regulatory standards are high. A real-world example of this occurred during the development of a large multi-center clinical trial for a cardiac device, where one site consistently failed to meet enrollment targets and made repeated protocol errors. While the rest of the project team was working hard to stay on schedule, this one site’s poor performance led to additional monitoring visits, re-training, and ultimately, a delay in the trial timeline. The frustration started to spread, with high-performing teams feeling like their work was being overshadowed or held back.
I think the solution starts with open and structured communication. Instead of immediately assigning blame, project managers should approach the situation with curiosity, identify if the underperformance is due to lack of training, unclear expectations, or external challenges. Performance management should be objective, with regular feedback and support. In some cases, reassigning responsibilities or providing additional resources can turn performance around. If not, setting clear expectations and boundaries ensures accountability without affecting the motivation of the rest of the team. When handled with fairness and transparency, these challenges can actually strengthen the team’s overall resilience. What do you all think, how do you handle situations like this in your teams?
The first step should be to identify why the underperformance is happening, which can lead to visits to monitor process or talking to the team themselves to find the root cause. Then the necessary changes can be made to see if the underperformance disappears. However, if the underperformance does not improve despite the changes, it might be necessary to set strict expectation. This may involve reassigning responsibilities of team members, or making a difficult decision to maintain the team's performance. It's also important to be fair and transparent during this process to maintain morale in the team. At what point do you think it's appropriate to report underperformance to HR or someone with more authority?
Understanding the clinical trials process involves delivering results through a service that fosters progressive collaboration, relying on clear communication. Underperformance becomes evident when it disrupts project workflow, leading to missed deadlines, compromised quality control, and increased costs, all of which can undermine data integrity.
According to PMBOK, addressing these issues effectively focuses on human resource management and risk management. The appropriate way to report underperformance is through a hierarchical approach. The project manager should develop performance plans, provide regular feedback, and document any corrective actions taken.
If conflicts arise due to team dynamics that affect communication established in the project initiation plan, a coordinated action plan is essential to improve communication. Additionally, all dialogues related to performance issues and corrective actions must be documented to maintain a record for future reference.
However, individual personalities vary, and each person has their own unique approach to addressing communication issues. This raises the question: Do you believe that individuals need to cultivate their own motivation, or can they become demotivated at work?
Having additional strategies and frame of mind can be always helpful in clinical research.
Low performance can be handled by doing an assessment and troubleshooting the problem.
1) Root cause analysis: The employee may be overburdened or not completely trained. The person may be facing cultural or handling barriers.
2) Faulty escalation: Sometimes the quality manager, while testing the project, may be using an improper input leading to a faulty output. This scenario can lead to false positive failure.
3) Peer collaboration and knowledge transfer: Experienced team members who have previously worked in the project can train and guide the newcomers. The previous design history file will have a record of the problems previously faced in a similar project.
4) Performance Dashboard: Delay in projects may be due to the regulatory boards and other factors. The project team is not solely responsible. There can be a high deviation rate, the team is not fully following protocols. Instead of presenting the metric, mention the backdrop also. This avoids demoralization of the team and shows that the performance is reviewed sensibly.
5) Recognize and reward : Appreciate team members publicly and present awards. Celebrate small developments, instead of project delays.
6) Feedback: Regular feedback and milestone checks can help to figure out what went wrong, any missed validation and verification.
7) Proactive engagement: Instead of waiting for a site to miss an enrollment target for a few months, a proactive manager will notice well in advance and reach out to ask. Boost team morale and confidence.
8) Accountability: Hold people responsible for meetings, deadlines, quality standards without blaming them. Understand the human side.
In medical device project management, dealing with low performers in research teams requires a careful and strategic approach to maintain overall morale. It is important to first identify the root causes of underperformance through open and private discussions, focusing on understanding challenges rather than placing blame. Setting clear expectations and providing constructive feedback can help guide low performers toward improvement without creating a hostile environment. Offering additional training, mentorship, or adjusted responsibilities can empower struggling team members to rebuild their confidence and skills. Recognizing small improvements publicly, while addressing serious issues privately, helps maintain a positive team atmosphere. If performance does not improve, reassigning roles or responsibilities should be handled tactfully to avoid demoralizing the broader group. Throughout the process, maintaining transparency with the team about project goals and expectations reinforces a culture of accountability and support. Encouraging collaboration rather than competition fosters unity and reduces resentment toward underperforming colleagues. Ultimately, addressing low performance with empathy and professionalism strengthens team cohesion and supports the success of the research project.
Open communication is key to identifying the root cause of underperformance. Sometimes external factors like site-specific challenges or personal issues can lead to performance dips and approaching it with curiosity (rather than blame) can uncover ways to help. Regular check-ins and clear expectations are essential to prevent misalignment from turning into larger issues. I also think offering additional training or reassigning tasks based on strengths can make a big difference. It’s important that the rest of the team feels supported, so maintaining morale and avoiding burnout among high performers is a key consideration. In my experience, fostering a culture of constructive feedback and making sure team members know they can come forward with challenges creates an environment where people are more likely to address issues before they snowball. Sometimes setting up mentoring or peer support systems can also help, especially in clinical or technical settings where tasks can be complex.
Reading through everyone's replies, I appreciate how much emphasis is being put on understanding the root causes of underperformance. From my own experience, both as someone who’s noticed underperformance in teammates and (honestly) been the underperformer at times, I feel like the reality can be more complex and simpler than we expect.
One thing that stands out to me is how case-dependent these situations are. It’s true that identifying the reasons behind underperformance is important, but sometimes, the team doesn’t have the luxury of time to dig into every cause. In those moments, it becomes even more critical for the project manager to keep the bigger picture in mind and focus on moving the project forward. That might mean having a strategy that balances helping the individual while protecting the team’s momentum. From what I’ve seen, the issue hitting the "low performer" is often something that everyone on the team is struggling with to some degree — like fatigue, frustration with project demands, technical barriers, or even personal challenges outside of work. It just happens to affect some people more visibly.
It’s definitely a double-edged sword for PMs. Handled well, these moments can strengthen team culture and show everyone that it’s okay to need support and still contribute meaningfully. But if it’s handled poorly, it risks lowering morale even further — team members might lose faith in the support system or feel like pushing through struggles isn't recognized or valued. Finding that balance between empathy and action, moving the project forward, and caring for the people doing the work, feels like one of the most challenging but most important parts of leadership.
Addressing underperformance within research teams, especially in the context of critical medical device development projects, is a subtle yet crucial challenge. Choosing to overlook poor performance may unintentionally support team morale in a deceptive manner, stifle overall progress, and strain the efforts of competent team members.
As one tactic, providing constructive feedback early in the process can prove beneficial. Underperformance may arise due to gaps between expectations and provided guidance, insufficient instruction, or role ambiguity. Managers can develop defined strategies for improvement that allow team members to self-correct in ways that won’t immediately impact the team’s dynamics.
Resentment or anxiety toward other members of the broader team when addressing underperformance presents the most complicated challenge. Maintaining self-confidence and motivation makes transparency, fairness, and lack of personal blame central to achieving a clear focus on team objectives essential. Reallocation of tasks, or personnel removal from the project, even when improvement does not remain likely, must be done tactfully to maintain overall team motivation and focus.
In your view, how should research leaders manage the balance between offering necessary assistance to team members experiencing difficulties and maintaining timelines for project schedules? Is it preferable to implement strict performance expectations, or take a tailored approach that allows for greater flexibility?
It's not fair to shift the blame onto one particular team when this is a team effort. It may be frustrating that the project team cannot advance because of a particular issue, but the first question here should be whether if this is really a result of under-performance or just a result of poorly made deadlines. It may just so happen that this team of under-performers are the team in which these problems are manifesting from errors done in previous processes and are now just being caught. It may also be the case where the project is at its most volatile stage and conditions for this process are not yet met or recognized. If there are constant delays and no the deadlines keep getting pushed back, then the project needs to be reevaluated to account for any future delays. The most effective solution here would be to track down where the error comes from and try to isolate the issue. If retraining is utilized, then it should be treated as a way to teach and learn rather than a disciplinary measure.
I think that a proper assessment should be made to find the root cause of the delay. Several things can be done to prevent these situations, such as communicating deadlines, and providing feedback on schedules. Another way would be to reward small improvements and developments rather than letting the team fail. There are many ways to improve or prevent these situations through cooperation and mediation.
