Document Type


Date of Degree


Primary Advisor

Christine Pintz, Ph.D., FNP-BC, WHNP, RN, FAANP, FNAP; Gaetano R. Lotrecchiano, Ed.D., Ph.D


clinical trial; pharmaceutical; recruitment; physician-researcher identity; mixed-methods; ideal-type analysis



The critical phase for a successful clinical trial is timely accrual of research participants. Interventions to improve the outcome of recruiting activities have been developed to address the research structure of clinical trials, the administrative and design burdens of study protocols, the lack of awareness and acceptance of trials from patients and clinicians, and the insufficient research training for trial investigators. Engagement with potential clinical trial participants is lower than expected with a contributing factor being that investigators do not identify and approach all potential participants. The behaviors of physician-researchers responsible for recruiting and enrolling their patients into clinical trials are influenced by physician-researcher dual identity as both care giver and scientific researcher. During recruitment and enrollment, physician-researchers must navigate the continuum between the diametric opposites of three tensions: Values, Agency, and Goals. This mixed-methods study investigated the oppositional relationship of the three tensions experienced by US physicians responsible for recruiting their own patients into industry-sponsored clinical trials. Four research questions were addressed in a multistage approach, first quantitatively descriptive and k-cluster analysis of POP Scale Score, then qualitatively with thematic analysis of semi-structured interview transcripts, and then with the integrated data ideal-type analysis. Three distinct physician-researcher identity types were found, and they were titled Cooperating Investigator, Capitalizing Investigator, and Campaigning Investigator. This research contributes to a more nuanced understanding of why clinicians decline to enroll eligible patients into clinical trials even when under pressure of clinical trial sponsors to meet a recruitment target. Findings of this study bring a new appreciation to the evolving research ecosystem, suggesting that we rethink the motivation of physician-researchers to participate in industry-sponsored clinical trials.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

Open Access


Available for download on Monday, March 02, 2026