03 · What You Need to Know
Productive Research Partnerships Need Ways to Disagree
Disagreement is often evidence that different perspectives are actually present
A stakeholder group in which everyone always agrees may be wonderfully harmonious. It may also be unusually homogeneous, reluctant to challenge authority, or involved only in decisions too inconsequential to provoke disagreement.
Different stakeholders bring different knowledge and priorities. Patients may value outcomes differently from clinicians. Practitioners may prioritize feasibility. Researchers may focus on validity. Community organizations may emphasize trust and accessibility. Funders and institutions may introduce additional constraints.
PCORI's current guidance on meaningful inclusion of partners in decision-making explicitly recognizes different viewpoints as potentially valuable because they can challenge assumptions and reveal new approaches that improve the acceptability and relevance of study activities.
The objective is therefore not agreement for its own sake. It is productive use of disagreement.
Start by identifying what people actually disagree about
Two people may appear to disagree about a method when their real disagreement concerns something else.
Consider a dispute over whether interviews should occur online. One partner may be concerned about accessibility. Another may be concerned about participant privacy. The research team may be concerned about cost and geographic reach.
These are not necessarily competing preferences about technology. They are competing judgments about which risks and benefits matter most.
Before trying to resolve the dispute, ask each side to explain the reasoning behind its position.
| Possible source of disagreement |
Example |
Useful question |
| Different evidence |
Partners rely on different information about what will work |
What evidence is each position based on? |
| Different expertise |
A statistician and community partner assess a sampling strategy differently |
Which aspect of the decision does each person understand particularly well? |
| Different values |
Partners disagree about burden versus completeness of measurement |
What trade-off is each person prioritizing? |
| Different affected interests |
Participants bear a burden that researchers do not |
Who experiences the consequences of this decision? |
| Different incentives |
An organization wants favorable findings while researchers prioritize independent reporting |
Are there interests that should be made explicit? |
| Different understanding |
Partners interpret a technical requirement differently |
Would clearer information resolve the disagreement? |
Diagnosing the source of disagreement can reveal solutions that a simple vote would miss.
Do not assume that the researchers' position is automatically the neutral one
Researchers often occupy the formal authority position in a project. That does not make their preferences neutral.
A researcher may prefer an established measure because it facilitates publication or comparison with previous studies. A community partner may prefer a different outcome because it reflects what people actually experience. Both positions contain legitimate considerations.
The team should examine the reasoning behind each rather than framing one as “scientific” and the other as merely “stakeholder preference.”
At the same time, not every disagreement is symmetrical. Some methodological requirements are necessary for the study to answer its question, and some ethical or legal obligations cannot be negotiated away.
Clarify who has authority over the decision
Disagreement becomes particularly difficult when nobody knows who is supposed to decide.
PCORI recommends establishing engagement structures and decision-making processes that clarify authority, communication, and information flow. Its guidance describes partner decision-making authority as existing along a continuum from providing input to shared leadership.
This means teams should decide in advance how different categories of decisions will be handled.
Some may be delegated to working groups. Some may require consensus. Others may use majority decisions. Particular technical or regulatory matters may carry specified professional responsibility. More collaborative projects may share authority more extensively.
The appropriate arrangement follows from how much influence research partners have been given over study decisions.
Explain genuine constraints rather than invoking them vaguely
“We can't do that” is rarely enough.
If a stakeholder proposal conflicts with the approved protocol, researchers can explain what amendment would be required. If an outcome cannot be measured reliably, explain the measurement problem. If a recruitment proposal creates a sampling concern, explain how it could affect inference.
Specific explanations allow partners to propose alternatives.
A desired outcome may not be measurable with the proposed instrument but could be investigated another way. A recruitment strategy may create bias but could supplement rather than replace another strategy. An ethics concern may be addressed by changing the procedure rather than abandoning the underlying idea.
Constraints should structure collaborative problem solving rather than end the conversation automatically.
Look for the underlying objective before choosing between proposals
Many apparent either-or disputes can be reframed.
Suppose community partners want shorter questionnaires because participants are overburdened, while researchers want longer questionnaires because several constructs must be measured.
The real objectives are not “short questionnaire” versus “long questionnaire.” They are reducing burden and collecting sufficient information.
Once those objectives are explicit, alternatives become possible: remove redundant measures, reduce measurement frequency, use administrative data for some variables, prioritize essential outcomes, or pilot the burden before finalizing procedures.
Good conflict resolution often begins by asking what each proposed solution is trying to protect.
Use evidence when the disagreement is empirically resolvable
Some disagreements concern questions that evidence can help answer.
Researchers and partners may disagree about whether recruitment language is understandable, whether a questionnaire is too burdensome, or whether a proposed intervention can be delivered in practice. Pilot testing, cognitive interviews, feasibility data, existing literature, or other evidence may help resolve the dispute.
Not every disagreement can be settled empirically. Questions about acceptable burden, fairness, priorities, or which outcomes matter can contain value judgments that data alone do not determine.
The team should distinguish disagreements that need more evidence from disagreements that require a legitimate choice among competing values.
Consensus should not be manufactured
Consensus can be valuable when people reach it through genuine deliberation. It becomes problematic when agreement is produced through pressure, exhaustion, status, or fear of damaging relationships.
PCORI describes productive disagreement as the ability to express different viewpoints and openly disagree while maintaining mutual respect.
A partner who disagrees should not automatically be treated as obstructive. Nor should a researcher be expected to abandon a legitimate methodological concern simply to demonstrate collaboration.
When reasonable disagreement remains, the project can use its agreed decision process and record the reasoning behind the outcome.
Minority views can be preserved
A final decision does not require pretending that everyone supported it.
Teams can record significant dissent in meeting records, internal decision logs, engagement reports, or, where relevant, publications. This can be particularly important when a minority perspective reveals an ethical concern, a limitation, or an experience that would otherwise disappear behind a statement such as “stakeholders agreed.”
Preserving dissent is not necessary for every minor disagreement. It is useful when the difference is consequential to understanding how the study was designed or what limitations remain.
Power affects whose disagreement gets heard
Not every person enters a disagreement with equal institutional power.
Principal investigators may control grants and employment. Clinicians may carry professional authority. Community partners may depend on the organization being studied. Junior staff may hesitate to contradict senior investigators. Patients may be the only non-professional members in a room full of academics.
PCORI's current guidance explicitly asks teams to recognize power imbalances and notes that status, background, institutional practices, and access to decision-making roles can affect partners' ability to participate fully.
Facilitators should therefore pay attention not only to what is said but to who has realistic opportunities to say it.
Team norms can make disagreement safer
PCORI recommends establishing and revisiting team norms so disagreement can be handled productively and respectfully.
Useful norms might address how people challenge ideas, how interruptions are handled, whether everyone has an opportunity to speak, how decisions are recorded, what happens when someone experiences disrespect, and how unresolved issues are escalated.
These arrangements can seem unnecessarily formal while everyone gets along. Their value becomes clearer during the first difficult disagreement, which is approximately when discovering that nobody agreed on the rules becomes least convenient.
Unproductive conflict may require neutral facilitation or mediation
Not every conflict can be solved inside an ordinary project meeting.
PCORI recommends acknowledging disagreement, seeking to understand differences, maintaining mutual respect, and addressing disrespectful behavior. When conflict cannot be resolved, it suggests considering an expert in mediation or conflict negotiation who can act as a neutral third party.
This can be especially useful when interpersonal history, organizational interests, or damaged trust prevent the group from discussing the substantive decision productively.
Bringing in mediation is not necessarily evidence that the partnership has failed. Sometimes it is evidence that the partnership takes conflict seriously enough not to let institutional power settle it by default.
Some decisions still have non-negotiable boundaries
Participatory decision-making does not permit a project to ignore research ethics, participant safety, legal requirements, contractual obligations, or basic methodological integrity.
If partners request a procedure that would expose participants to unacceptable risk, violate privacy requirements, or make the study incapable of answering its research question, the project cannot implement it merely to preserve consensus.
Researchers should explain why the boundary exists and explore alternatives where possible.
The same principle applies when stakeholder priorities improve relevance without being allowed to predetermine evidence.
Repair the relationship when conflict causes harm
Sometimes the decision itself is resolved but the relationship is not.
A dismissive comment, repeated interruption, misuse of authority, or failure to honor an agreed process can damage trust even if the project eventually reaches a workable methodological solution.
PCORI's guidance explicitly addresses repairing trust after conflict. This includes recognizing how behavior affected team members and agreeing on changes needed to restore a productive working relationship.
Partnership governance should therefore consider both the substantive research decision and the quality of the relationship through which it was made.
