Psychometric Rater Stress and Burnout

May 29, 2024 | Blog, News, Posters

Salt Lake City, Utah, May 29, 2024 (GLOBE NEWSWIRE) — Poster presented today at American Society of Clinical Pharmacology (ASCP) Annual Meeting in Miami Beach, Florida, shows:


  • High levels of work stress and burnout in raters for psychiatric and neurological studies, with nearly 80% of 209 responders in countries outside the United States experiencing some burnout. Raters have an essential role in gathering primary efficacy data in these clinical trials.
  • Troubleshooting digital technology was a major source of stress to raters, noted by 37% of responders, followed by inconsistent training, mentioned by 33%, and limited site resources, by 31%.
  • These findings suggests a need for improved assessment platforms, enhanced rater training by vendors, and adequate staffing and resourcing at site level.


CenExel Research announced today that results of a survey on work stress among non-U.S. raters for psychiatric and neurological trials has been presented as a poster at the 2024 American Society of Clinical Pharmacology (ASCP) Annual Meeting. The ASCP meeting is being held in Miami Beach, Florida, on May 28-31, 2024.


The online survey, fielded in April and May 2023, found that almost 80% of psychometric raters experience some degree of burnout, with 27% reporting at least a moderate current burnout level. This was based on responses from 209 raters in Canada, Mexico, South America, Europe, Southeast Asia, Russia and Africa. Psychometric raters – who are highly educated, experienced and trained – are vital to the success of psychiatric and neurological clinical trials, with responsibility for collecting primary efficacy endpoint data. Given the known relationship between stress and work performance,[1] these survey results indicate that rater-reported burnout and levels of distress may understandably impact their overall quality of work.


The poster – entitled, “Exploring Non-US Rater Work Stress and Burnout: How Can We Do Better to Preserve Our Primary Endpoint Evaluators?” – was presented by Elan Cohen, Ph.D., Principal Investigator at CenExel HRI. The poster session was held in Salon 4 at the Loews Miami Beach Hotel from 11:15 a.m. to 1:00 p.m. on May 29.


“Sponsors should keep in mind the potential impacts of these high levels of rater stress and burnout when planning  psychiatric and neurological trials,” said Stuart Goldblatt, Chief Executive Officer of CenExel. “Experienced partners such as CenExel have approaches in place to mitigate these issues, including a robust and integrated rater training and development program. This  provides ongoing positive growth of raters and offers an internal support network to this department, in addition to ensuring that sites are fully staffed in all departments.”


Survey findings “are alarming for industry leaders”

“Given the typically low success rates of psychological and neurological trials, the role of raters is especially critical, “said Cohen. “Yet, in this survey, nearly 90% of raters said that burnout had a negative impact on data quality. The highest levels of stress were linked to troubleshooting digital technology, vendor training that seemed inconsistent, and lack of resources at site level for raters to effectively complete their work. These findings are alarming for industry leaders.”


Among raters who responded to the survey, 37% said troubleshooting of digital technology as very or extremely stressful; 33% said inconsistent vendor training was very or extremely stressful; and 31% said limited resources at the site were very or extremely stressful. Over two-thirds (68.9%) of raters reported some level of interference from stress and burnout in their role, with 27% saying they would likely to leave their job if they received another offer.


Other authors of the poster are: Vera Grindell, Ph.D., CenExel CNS; Judith Montero, PsyD, CenExel Clinical Research;  Katarzyna Wyka, Ph.D., The City University of New York, Graduate School of Public Health and Health Policy;  Howard Hassman, DO, CenExel HRI; David Walling, CenExel CNS; Cassie Blanchard, Ph.D., CenExel HRI; Mark Opler, WCG Inc. and The PANSS Institute; David Mischoulon, Massachusetts General Hospital, Harvard Medical School; and Larry Ereshefsky, PharmD, BCPP, Chief Scientific Officer, CenExel Early Phase and Retired Professor, The University of Texas.


Future approaches to supporting rater wellbeing

Supporting rater wellbeing is key to success of future trials. our industry. Approaches that could help mitigate stress and support quality include:


  • Rater training vendors could streamline training by acknowledging the repetitive nature of certifications and allowing for exemptions for recent or redundant certifications
  • More intuitive and user-friendly assessment platforms could be provided, with quick reference guides and increased access to help desk staff
  • Sites could ensure adequate staffing and allot appropriate lengths of time for raters to complete their tasks and responsibilities



About the survey

The Site Rater Stressors Survey (SRSS) was written in English, took about 10 minutes to complete and contained 39 items covering demographics and perceptions of various job-related tasks. Likert-type items assessed stress associated with rater tasks (18 items), burnout frequency and severity (2 items), job stress impact on work performance (4 items), and open-ended questions soliciting additional feedback (3 items). The SRSS was distributed by three rater training vendors to raters within their databases who had completed rater training.


About CenExel

CenExel ( provides unparalleled medical and scientific support in the design and execution of clinical trials. Our therapeutic area focus, attention to detail, and auxiliary services assure quality, reliable results and help CenExel consistently achieve and exceed patient recruitment goals. CenExel’s eighteen Centers of Excellence have conducted thousands of studies, the variety and complexity of which have resulted in a vast depth of experience and insight for the Principal Investigators and research staff in each facility. The CenExel Centers of Excellence deliver the engagement, expertise, and results to ensure that clients achieve their clinical research goals.




[1] American Psychological Association web page. Employers need to focus on workplace burnout: Here’s why, May 12, 2023. Available at: