The COVID pandemic meant that monitoring had to change. Trials still needed to mitigate risks but within restrictions of paper and monitor movement. Our paper outlined changes including some that will be useful when not in a pandemic situation. For example in a trial with many sites, allowing individuals at sites to book and attend protocol training at a time convenient to them has proved useful.
We realised that data cleaning and central monitoring are often intertwined. This is unhelpful for communication, poses a risk to good quality monitoring and can mean that data is not at its best.