RT Journal Article SR Electronic T1 Confessions of a chagrined trialist JF BMJ Quality & Safety JO BMJ Qual Saf FD BMJ Publishing Group Ltd SP i97 OP i98 DO 10.1136/bmjqs.2010.046623 VO 20 IS Suppl 1 A1 Steven Goodman YR 2011 UL http://qualitysafety.bmj.com/content/20/Suppl_1/i97.abstract AB As a clinical trialist, I had thought that the methods I employed were far more challenging than those I had thought were needed for quality improvement. However, some personal experiences and participation in the Cliveden conference led me to a new appreciation of the methodological and conceptual challenges faced by those trying to improve medical systems.