At the DIA in Washington on the 17th of June, GetReal representatives Iris Goetz, Tom Rhodes and Pieter Stolk hosted a workshop on the operational and methodological challenges involved in conducting pragmatic clinical trials. In the workshop we focused on the implications of pragmatic designs for the feasibility of the study, and scientific aspects such as generalizability, validity and precision. During the workshop, we used a fictional example of a trial on a new medicine to guide the discussions. The workshop led to a lively discussion about the various challenges involved (incl. regulatory/HTA and ’new’ challenges such as trial insurance). We received positive feedback from the participants. The session was also a valuable experience for the team on how these workshops can be made most effective since we will surely hold them again in the future!