The conduct of clinical research often challenges our ability to keep information about research participants confidential and our ability to enhance trust from participants and the public. Extensive information may be included in medical record systems that allow a wide range of individuals ready access to confidential research information not only during a study, but long after the study is completed. Rarely are there clear standards as to what information is necessary to be included, and what should be maintained outside of the medical record in more confidential research records. This information may be used in secondary research such as medical chart reviews or pulled to develop AI models or even be released inadvertently in medical records release requests. Consent forms often promise that this information will be protected and only released under limited conditions or may include protections under a Certificate of Confidentiality. However, it maybe be challenging to fulfill these promises in the clinical research environment and may be contributing to an erosion of participant and public trust in research. This session will explore these and other challenges and discuss possible solutions.