Today’s rapidly convened virtual events are pointing the way to a greener, more inclusive future

Spare a thought for conference organisers. Over recent months covid-19 has put paid to months of meticulous planning. Meetings have been cancelled, participants’ expectations dashed, and those with an eye to financial returns, left tightening their belts. Of the clutch I was due to join between April and October, two have been postponed, one deferred indefinitely, and another will now be a wholly digital event.

Invitations to virtual events are the order of the day. From in house office meetings to external webinars and teaching sessions. Outside work the offers of free access to pre-recorded arts and sports events are legion, and laced with urgent calls for donations. The future of many event organisers is on the line as they struggle to find viable new business models, and this includes conference organisers too.

Many are discovering that working from home and joining meetings and intermittently following events via a variety of audio and visual on line technologies is not only possible, but preferable, some if not all of the time. Few are mourning grinding commutes. I have probably got as much out of the short online meetings I have joined over the past couple of months, as I would have done if they had been face to face, although they have been less fun and I miss the social side.

Mounting long large virtual conferences (and mustering the staying power to attend them) is challenging. But pace setters are showing the way. The American Physical Society held its entire annual four day meeting in mid April online, complete with 175 sessions and 15 parallel streams. Registration was free and open to all. It usually attracts around 1700 participants. This year over 7000 people joined and reports from participating physicists were positive. 

Some flagged it was useful to be able to pause and rewind talks, and take time to study crucial slides. One mentioned  “loving the minimal FOMO” [fear of missing out] Strike a chord? Who has not been to a large conference, struggled to identify the most promising sessions, (catchy titles guarantee nothing), sat through several indifferent ones, and later been told you missed the blockbuster of the day. 

But the prime advantage of virtual conferences must surely be reduced carbon footprints on a planet gravely jeopardised by climate change. One of the few silver linings of the pandemic is that it made us rethink work patterns, life styles, and what counts as an “essential journey” or a “must attend” live event.

Unlike health services where disruption to normal care during the pandemic has resulted in a tsunami of unmet need, and mounting concern about (avoidable) morbidity and mortality, no one dies as a result of a conference being cancelled. Conference organisers must market their meetings more temptingly than ever to persuade people to pay registration fees to join virtual events at a time of worrying economic downturn. 

Offers from conferences which have recently plopped into my inbox include access to all sessions, built in “comfort breaks,” opportunities to pose live questions to speakers, interact socially with other delegates, take virtual exhibition tours, get full recordings of the event, and access to post conference microsites.  

The case for “fewer conferences, better conferences, and conferences held for the right reason”

From my office eyrie at home, I reflect, with some guilt, on a lifetime of travelling to conferences. It’s part of a BMJ editor’s job. I enjoy the stimulus of different environments, soaking in new information, ideas, and views, making new contacts, and forging new professional relationships. Reporting back, writing about, and commissioning articles adds to the rewards. But I doubt all, or possibly any, could be deemed essential, and I might struggle to defend the output v time spent ratio. 

I find short meetings more productive than long ones. Massive conferences extending over days with showbiz style social programmes can feel like an endurance test. Invitations to attend gargantuan events via emails which begin: “Dear Sir, it is our pleasure to invite you to speak on a subject of your choice” at our upcoming [….far flung specialist conference] incense me.

It’s tempting to conclude, as Doug Altman did years ago about the poor quality of much research, that “We need fewer conferences, better conferences, and conferences held for the right reason.” 

But what’s the right reason to hold a medical conference? Its potential to improve the health and wellbeing of patients and the public rather than realise commercial opportunities or provide academic kudos for health professionals and their societies? That’s not easy to assess.

Arguably one “right” reason is to air broad multidisciplinary and international perspectives on shared knotty problems, and spread the learning. On this front, virtual conferences have advantages. Many people lack the money or the physical ability to travel to meetings, but they can be brought “into the room” via digital technologies and participate flexibly in relevant sessions. Software to filter attendees lists can facilitate matching participants and broke connections. 

It certainly paves the way for stronger and more representative, patient and public participation in medical conferences, which is something The BMJ, actively pursues and campaigns for. It’s also a route to increase the participation of people from a wide range of countries and communities, particularly marginalised groups, which are not so “hard to reach” if the will is there.

Hybrid meetings, where some are in the room and others join remotely may have something to commend them. But it takes skill and diplomacy to avoid  a “them and us” divide. 

 As Gillian Tett observes in a recent FT.com/magazine column:

“While the internet has the power to connect us all….group cohesion fragments once the team gets beyond a certain size and… communication is harder without physical cues and causal conversion.” 

She also warns of the danger of people customising their digital worlds to reflect their own views which makes it “easier to get stuck in a mental echo chamber.” It’s a good point. There is much to be gained from being provoked to think out of the box.

We need to learn from the experience of both sides of the virtual fence

Whatever the shape of tomorrow’s conferences, learning from attendees experience at  today’s virtual events is important. Understanding what works and what does not, is key to successful design of future events. Just as it is essential to inform new policy decisions and health service reconfiguration in the wake of covid-19. 

Collection and analysis of people’s experience of the quality of the exchange, and perceived value of rapidly introduced remote “services” of all kinds is crucial, and should not be confined to health professionals and conference organisers. During the pandemic, patient organisations have been actively conducting virtual events, supporting and informing their communities, and encouraging people to post stories of their experience to their websites. There is wisdom to be captured from these resources. (See here, here and here).

Virtual events can’t generate the collective passion of live ones, nor offer the same potential for inspirational chance encounters. But we all stand to gain from the adoption of new conference norms which involve less travel and utilise the gamut of exciting new technologies on offer—provided a critical lens is applied to analysing their benefits, risks and possible harms.

Tessa Richards, The BMJ 

Twitter @tessajlrichards

Competing interests: None declared.