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COVID-19 has changed many things in otolaryngology, including the way physicians and their colleagues meet. Virtual meetings through platforms such as Zoom, Microsoft Teams, and GoTo Meeting have increased exponentially—Microsoft Teams reported a new daily record of 2.7 billion meeting minutes in one day on March 31, a 200% increase from the 900 million minutes recorded on March 16.
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July 2020“It has become a necessity to move to virtual meetings to keep communications going,” said Mark Gerber, MD, division chief of otolaryngology at Phoenix Children’s Hospital in Arizona. “Virtual meetings aren’t a replacement for in-person meetings, because there’s something about a face-to-face meeting we as humans like. But getting together over the internet is useful when we’re left with limited options.”
During a time in which public health conditions in cities, counties, and states and medical knowledge are changing dramatically and quickly, making sure everyone is on the same page is an important function. “In my institution, the meetings have almost all gone virtual, both one-to-one meetings and those with several people,” said Dr. Gerber. “It’s more comfortable for everyone if we’re in our own offices because we can do away with masks.”
He points to increased productivity as another selling point. Participants can work right up to meeting time instead of wrapping things up early for a 20- or 30-minute walk across the hospital.
Keeping those virtual meetings productive, however, requires careful planning and execution on the part of both hosts and attendees.
Planning for Productivity
As with face-to-face meetings, preplanning is an important factor for success in virtual meetings. The agenda should be sent well ahead of time, along with any files that will be needed for review. Send log-in information (access codes, URLs, and call-in numbers) at least one day in advance so that participants can test for software downloads and system requirements.
Make sure the meeting application is working at your end. Test your microphone ahead of time, especially if using the one from your computer or mobile device, and check any program components, such as screen sharing, that are being used for slide presentations. Make sure you’re in a quiet space. If at home, limit access by family members and pets, and switch phones and smart watches to silent mode. Dress appropriately—striped shirts and large, shiny jewelry don’t transmit well on camera.
It has become a necessity to move to virtual meetings to keep communications going. —Mark Gerber, MD
If you expect that you or others in your meeting will use certain features of virtual meeting software, such as Zoom’s whiteboard screen-sharing capability, make sure you test it thoroughly before the meeting starts. Otherwise, you’ll waste a significant amount of meeting time explaining the process and testing it while others wait.
“Preplanning for virtual meetings is a little bit different,” said Martin J. Citardi, MD, chair of the department of otorhinolaryngology–head and neck surgery and vice dean of clinical technology at the McGovern Medical School at the University of Texas Health Science Center in Houston. “You have to consider the size of the screen your attendees may be using. Some may use a desk computer, others a laptop, and some [will be] on mobile devices with small screens. Instead of putting visual elements on a regular-size slide for projection on a large screen in an auditorium, you’ll need fewer words projected across multiple screens.”
Best Practices for Hosting
Leading a virtual meeting has some things in common with traditional gatherings, but a virtual meeting host takes on additional responsibilities related to the format.
Institute a set of guidelines on technology use and meeting conduct before the main meeting starts—for example, meeting participants must turn on their video; those who wish to speak should raise their hands; participants should not multitask during the meeting; and all present must mute their microphones unless they are speaking. Explain how the chat function works if it will be used as a conduit for questions or to allow participants to discuss the presentation among themselves.
Being able to see each other is important in situations not related to didactics, such as grand rounds or a single speaker with a PowerPoint presentation. But for division or departmental meetings between colleagues, the ability to see visual cues and body language can help the host increase audience involvement and attentiveness.
“In my experience, meetings where you can’t see the other participants usually result in very little dialogue,” said Julie Wei, MD, division chief of pediatric otolaryngology at Nemours Children’s Hospital, Orlando, Fla. “Dialogue is critical for stakeholders to achieve consensus and increase engagement. The higher the stakes, the more important it is for all involved to see other’s facial expressions and body language.”
In my experience, meetings where you can’t see the other participants usually result in very little dialogue …. The higher the stakes, the more important it is for all involved to see others’ facial expressions and body language. —Julie L. Wei, MD
This means that the host may need to function as a moderator. Video meetings usually move at a slightly slower pace than face-to-face meetings due to a short delay for most systems to communicate. Make sure you leave short pauses after speaking and consider calling on attendees to speak to ensure that the meeting goes smoothly.
An important variable to consider is differences in internet speed among participants. If attendees are all in their offices, this may be less of a concern than if some are at home; hardwired connections usually work better than mobile ones. If someone’s video and/or audio seem to be lagging, ask through the chat feature if that attendee is having connectivity issues. Check internet speeds through online tests such as fast.com or speedtest.net and suggest switching to audio only to save bandwidth. Try to keep body movements to a minimum, as excessive movement can degrade video quality.
It’s the host’s responsibility to make sure the meeting follows the agenda and to avoid trying to squeeze too many topics into a single meeting. One or two main points of about 30 minutes or less are generally the most that attendees can concentrate on at one time without losing focus. If you need to cover more items, give attendees a small break to stretch, get a cup of coffee, or use the restroom. After the meeting, plan to spend five to 10 minutes gathering feedback on how the meeting went and what might be improved.
“I don’t think that virtual meetings are going away after COVID is over,” said Dr. Citardi. “As the technology and our familiarity with it improves, virtual meetings will be even more productive.”
Kurt Ullman is a freelance medical writer based in Indiana.
Security Concerns
As virtual meetings have increased, so have concerns about security. Uninvited guests have made awkward appearances. While these hackers can be annoying, they also pose the risk of compromising patient information. Here are some ways to make your virtual meetings more secure:
- Opt for randomly selected meeting IDs and control their dissemination through email and on the internet. Don’t reuse access codes.
- Always set a password for meetings.
- Enable notifications when attendees join. If this function isn’t available, ask newly arrived participants to identify themselves.
- Enable use of a “waiting area,” and don’t allow people to sign in to the meeting until the host is available to control access.
- Once a virtual meeting has begun, “lock” your meeting to prevent others from joining.
- Disable participant screen sharing; you can turn on this function once all of your attendees have arrived and you have locked the meeting.
Professional Society Meetings Go Virtual
Some professional societies are going virtual for their national or international meetings. “The American Broncho-Esophagological Association (ABEA) was the only Combined Otolaryngology Spring Meetings (COSM) society that went ahead with its 2020 scientific meeting,” said Albert L. Merati, MD, surgeon and chief of laryngology at the University of Washington in Seattle. “We decided to take our whole 100th annual meeting online, not as a substitute, but as the actual meeting.”
Presentations on the 24 best original papers were recorded in advance to avoid real-time technical problems. “We had our speakers live for a question-and-answer session following the recorded report on their investigations,” said Dr. Merati. “Adding the interpretation, introductions, and questions in real time added the element of community. This was something more than just sitting down and passively watching.”
Although a small part of the proceedings, the live component added greatly to the program’s complexity. The association hired a professional production company to produce the recorded presentations, play each at the proper time, coordinate with the presenters at remote locations, and link them with the virtual participants for the Q&A sessions.
“The actual scientific content was still in the hands of ABEA’s program committee members,” said Dr. Merati, who served as 2019-2020 ABEA president. “We also kept responsibility for regulatory requirements.”
Attendance was good (there were 800 attendees; ABEA membership stands at 500), and attendees generally rated the programs highly.
“The goals of promoting community and maintaining connections within our membership are absolutely achievable in a virtual format,” said Dr. Merati. “Doctors yearn to see their colleagues, though, so in-person meetings will continue.”