The virtual setting is often a unidirectional flow of information with limited discourse. I think successful grand rounds are those that engage the audience and intentionally involve participation. —Sonya Malekzadeh, MD
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February 2021
Discussion and Content
Any fair comparison of virtual versus in-person grand rounds must address the key aspects of interaction and personal connection, both of which suffer in varying degrees in a virtual format. “A sea of black screens is less inviting than a roomful of colleagues,” observed Dr. Rowan. “As a speaker, it can be hard to engage a virtual audience or gauge its attentiveness. There isn’t much opportunity to feed off the crowd’s energy.”
It’s hard to foster a sense of community over a screen, and even harder to reach out directly to other individuals without disrupting the session. “Grand rounds have traditionally been a venue for me to connect with colleagues and trainees on a personal level and I miss those opportunities for camaraderie and networking,” said Dr. Malekzadeh.
There’s no denying the sense of detachment that’s inherent in the virtual experience. Group discussions can be technically tricky without the benefit of physical cues such as hand raising, eye contact, nodding, and smiling that let a speaker know he or she is connecting, and attendees might err on the side of caution and stay silent. “I think for some people, it’s a bigger hurdle to speak over Zoom than to speak across a table in a conference room. Because of this, there aren’t as many questions or as much discussion as you would have when you’re in a room together,” said Dr. Oghalai.
Although decreased discussion saves time, it limits the opportunity to learn and share ideas, a vital objective of grand rounds. “The virtual setting is often a unidirectional flow of information with limited discourse. I think successful grand rounds are those that engage the audience and intentionally involve participation from as many participants as possible,” said Dr. Malekzadeh. She suggests encouraging use of the chat function within your chosen online meeting platform for questions and answers and implementing polling or other audience response methods several times during the rounds. “Other specialties have introduced ‘open Zooms,’ in which the grand rounds speaker stays in a single Zoom session after the formal grand rounds to meet with a small group for a more in-depth discussion of the topic,” she said.
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Despite the significant differences between virtual and in-person formats, program directors report that session content has remained unaffected. “The goal of our grand rounds is to provide a rich educational experience for all of our residents and physician educators, and that has remained unchanged from prior to the pandemic,” said Dr. Rowan.
“We seek to be well-versed in relevant topics related to otolaryngology ranging from cutting-edge advances, to the impact of COVID-19 on some of our subspecialities, to other relevant topics such as changes in medical billing and reimbursement practices,” added Dr. Kutz. “I recently spoke in a virtual grand rounds session about my approach to treating chronic otitis media and cholesteatoma. I believe the talk was successful because of the extensive use of surgical videos and illustrations. We also published on this topic, so I was able to present our own data.”
Even with a less-than-compelling topic, an effective speaker can be successful in a virtual setting, said Dr. Rowan. “We recently had Dr. James Lin, an associate professor from the University of Kansas Medical Center, visit us virtually, and he spoke about the development and utilization of current procedural terminology codes and billing practices,” he said. “Though CPT coding may not be the most exciting topic for a surgical audience, Dr. Lin was well prepared with examples that were relevant for our audience. He called on individual attendees and asked relevant questions about their billing practice. Dr. Lin was capable of engaging an audience of approximately 65 individuals and had several questions asked throughout his talk.”