Webinared out? The future of learning post COVID-19

While online medical conferencing is necessarily booming, it doesn't seem likely that we will see a paradigm shift away from face to face learning once COVID-19 is over

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Cancel or go digital. Those are the two options medical conference organisers are facing due to COVID-19.

Medical conferences were some of the first events to be cancelled when the pandemic took off, and they are likely to be some of the last events to return.

Cramming conference centres with thousands of doctors can pose quite a risk to public health if it means a rampaging virus takes out almost an entire specialty.

With social distancing measures looking likely for the whole of 2020 (and beyond), it’s hard to imagine that doctors will be hopping on flights to attend annual scientific meetings any time soon.

GPs who work in small practices often only get to mingle with other GPs at events, so the ban on gatherings has created a big hole in their professional and social calendars.

Groups such as the AMA, the RACGP and GP education provider Healthed, are stepping up to the task by hosting more digital meetings and webcasts than ever before. And it shows. Webinars are a new part of our workcylce, and some people seem to already be suffering from webinar fatigue. One long time professional GP trainer and educator told us that they were literally “webinared out”.

It’s relatively easy to get these digital events up and running from a technical perspective; just set up an account with a digital conferencing provider and off you go. No need for catering or venue hire.

Live webinars still require moderation, content planning, technical run-throughs, registration processes and promotion, so they do take time and effort to set up properly.

The main drawback to the digitisation of events is that it removes a lot of the human elements that doctors have come to love about medical conferences – the networking opportunities, the morale-boosting effect of meeting colleagues in person, and the feeling of getting out of the office and doing something different.

It’s hard to digitise the experience of bumping into colleagues at the coffee cart, hovering after an event to ask the speaker a private question, or hatching a crazy startup idea over drinks with a GP friend you haven’t seen in years.

It’s also exhausting to do telehealth all day with patients and then log onto a Skype or GoToWebinar event for the evening. Who wants to stare at the same screen for 10 to 12 hours (or more) a day?

But there are ways to make digital meetings more engaging and exciting. This is just the start of a digital learning curve for the GP profession, and as COVID-19 drags on, the pandemic is giving professional associations plenty of time and impetus to experiment.

Dr Ramesh Manocha, the CEO and founder of education company Healthed, says that GP audiences are following the business across to digital during COVID-19 but pharmaceutical sponsors are responding very slowly in terms of moving funding from physical to digital events.

Healthed is pivoting quickly; the company usually runs about eight to 10 webcasts a year but has upped that number to more than 20 due to the COVID-19 crisis. Around 1,000 to 1,500 GPs tune in to each event

Healthed has also launched the “Going Viral” podcast hosted by RACGP President Dr Harry Nespolon, which focuses on a different topic related to COVID-19 each episode and averages around 1,000 to 2,000 GP listeners per episode.

“Putting aside the stress and the uncertainty that coronavirus has imposed on the business environment, we’re in the middle of a fascinating experiment, which we could never create intentionally,” says Dr Manocha.

“The experiment is: if GPs had no access to face-to-face training, CPD education, professional development, what would they do?”

Healthed’s experience shows that, at least for now, GPs are willing to engage in digital education; there’s been a huge spike in podcast listening and webcast attendance since the lockdowns started in mid March.

“We’re seeing a huge migration into webcasts and podcasts,” says Dr Manocha. “There’s been less interest in online learning modules and not a major jump in consumption of print.“And the question is: will it ever get back to the way it was before? To what extent will the new digital behaviours persist?”

Now that even reluctant GPs have been forced to engage with online platforms, what’s going to happen when everyone comes out of their bunkers and medical conferences start up again? “How many are going to come back?” asks Dr Manocha.Virtual learning has some advantages, such as overcoming the tyranny of distance, but it really only works for didactic teaching where the transfer of information goes in one direction.

“The human brain was not optimised for screen-based learning,” Dr Manocha says. “It was optimised for person-to-person learning. It’s simple evolutionary biology.

“Digital learning can come close, but face-to-face education will always have more impact. It engages attention of learner. It has higher levels of interaction and it’s a more dynamic environment.”

Dr Amandeep Hansra, a GP and digital health expert, has been in high demand as a panelist for webinars since the COVID-19 crisis hit.

She’s participated in webinar events for the General Practice Registrars Australia, the AMA, the RACGP and the Australian Digital Health Agency, among others.

“It’s actually getting a bit exhausting because so many groups are putting on webinars,” Dr Hansra says.

The barriers to entry into the webinar market are very low in terms of cost.

GPs need to keep collecting CPD points even while social distancing, but many are struggling to filter the good quality webinars from the rest because the market is so flooded, she says.

“I see patients sitting in front of my computer, I deliver education to the front of my computer, I receive education sitting in front of my computer, everything I do is in front of that computer now. It does get a little bit mind-numbing.

“And you do feel like you just need a change of environment or scenery. At least if you’re going somewhere, it’s a different environment to everyday practice.”

It’s also not as satisfying delivering a presentation on a live webinar where the audience’s faces are often not in view and the presenter can’t see people nodding along.

“You’ve got no idea who your attendees are, and you are kind of talking to this empty audience,” Dr Hansra says.

And when videos are switched on, webinar attendees are often very distracted – maybe a cat has just jumped onto their table or a child has run into the room.

Also, virtual conferences are very time consuming for presenters because they often have to upskill for each event because different organisations use different webinar platforms.

But there’s a real risk that conference organisers will switch to digital events in the future because it’s so much cheaper and easier to host, and that would be a real shame, Dr Hansra says.

Medical conferences aren’t just about learning new content, they’re about meeting new people and getting that time to connect, debrief, reflect and remember that you’re not alone in general practice, she says.

“I’m a big believer in digital health, but I think when it comes to teaching, I like a mixture of both digital and face-to-face,” she says.

 

These blended models of learning are already coming to life. For instance, the RACGP’s annual meeting – GP20 – will happen in “late 2020” and will take place on one day in multiple locations across the country simultaneously, with GPs connecting virtually with colleagues at the same event in other cities.

Dr Irwin Lim, a rheumatologist at BJC Health in Sydney and the editor of sister publication Rheumatology Republic, is keenly aware of the limitations of virtual events.

He usually runs a day workshop for GPs once a year and he doesn’t want to let all that planning go to waste.

But how do you keep the attention of GPs for a full day online? “I can’t imagine GPs want to do a whole-day webinar,” says Dr Lim.

Instead of running hour-long sessions, Dr Lim has decided to limit online presentations to 20 minutes and then switch to Q&As or interactive sessions so that participants don’t lose interest.

He’s exploring using a service such as Delegate Connect to create “virtual break-out rooms” so that participants have spaces where they can have a casual conversation about the event or do more interactive activities.

These virtual conference providers offer more infrastructure and design functionality than webinar providers. “It’s prettier than Zoom,” says Dr Lim.

It’ll be interesting to see how organisations such as EULAR (The European League Against Rheumatism) transform their conferences into a digital environment.

EULAR usually attracts around 15,000 delegates internationally and is hosted in a European city, which provides plenty of entertainment and novelty for many of the participants.

EULAR usually has around 10 sessions running simultaneously every hour, so it’s a massive event to produce.

This year, EULAR will be hosted virtually for the first time, launching on 3 June and then being accessible on demand for several months.

Many other specialties are thinking along the same lines.

Associate Professor Heather Mack, the president of the Royal Australian and Zealand College of Ophthalmologists, says the Council of Presidents of Medical Colleges is now meeting once a week in a virtual setting. Before the pandemic, this group met in person quarterly.

The International Council of Ophthalmology meeting was supposed to happen in person in June. Now, it’ll be a virtual event, she says.

“So, we’re all we’re all learning how to do virtual presentations. People in The Netherlands are going to record me doing a video presentation of my slides.”

It’s likely that some of these moves to online will stick post-COVID-19, Professor Mack predicts.

“There’s always that benefit to seeing people face to face, but if you live in Australia, or and you’ve got to get to a lot of these conferences, it seems kind of crazy that you travelled 24 hours,” she says.

Lachlan Jones, the media officer for AMA NSW, says the transition to digital events has been relatively painless from a technical perspective, but that the vibe isn’t quite the same when you’ve got attendees “popping up out of the ether to ask a question”.

Some of the digital events have been very successful, particularly the briefings by NSW Health and the AMA NSW AGM, but each online event has its own nuances and challenges, says Mr Jones. For instance, at an AGM it’s important to have processes in place to thoroughly check ID of participants who are voting, and for large events, it’s important to turn the chat box off so that questions don’t get lost in the conversation.

Mr Jones says the popularity of the AMA NSW’s online events during the COVID-19 crisis  opens the door to doing more online functions in the future, which will be particularly beneficial to rural and regional doctors.

While doctor associations will probably benefit from having a mix of online and in-person events, providers of free GP education are looking into a bleak future if pharmaceutical sponsorship money doesn’t follow the move to online.

“There’s this funding vacuum emerging, which is going to suck the oxygen out of the medical education industry if we’re not careful,” says Dr Manocha.

For this story, we reached out to one pharmaceutical company, GSK, as a case study of what’s happening with pharma sponsorship of GP education resources.

The Medical Republic asked GSK whether it was investing more in digital events for GPs during COVID-19 and we received an interesting “non-answer” by way of response.

“We have been engaging digitally with healthcare professionals, and we’ve learned a lot about what their needs are in this incredibly challenging time,” a GSK spokesperson said.

“Face-to-face engagement will always have an important role to play, and we’re actively planning for a return to this, but we know that healthcare professionals want to receive information in different ways, especially now.

“We are working flexibly and using different channels to tailor our interactions in order to ensure we’re adding value as the environment continues to shift.”

GSK wasn’t prepared to provide any examples of how they are switching to digital information delivery for GPs at this stage.

But some pharmaceutical companies are being quite nimble in moving their education funding across to digital. However, the transition needs to happen a lot faster to fill the funding gap, Dr Manocha says.

What we’re seeing is a sudden flip to digital across GP meetings and education, which is both thrilling and terrifying for different stakeholders.

Hopefully, this lockdown experience will be the push some GPs need to learn how to interact digitally – but hardly anyone in the industry wants the pendulum to swing so far that doctors lose the benefits of face-to-face gatherings altogether