A Note to Conference Organizers Everywhere

Social Media, FOAM… Call it what you will, it’s pretty amazing.

Over the last few months I attended a bunch of conferences without having to pack a single bag.  In fact, I was able to keep up with regular ED shifts and continue with my “normal” life as an Emergency/Internal Medicine resident all while experiencing the 2012 Scientific Assembly of the American College of Emergency Physicians (ACEP), the 2012 meeting of the American Society for Bioethics and Humanities (ASBH), and the 2012 “Essentials of Emergency Medicine”.  These meetings took place in Denver, Washington DC, and Las Vegas, yet I had only to pick up my iPhone once or twice a day to keep up with all the latest updates and controversies coming out of these fora.

My impressions from ACEP and ASBH, based primarily on conference hashtags, can be found in the following posts: “Freeloading ACEP12“, “Virtually There“, “Lively Day at ACEP12“, “Final Counts…ACEP12“, “Peds Addendum“, and “ASBH From Afar“.  Thanks to the many active participants in both meetings I was able to create a daily narrative for each.  Reflecting on these meetings, and on my experiences live-tweeting from other national and local gatherings, including “iReporting” from SAEM 2012, got me to thinking…

Is the medical conference dead?

Dr. Tim Leeuwenburg at KI Docs had this to say in a post from October 29, 2012. He makes a very good point that: “…perhaps recent exposure to high-quality asynchronous #FOAMed learning has raised my expectations.”  He had, in fact, already learned much of what came out of the meeting he attended by utilizing the myriad of resources available via FOAM so what use is the conference?  My own experience has been the same.  By following Twitter, blogs, podcasts and vodcasts I find that by the time I get to the conference, the speakers are mostly rehashing what has already been discussed online.

Dr. Leeuwenburg quotes the never-ending wisdom of EM/CC educator and bard Dr. Joe Lex:

“If you want to know how we practiced medicine 5 years ago – read a textbook
If you want to know how we practiced medicine 2 years ago – read a journal
If you want to know how we practice medicine now – go to a (good) conference
If you want to know how we will practice medicine in the future – use FOAM”

Conferences used to be a place to hear the leading voices in our fields and to be exposed to the vanguard of our profession.  In an era of instant messaging and nonstop communication they are simply too unwieldy.  This role has been unceremoniously taken out of their hands.

Wait, Rewind

Didactics and innovation are not the sole purposes of medical conferences.  We also go to meetings for the human piece, the meeting of the minds.  Shmoozing, networking, campaigning – call it what you will, people like to get together and talk. They use this time to come up with new ideas, explore projects, find new collaborators.  Conferences also provide hands on, physical, access to equipment and practical workshops in ways that simply cannot be done (yet) in a virtual world.  Finally, the problem of quality assurance in FOAM remains unresolved (as addressed here on Academic Life in EM; and, here at IVLine and here at BoringEM).  Yes, FOAM can show us where the practice is headed, but it has a serious “buyer beware” attached.  For all you know I could be a 13 year old with good language skills and a pathologic personality.

So the medical conference must rethink itself.  While didactics are essential, once FOAM straightens out the kinks it will supersede conferences for straight-up learning.  The added value in traveling to a conference value comes out of physical human interaction and, of course, from being at the venue itself.

What To Do?

• Avoid traditional lectures to large groups, with exceptions for those particularly gifted speakers and thinkers who are able to effectively convey knowledge, and whom everyone simply “must” hear.  In most cases there other, more effective fora should be used.
• For large group sessions make use of panel discussions with innovators/thought leaders.  These provide for distribution of knowledge while allowing participants a peek into the cognitive processes driving changes in clinical practice.
• Maximize the use of hands-on practical sessions.
• Focus on simulation for procedural and general skills training.
• Embrace Social Media and FOAM.  Conferences are sometimes money making endeavors, and if not, they at least rely on registration fees and sponsor support to offset costs so “free” is often left out of the equation.  That said, the cost of attendance is a significant barrier to many trainees and physicians.  As free resources improve, the impact of conferences will decline unless they step into the world of Free Open Access Meducation (FOAM).  By doing so they will cement their role in the new order of medical education.  Online buzz preceding meetings could actually increase registration, and speakers, organizations, and sponsors will be able to reach a much broader audience.  Virtual meeting attendance (i.e. via social media resources) could increase conference reach and impact by orders of magnitude.  It might even be leveraged for financial gain by linking to paid resources, organizational membership, merchandise sales, etc. (sorry FOAM colleagues, got to make a business case here too).

Making Conference FOAM Happen:

Consider any and all of the following for a conference of any size.  Weekly local conferences, regional meetings, committee meetings, national assemblies, whatever.  They all can be enhanced through the tools of FOAM. 

1. Primary Hashtag – Decide on a catchy, intuitive term with minimal character use (5-6 characters seems to be the norm).  Hashtags are essentially keywords used to quickly locate a themed content on Twitter (other social media sites use the same concept).  Typically, the tag is preceded by a “#” (pound sign).  For example, the SAEM 2012 hashtag was #SAEM12.  Entering #SAEM12 in the Twitter search box would bring up all conference related posts organized by time.  Some hashtag uses: a) Conference promotion/PR, b) Backchannel communication (live, and around the clock conversation on conference topics), c) Speaker Q&A (and also allows participants to ask questions live without standing in those arduous microphone lines), d) Off-site participation (by following a hashtag and adding it to their tweets people can follow conference sessions from afar and contribute to backchannel discussion.  They can learn, submit questions and supplemental information, and participate in other constructive ways), e) Dissemination of information to the general public, f) Participation in multiple conference sessions simultaneously (by being in one room and following tweets from another), g) Marketing (unfortunately, hashtags are sometimes used for direct to physician marketing by conference sponsors and other commercial interest).
2. Sub-hashtags – Twitter feeds from very large meetings with thousands of participants and multiple parallel sessions can easily resemble the ramblings of a deranged mind.  With multiple people tweeting from simultaneous sessions it is sometimes hard to keep track of who said what.  Talk abut flight of ideas.  Also, the deluge of tweets from particularly popular sessions can easily drown out smaller concurrent sessions.  Consider, for large conferences, using sub-hashtags to identify tracks or particularly popular sessions.  This way users can filter out extraneous information and focus only the session they are following.  Of course, space is at a premium in the 140 character twitterverse, but adding even one letter to the primary hashtag can help.  For example, #ASBHa (for sessions in Track A) and #ASBHb (for sessions in track B) to allow for two parallel speakers and twitter feeds.  Other solutions would be to use specific identifiers, such as a session number, room number/name, or speaker name.
3. Register the hashtag – Sites such as Symplur and Twubs allow you to register hashtags.  Both have free and paid options.  Symplur specifically aims its services at the medical world.  Registration has a few potential uses, including staking your claim on the hashtag and listing it in a searchable database with a link to conference information.  It is unclear if registration provides any real benefit.  However, Symplur will also provide metrics so anyone can see who the most active hashtag users are, how many tweets have been posted, how many users they’ve reached, rates of retweets, etc.  A sort of real-time impact factor.
4. Encourage participation and include hashtags in PR materials – Picking a short and witty hashtag isn’t enough, people need to use it.  Get the word out by deciding on a hashtag early and including it in all promotional materials.  Not only will this help participants during the event, early adopters will also create a buzz long before the first session.  During the meeting, post hashtags prominently.  Consider asking speakers to incorporate them into their presentations, and remind participants to use them in their posts, blogs and other communications.
5. Twitterwall –  Reach those who aren’t on Twitter (or whose batteries have died) by installing twitterwalls in central locations (registration, lobby, etc) and on-stage during sessions.  There are two primary goals here.  First, LCD screens or projections in central locations allow everyone to see what’s going on in real time.  Lobby loungers or cafe chatters can see what sessions they’re missing and run to the rooms to get there in time.  Secondly, live twitter feeds presented on a second screen during sessions facilitate Q&A and allow speakers, and those not on Twitter, to keep tabs on the backchannel.  Some speakers will also embed tweets into their presentations (see next item, below).  Modalities range from a straight listing of all tweets in sequence (as might be used in a live session) to attractive animations of individual tweets as they come up (visually pleasing way of watching tweets in central locations).  There’s always a risk of inappropriate tweets showing up in public spaces, so some services offer a time delay or moderating function.  Examples include: Tweetwallpro, Tweetwall, Twijector, VisibleTweets, WallofSilver, TwitterWall, and many more…
6. Embedding twitter into presentations – Presenters may start incorporating tweets into their presentations.  For a variety of resources and uses, see this post by Timo Elliott on “Presentation 2.0“, Twitter Powerpoint and Twitter Prezi tools.  Some, not all, of these tools are free, but Twitter always is (for now).
7. iReporters – Assign specific people to “livetweet” sessions and call attention to special events.  This assures a constant flow of information and provides for some quality control.  Also, depending on how many followers an iReporter has, their posts can seed further discussion and conference buzz.  The conference hashtag ends up being associated with the brand, and organizers benefit from a well written feed.
8. Google+ Hangouts – Hangouts are essentially a video conference with up to 10 different users.  Google+ also offers a streaming mode, “Hangout on Air”, that automatically saves sessions to an associated Youtube account.  This tool might be used to informally Q&A with speakers or moderators, stream sessions live, facilitate discussions and committee meetings, etc.
9. Vodcasts/Podcasts – Develop complementary and summary podcasts to facilitate learning and discussion, and to drum up attention to the conferences.  Post these materials to the conference website and associated blogs.
10. Learn from other conferences – SMACC – The Social Media and Critical Conference that will take place in Sydney this March is testing the limits on this stuff.  Aside from incorporating some of the ideas listed above, they have also pushed user participation and user driven conference content to the extreme via PK-SMACC Talks and SMACC-Club.  Please follow the preceding links to learn more.
11. Create a Dynamic Online Presence – Most conferences already have some kind of a website.  A standard web page is a fantastic place to post static information, supplemental resources, speaker bios, whatever.  Consider adding to this a blog, Facebook page, Twitter account, Google+ page or community.  Just be sure to keep updating whatever channels you use.  An out of date or inactive blog, Facebook page or Twitter account is a huge turnoff.

I don't understand conf facilities charging for WiFi. I'll promote them if I can tweet more w/ tablet using WiFi. Hint hint @MarriottRVA

— Chuck Gates (@RVAChuck) February 1, 2013

Yes, all of the above assumes that participants have access to the internet.  Hopefully,  potential registrants will generally be able to use the internet before they come.  The real problem arises when lecture halls and convention centers lie under a monstrous hotel in cellphone dead zones, and then facilities try to take conference organizers or participants for all they’ve got just to pay for WiFi service.

It doesn’t make much sense.  But just as some hotels and airports are beginning to loosen up access to WiFi services – realizing the significant marginal profit to be had around internet use (after all, the internet itself isn’t the commodity, it’s everything else that exists online) – so I hope, conference centers will come to the realization that they are losing out with their current approach.

Be the Switchboard

Medical education is, slowly, being liberated by free online resources.  Thanks to its inherent flexibility, versatility, and pluralism, FOAM has already become the epicenter of cutting edge medical care.  It is clear that the medical conference is too slow to teach us “how we will practice medicine in the future”.  As web resources continue to increase in scope and reliability it will probably not be good at teaching us “how we practice medicine now” for much longer either.

But don’t give up on your frequent flier miles just yet.  Many physicians still rely on regional and national meetings to learn about new equipment or techniques and to undergo advanced skills training.   Furthermore, conferences remain an excellent venue to showcase research and to form new connections.  But the fact remains that conference conversations and even conference content have, like medical education, been jailbroken.  They are instantaneously conveyed to every corner of the earth on tides of FOAM.

For the medical conference to remain a vital part of the Med-Ed ecosystem it must build on its strengths while immersing itself in the new learning environment.  Organizers should capitalize on human interaction by focusing on high yield, small group sessions with content experts, and on practical workshops and directed networking sessions.  Large fora should be limited to a few particularly inspiring beacons of wisdom conveying not only content but also cognition; how do the masters think?  Most importantly, organizers must integrate a coherent FOAM strategy into the conference experience itself.  They are no longer there just to deliver information.  Conferences are now entering the realm of managing the live flow of data in and out of meeting halls, to and from the global medical conversation.

Don’t drown in the FOAM.  Love it, embrace it, flow with it.