“Life is what happens to you while you are busy making other plans.”
With practice, business, and travel collapsing in mid-March as the coronavirus disease 2019 (COVID-19) unfolded in the U.S., the leadership of the Florida Chapter of the American College of Surgeons (ACS) faced a difficult decision. We could cancel the in-person Chapter Annual Meeting, May 1–3; postpone the meeting until later in 2020; or conduct the meeting virtually. Changing the annual meeting was no small matter: The chapter year ends and begins anew with the annual meeting, and a positive contribution margin from the annual meeting is essential to fund other chapter activities throughout the year.
Factors that shaped the decision were the resolution of financial repercussions from canceling hotel and venue contracts, bylaws requirements for the annual governance transition, and the necessity of supporting chapter entries into ACS competitions. Importantly, leadership anticipated the need for surgical community in a time of lingering crisis in a way that would support workforce readiness.
On March 20, Florida Gov. Ron DeSantis (R) issued Executive Order 20–72, which halted elective surgery through May 8 (subsequently changed to May 3) and reinforced the need for surgical readiness. On March 23, the chapter’s Executive Committee decided to go virtual with the annual meeting May 2.
The theme of this year’s program was “Predicting the Surgeon of 2030.” The program was reshaped from 8.25 Continuing Medical Education (CME) hours in-person to three hours virtually (see Table 1). The Edward M. Copeland III, MD, FACS, Resident Abstract Competition was condensed into two presentations, the top-scoring basic and clinical science abstracts, and inclusive of the Florida Commission on Cancer (CoC) Competition. Other high-scoring abstracts were presented on the chapter website as a Resident Research Abstract Showcase (available at floridafacs.org/2020-abstracts). Medical student poster submissions also were posted as a Medical Student Research Abstract Exhibition.
Table 1. Moving from aN In-Person to virtual meeting format—differences
Presenting speakers were accepting of the necessity of the virtual format, and postponed speakers were gracious in deferring presentations to the future.
A virtual format for chapter meetings is a good option for staying connected when in-person meetings are infeasible. For chapters representing a large geographic area and who have interest in connecting with other chapters, the virtual option might substitute for in-person meetings.
The in-person Exhibit Hall for industry sponsors was converted into a Virtual Solutions Center on the chapter website, available at floridafacs.org/annual. Exhibitors had “space” to demonstrate their products and technology, and some provided videos.
The chapter’s online platform was assessed for compatibility with virtual program expectations and then tested with two moderator and three full-scale presenter drills. Program flow was adjusted to accommodate the online platform. Because moderator and presenter video challenged system performance, audio accompanied slides in unrecorded presentations.
Costs for the virtual meeting were anticipated to be significantly less than the in-person meeting, yet still required funding through two sources—participant registration and exhibitor fees. Participants paid by category as follows: Fellow/Associate Fellow, $20; Resident, $10; and Medical Student, $5. Registration also helped to solidify participant intention to attend the virtual meeting. Given the novelty of a virtual meeting and general uncertainty, we set a goal of 100 ACS member participants. The meeting was marketed to members of all three Florida Chapters and the College as a whole through e-mails and the ACS Communities. The exhibitor fee for the Virtual Solutions Center was $250.
Virtual becomes reality
A total of 118 ACS members registered for the 195-minute meeting; 113 participated in some portion of the program, with an average time of 163 minutes, and 93 remained for the business meeting. Domestic out-of-state participants connected from Georgia, Massachusetts, North Carolina, South Dakota, Texas, and Virginia; there were international participants from Kuwait. The range of ACS member registration for the last three in-person Chapter annual meetings (2017−2019) was 122−138, with an average 130. The Virtual Solutions Center hosted 18 exhibitors.
The program opened with brief leadership remarks and moved quickly to the first of two 30-minute recorded lectures, Surgical CME by 2030, given by John A. Weigelt, DVM, MD, FACS, ACS First Vice-President.
Next was the one-hour Edward M. Copeland III, MD, FACS, Resident Abstract Competition, with a single moderator and five abstracts. Questions were easily sent via chat and Q&A rooms. The Florida CoC Abstract Competition was scored online.
The one-hour Spectacularly Challenging Case Competition followed with five cases. Again, chat and Q&A rooms ensured engagement between participants and presenters. The winning case was determined with a live poll, with results rapidly visible to all participants and the winner announced moments later.
The second recorded lecture, The Past, Present, and Future of Women in Surgery, by V. Suzanne Klimberg, MD, PhD, FACS, followed.
The business meeting concluded the event and included election of officers and councilors, as well as the annual leadership transition. The meeting started and ended on time, with 93 participants still online at the conclusion. Importantly, there was a high level of engagement throughout the meeting with 255 chat comments and questions.
Meeting expenses were $2,300, inclusive of technology, marketing, and competition awards. Registration fees did not cover these expenses, with the difference made up by Virtual Solutions Center fees.
Keys to successful virtual meetings
A virtual format for chapter meetings is a good option for staying connected when in-person meetings are infeasible. For chapters representing a large geographic area and who have interest in connecting with other chapters, the virtual option might substitute for in-person meetings. We identified seven key considerations for success, as follows:
- Establish meeting expectations. The virtual format cannot replicate all of the dimensions of an in-person meeting, including length. Three hours for a meeting is consistent with a baseball game or movie and makes the meeting more accessible. Thoughtful selection of content and presentations promotes meeting coherence. A place to start in program development is determination of the essential meeting requirements, such as chapter resident paper and case presentations for time-sensitive College competitions, and core governance functions with elections and transitions. The meeting can then be built out with 30-minute lectures on hot topics that add variety and pique interest.1 Opportunities for engagement between presenters and participants should be defined for each session—not all sessions need Q&A.
- Identify the technology platform. Operating characteristics and engagement possibilities vary across platforms. In the emerging remote meeting industry, the tendency is to overpromise and underperform. The technology creates a temporary network with a dependency on the quality of Internet connectivity, including service providers and browsers. Maximum participant load, ease of connection (initial and sustained), audiovisual quality, and simplicity of use should be defined.2 Chat rooms, text Q&A, and polls promote interactivity and real-time feedback.
- Define the budget. Though expenses are significantly lower with virtual compared to in-person meetings, they still exist. Costs for the technology platform may vary by participant number. Setting a reasoned assumption for the number of participants is necessary to determine registration fees, which should be much lower than for live conferences. Exhibitors are receptive to modest fees for a virtual presence.
- Script the meeting. A virtual meeting requires specific discipline with regard to flow. Participants are less tolerant of glitches and gaps in virtual meetings and, with one click, can leave. Similar to TED talks, virtual meetings should be scripted tightly to stay on time.3 Scripting helps to sustain meeting tempo. Chat rooms make meeting comments visible in real time and capture thoughts that might otherwise have been expressed in hallways and receptions at live meetings. Q&A rooms are efficient, as typed questions generally are more focused than verbal queries and comments.
- Conduct meeting simulations. Virtual meetings do not move seamlessly between multiple moderators and presenters. Practicing with the technology helps organizers to define strengths and limitations and to make adjustments before the actual meeting.4 We discovered audiovisual fidelity issues with open virtual microphones and video, so we restricted open audio only to moderators and presenters with no video. Group audiovisual restriction is more reliable than individual participant muting (left uncontrolled, the “airwaves” are filled with echoes from the presenters and background noise). We also recognized the increased importance of moderators in controlling flow by keeping speakers on time and guiding discussion between presenters and text questioners. Simulation also instilled confidence in the presenters and moderators using the technology.
- Include website content. Links to the chapter website enhance virtual meetings. Links to a meeting program booklet, virtual poster exhibit, and industry virtual exhibit area extend meeting connection beyond the assigned time.
- Simplify. The meeting experience is shaped by content, technology, and interaction. The virtual environment has its own complexities. Keeping the instructional design of presentations and technology requirements as simple as possible reduces the risk of failures during the meeting.5
- Frisch B, Greene C. What it takes to run a great virtual meeting. Harvard Business Review. Available at: https://hbr.org/2020/03/what-it-takes-to-run-a-great-virtual-meeting. Accessed May 12, 2020.
- Harvard Business Review. Running Virtual Meetings (HBR 20-Minute Manager Series). Boston, MA: Harvard Business Review Press; 2016.
- Anderson C. TED Talks: The Official TED Guide to Public Speaking. New York, NY: Houghton Mifflin Harcourt; 2016.
- Frisch B, Greene C, Prager D. Virtual offsites that work. Harvard Business Review. Available at: https://hbr.org/2020/03/virtual-offsites-that-work. Accessed May 12, 2020.
- Reynolds G. Presentation Zen: Simple Ideas on Presentation on Design and Delivery. Berkeley, CA: New Riders; 2008.