June 22, 2020

What is the future of the conference?

There is no doubt that the COVID pandemic is going to change the World. When we consider orthodontics, there will be changes in the way that we deliver our care.  However, other areas are likely to be influenced. One of these is the conference. This post is my personal view on the future of orthodontic meetings.

Most conference organisers have cancelled their meetings because of the COVID-19 pandemic. The last major meeting to announce cancellation was the World Federation of Orthodontists meeting in Japan.  This has now moved to a virtual conference, and we await further details with interest. Other meetings were postponed to next year. As things stand, the new conferences are going to follow the usual structure with the possibility of some presentations being virtual.  But are these steps sustainable with concern about being close to other people and potential problems with travel?

Looking back.

I will start my discussion by looking back at an editorial that I wrote for the Journal of Orthodontics in 2002.  This was soon after the 9/11 attacks, and I had decided not to fly for a while. This resulted in me pulling out of a couple of conference presentations. As a result, I wrote about the “value of the conference. I questioned the value of conferences for the dissemination of information and stated;

“When we consider the information that is available from the presentations, a review of past conferences reveals that it is frequently expert opinion based around a few case reports, the early publication of study results (which may change before publication in refereed journals), neither with much hard science”.

I went on to suggest that conference proceedings could be refereed, as this was done in other areas of medicine. I also wondered if we would make better use of our time by obtaining clinical information from the refereed journals and not the conferences.

Finally, I mentioned that one significant value of the conference was the social aspect and meeting up with colleagues from all over the World. This allows a great exchange of ideas and philosophies.

Changes to the conference?

Since 2002, I subjectively feel that the orthodontic conference has changed. There is still a high proportion of clinical “show and tell” lectures, but they are now balanced by more research presentations.  But has this style of conference gone?

I cannot help feeling that it has.  My perception is, of course, influenced by my own feelings about travel. At the moment, I cannot imagine going to an airport, queuing in a small security zone, then lining up at gates to get on a crowded plane for up to 8 hours.  Never mind, packing into a conference centre with crowded lecture theatres.  This may change if there is a vaccine for COVID, but we are not sure that this will happen.  As a result, we may not be able to hold the “traditional” conference for a while.

The virtual conference?

Orthodontic conference on lineThe virtual conference could provide us with a solution. There is undoubted, tremendous scope because many speakers have become experienced in the use of Zoom and other platforms.  Currently, there are proposals for several virtual conferences based around a couple of days of continuous presentations.  This may appear compelling; however, this means that “delegates” will have to put time aside in their diaries to “attend”.  There may be hesitation to do this, particularly as clinicians may feel the need to be working in the clinic.

One solution to this may be to simply record the presentations and put them on open access platforms.  This will let people view presentations in their own time. Importantly, this may enable us to make efficient use of our time.

What about the trade?

Moving to a virtual conference would mean that there is no opportunity for the trade component. In addition to providing an important component to delegates, this results in considerable income to the conference.  I cannot see a solution to this problem. However, several companies are holding their own virtual meetings where their clinical salesmen present their products.  Furthermore, I wonder if they are increasing their social media presence, but this is just my subjective opinion.

What about the speakers?

I have given keynote presentations at many conferences, and I have enjoyed every meeting that I have attended.  I have experienced great hospitality, and it has allowed us to travel all over the World.  So, my views are influenced by my experiences.  I feel that it would be a loss for speakers to not attend conferences. However, this is balanced by the fact that presentations only need preparing once before posting.   Thus, saving a great deal of time away from their regular work.

Accessibility?

One of the major disadvantages of the traditional conference is cost and accessibility. For example, conference registration, social events and accommodation are expensive. Furthermore, our meetings are not accessible to orthodontists who do not have the resources or time to travel.  By making the conference more available through online lectures, we will be able to inform more people. For example, I have been doing some webinars during the lockdown, and my highest “attendance” was 1700 people who did not have to pay anything.  This can only be a good development.

The future?

This is a hard time for us all, and it is difficult to see a way forwards.  We are continually being told that there is going to be a new “normal”. In some ways, this should better than the way that things were.  I cannot help thinking that the traditional conference has had its day.

Indeed, we may be rapidly moving to the exchange of information using lectures on freely accessible platforms. We will also not be travelling a long distance to meetings at a cost to ourselves and our environment. Paradoxically, these are fascinating and exciting developments that may change orthodontics.

I hope that the specialist societies can embrace this challenge when they consider their future conferences.

p.s. since I published this post I have heard that the AAO will be making their next meeting in Boston both conventional attendance and virtual.  This is a great step and I am sure that the attendance will be high.  Well done AAO, I hope that the other specialist societies can do the same.

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Have your say!

  1. Kevin you’ve forgotten an important aspect. Intellectual property …every time I give a webinar I feel swindled…..everyone is taping and taking your material…impossible to fight against this and no way to work around it…..not all that glitters is gold my friend

  2. The classic orthodontic conference ,or any conference ,is almost totally unnecessary,in my view.
    Recent events have only served to reinforce this.
    Time ,money ,damage to the environment by air travel etc.could be reduced significantly by using virtual platforms.
    This has been the case for many years but change moves slowly.
    Thanks.

  3. Nicely put, Prof. O’Brien.
    One of the few things that is good about the pandemic is the opportunity to attend virtual presentations by the world authorities in Orthodontics. I attended quite a few of your presentations and the experience was surreal. From missing your presentation due to your surgery in WFO conference London (2015) to attending nearly one presentation in two weeks; was a new normal for me.

  4. Thank you, Kevin, for another thought-provoking blog. As you know, the AAO held a virtual Annual Session in May and achieved the highest number of doctor registrations in our history. Of course, there were many factors that lead to this including great speakers, the general feeling of needing to “do something” while our practices were closed and we were all at home, and of course we offered this conference for free to our members in these challenging economic times. In the end, our virtual meeting was a great success and proved to all that it could be done.

    However, we all know that a virtual meeting, whether it is an annual conference or a board meeting, is no substitute for the face to face alternative. We all missed the interaction with friends and colleagues, the ability to engage in both one-on-one conversations and group discussions, and of course the special events offered in different local venues. These are the memories we all hold of meetings past. It’s just not the same spending days sitting in front of a computer.

    The AAO plans to hold a combined meeting in Boston next April. Along with our usual face-to-face meeting at the new Boston Convention Center, there will be a virtual component for those who do not wish to travel or are prohibited traveling. Our hopes are to satisfy doctors and team members no matter what their circumstances. I look forward to an outstanding meeting and hope to see you there as you present the 2020 Salzmann Award lecture which you were to give in Atlanta. I guarantee you will enjoy the conference and the great city of Boston.

    Chris Roberts
    President, American Association of Orthodontists

    • Hi Chris, thanks for the comments. I am really looking forward to the meeting in Boston and it is great to see that the AAO is leading the way with making the sessions virtual. This is a great development and it will be very interesting to see the number of attendees. I will do my best to be in Boston depending on travel restrictions etc….I really hope that we are back to normal by then. Best wishes: Kevin

      • I think the virtual meeting works both ways- – the presenter might not be there in person as much as the delegates.
        People may be attending in person to watch a guy giving a lecture on a screen. Which is what happens anyway in a mega conference like one of the big halls at AAO or IOC.

        If a country like New Zealand or Iceland sorted out its covid problem, all their orthodontists could attend together and watch a presentation from a professor on the other side of the world (albeit at an awkward time for the professor).

        I think this opens up a bigger question – not just conferences but ortho education. We are used to the idea of treating patients with a supervisor and attending lectures – usually in small groups (there were 5 post grad students in my ortho class – with the lecturers in that university. But why limit ourselves to that university’s professors? The authors of classic papers or research could be giving the lecture around the world simultaneously and to enough people to make it worth their while. The local unit is still needed for the day to day clinical supervision and small tutorials, but a lot of the formal modular stuff could be done by the best communicators at the ortho equivalent of Harvard or CalTec or Oxford or Cambridge. Treatment planning exercises could be shared by a hundred people instead of 5.

    • Hi,you make a statement that “we all know that a virtual meeting is no substitute for a face to face meeting “
      Is this statement data based ??
      I believe in the first 10 yrs or so ,of ones practice that may be true.
      For me ,I would rather do a virtual meeting in the comfort of my own home ,by a roaring fire and a coffee .in the middle of a Canadian winter .
      Different strokes etc.

  5. A few years ago I invited my old friend Prof. Ellen BeGole to join me at the AAO meeting in Orlando. Although she had passed her retirement age by decades (she was in her eighties, I believe), she was still very active, spending about two to three days a week at the UIC. I was very interested to know her take on the lectures she attended, especially with her specific biostatistical background. Her impression was that the majority of the lectures still carried a ‘my way or the highway’ subliminal message, with a general lack of scientific substance and open mind. I’m sure it improved somehat in the years since, although I cannot seem to shake the impression that the voice of the KOLs remains disproportionally amplified in the lecture circuit, and that the orthodontic community remains receptive to alternative facts…

  6. I agree: the Covid Emergency will have ramifications for Professional Conferences and meetings of all sorts.

    On the one hand, I have attended several presentations and lectures delivered by the Royal Society of Medicine in London using Zoom as a result of the Covid Emergency. Its not a perfect presentation but the technical imperfections will be overcome and it was well worth an hour of my time. The Royal College of Physicians and Surgeons in Glasgow are also experimenting with electronic presentations. This must be a positive development.

    On the other hand, I have always thought that contact with colleagues and face to face conversation was important but even that might be delivered over an internet connection: One of my daughters made internet friendships with people as far apart as The Lebanon and The State of Mississippi when she was on multi-player Red Dead Redemption! That has a somewhat different ‘aesthetic’ to the British Orthodontic Conference but I think the example of meeting in a shared space in the Global Electronic Village points the way.

    Finally, notwithstanding virus pandemics, I think we have to question the environmental impact of large international conferences and look to more elegant ways of delivering the experience.

  7. Kevin,
    I think that the people that read this blog are well aware of the difficulty returning to a normal or new normal life. In a paper that Bill Gates has written, “Pandemic I: The First Modern Pandemic”, one of the topics that he discusses is confidence level. Your own reservation about attending a conference is an example of this. He points out that this is a great unknown for many different aspects about our work and social lives. I find the first paragraph of his conclusion ever so true, “Melinda and I grew up learning that World War II was a defining moment of our parent’s generation. In a similar way, the Covid pandemic—the first modern pandemic—will define this era. No one who lives through Pandemic I will ever forget it. And it is impossible to overstate the pain that people are feeling now and will continue to feel for years to come.”

    Some aspects of this paper have been published in the general media and in the New England Journal of Medicine. The following link is for the complete paper:
    https://www.gatesnotes.com/Health/Pandemic-Innovation

    One other paper that I suggest reading (no pay wall) that could boost confidence level was published in the New Yorker, ”The Quest For A Pandemic Pill” – can we prepare antivirals to combat the next global crisis? by Matthew Hudson. I think that you and the other scientists and investigators that read this blog will appreciate the 40-year scientific journey of David Ho, MD from Cedars-Sinai Hospital in Los Angeles to Columbia University on his great quest.
    https://www.newyorker.com/magazine/2020/04/13/the-quest-for-a-pandemic-pill

  8. I’d be very sad to see the loss of the traditional conference. Thinking back on the lectures I’ve enjoyed most many have been personal opinion or interest, but they can still make me think about my own practices. I get a lot out of the social aspect, chatting with colleagues and talking about how we work. Having sat through many webinars over the last few months I find one or two short ones a day quite sufficient, having tried a full day ‘course’ I wouldn’t sign up for one again, and whilst the idea of accessing a conference I might not otherwise attend sounds attractive in the outside, I doubt I would sign up for many. Working in practice (especially as the only orthodontist) can be isolating and meetings/conferences are a good antidote to that.

    • I second Megan’s opinion. Every conference I have been to I come away with some pearls I can apply in my practice. Many conferences I have been to those pearls were delivered over a coffee or a beer away from the lecture hall. Hard to do that by zoom!
      Cheers
      and best wishes to all

  9. Dear Kevin

    Many thanks as always for your blog and I would like to offer some thoughts. As chair of the British Orthodontic Conference, I may appear to comment with some bias but hopefully with reasoned opinions.

    Of course, the recent pandemic has created change in our teaching and presentation methods. Over the last few months most teaching has been done via remote platform such as Zoom. Clearly, while this has many benefits, and has allowed us to continue teaching, most attendees and presenters are only too aware of the shortcomings. For any individual a full day of zoom presentations would be ‘heavy-going’ and face-to-face teaching brings a realism that is hard to replicate over a screen. Nevertheless, they will inevitably become part of our modern-day teaching and presentations.

    A conference, however, provides many benefits aside from presentations. Nowadays, like many experiences, it is the surrounding package that is important and desired. Nobody would equate watching Glastonbury on TV to the real deal of being there. A live presentation or hands-on clinical skills session, especially in small groups, stimulates conversation that wouldn’t be ‘voiced’ digitally. I would accept that many research presentations may be equally read and digested from journals, but the value of a great speaker cannot be matched in any written article. That is why most conference chairs spend considerable time attracting the best of speakers who will engage and stimulate an audience.

    You mention trade and salespeople; however, most orthodontists have a relationship with a supplier which is of immense value. This is much more than an orthodontist trading from a salesperson – this is a friendship that is mutually beneficial and we often call upon that supplier to help and support us in practice. Having respectable and professional trade at a conference is much more than a financial support, it allows us to foster and harbour relationships as well as looking at new innovations and discussing possible advances.

    Finally, there is the social side to a conference. This is often downplayed but is hugely important to many delegates be it clinicians, staff members, trainees etc. Many use the Conference to meet colleagues and discuss issues – clinical, management and political. For those Orthodontists who are less well connected, a conference meeting may be one of the few times they can genuinely and honestly chat with similar minded colleagues. It is easy to underestimate the value of this if you work in a large department, able to discuss things on a daily basis.

    Conferences foster future Orthodontists. Last year we had a record number of aspiring Orthodontists who enjoyed meeting specialist practitioners, academics and current trainees. This wouldn’t and couldn’t happen over Zoom.

    Following this period of time, it is true that conferences need to transform and re-appear with innovation, but not disappear. We aim to offer remote access to all the lectures but also very much intend to continue to bring an experience of collegiate teaching, networking, interaction and, of course, enjoyment.

    Thanks again for your timely post and hopefully you won’t mind the shameless plug:

    “ALL ZOOMED OUT, WANT TO SEE LIVE PRESENTERS, NEED TO CHAT TO FRIENDS & COLLEAGUES?”
    SAVE THE DATE BOC 2021 16TH -18TH SEPTEMBER, MANCHESTER!

    Thank you

    David Waring
    Chair BOC

  10. Thank you so much for sharing your thoughts on this subject. Personally I feel it’s crazy that it has taken a pandemic for both educators and event planners to see the amazing possibilities of the virtual platform in terms of accessibility for all. I started my specialist training with a young family already and countless times I have had to get up at 4am to be able to get a hideously expensive train halfway across the country, only to spend the day sitting in a small room just being lectured to…often wondering why this teaching couldn’t be delivered remotely. Since then my life has only got busier and I find it often impossible to be able to attend far-flung conferences and study days even though I’d desperately love to hear the speakers. I may still need to set time aside to “attend” a remote conference but I wouldn’t need to worry so much about finding childcare or the expenses of travel (both financial and time!)
    In terms of the worry of isolation and missing the social element – in 2018 I set up a peer review group for local orthodontists and I would argue it has had far more impact on me feeling part of a network of orthodontists than attending a conference would.
    In terms of missing the trade stands – could it be set up like youtube? Lectures are sponsored and you have to watch the short! Trade presentation to be able to then watch the lecture. Maybe this would also decrease the ticket price for virtual attendees? I do feel there will be a place for the conference in the future but also many exciting possibilities for virtual set ups…as long as we will allow ourselves to embrace the change.

  11. I have zoomed myself to oblivion over the lockdown. Attending a lecture, or conference, in real life allows the disconnection from the usual environment and to apply yourself totally to the new location and information – usually this allows for better focus on the material. I would like to try the virtual alternative but I don’t know if I would have the discipline to completely commit to it or start noodling on the internet – which I could do in a conventional lecture but I don’t.

    Also, despite the legit environment arguments for not flying around the world to hear a guy talk for a few hours physically attending a conference facilitates some or all of the following:
    networking
    tradeshow visiting
    adultery/infidelity opportunities not usually available at home
    tax deductible travel

    Stephen

  12. Screentime can’t substitute for real life travel, social and human touch and feel experiences. The desire for real experiences will never die. And without recency in real experiential engagement with real people, the ability to organise good virtual meetings will quickly wane.

    The very well resourced conferences like AAO have provided electronic media backups for years. Its extremely useful with a unique place. But its only a recording.

  13. For many years my feedback to conference has been – remove the Black tie as it is not the 1920’s anymore and fact check the presentations (or the speaker needs to declare that their presentation is only personal opinion). Present conferences can hardly claim they represent the pinnacle of scientific discoveries.

    Conferences exist for socialising, selling and transmission of information. The latter is effectively achieved via the internet. Many conferences have the same presenters talking about the same set of data they acquired many years past. I have listened to lots of “new” ways of treating a class 2 using “new” miracle appliances. They all do the same thing.
    There is the occasional worthwhile presentation, (not another systematic review suggesting we need better research) though unfortunately too rare. I do understand that funding for orthodontic research is hard to come by (due to our marginal health gains) and therefore manufacturer driven low level science predominates.

    Flying presenters around the world in expensive seats is rather silly and hardly progressive, though im sure the presenters enjoy it.

    Charging companies a lot of money to sell at stands will only result in higher prices for patients and misleading advertising claims.

    It is good to meet colleagues and have a chat but it has become rather an expensive chat.

  14. Thank you all for the thoughtful comments. I think that the pandemic has opened our eyes (forced I may say) to the possibilities and limitations of teleconferencing. A point I noted has not touched in depth is the perspective of the speaker. While lecturing to my under and grad students I find that after 45 minutes it is difficult to maintain focus as I am looking into slides all the time and not interacting with the audience. Non-verbal communication signs are something I miss. Again the future may be a combination of both worlds so that each picks up the lecture style that best fits our own needs, situation, and learning style.

    Leonie’s comment about feeling part of a network is important. It is not only about listening to peers but actually interact. Teleconference approaches that facilitate peer interaction in a safe non-judgemental environment maybe a nice sweet spot.

  15. Thank you all for the thoughtful comments. I think that the pandemic has opened our eyes
    (forced I may say) to the possibilities and limitations of teleconferencing. A point I noted has
    not touched in depth is the perspective of the speaker. While lecturing to my under and grad
    students I find that after 45 minutes it is difficult to maintain focus as I am looking into slides
    all the time and not interacting with the audience. Non-verbal communication signs are
    something I miss. Again the future may be a combination of both worlds so that each picks
    up the lecture style that best fits our own needs, situation, and learning style.
    Leonie’s comment about feeling part of a network is important. It is not only about listening
    to peers but actually interact. Teleconference approaches that facilitate peer interaction in a
    safe non-judgemental environment maybe a nice sweet spot.

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