Abstract
During the current coronavirus pandemic, social distancing and restrictions on travel have resulted in a dramatic rise in the use of technology (including video conferencing) for remote meetings. From local multidisciplinary team (MDT) meetings to national and international committees, this form of communication has been vital to ensure patient-related and other business can continue, albeit in a sometimes unfamiliar environment.
In this article we consider some of the human factors elements of remote meetings and provide suggestions to enhance the experience of team and committee members during this unsettling time. It is possible that this form of communication will continue to flourish after the pandemic is over.
Introduction
In just a few months, the coronavirus (COVID-19) pandemic has changed our current way of life both personally and professionally. Social distancing regulations across the world are proving beneficial in reducing the spread of the virus. However, this necessary alteration to the way we interact has resulted in the cancellation and postponement of many national meetings, conferences (including the BAOMS Annual Scientific Meeting in June 2020), surgical exams including MRCS and FRCS as well as other events involving close interaction between colleagues. However, national and international business and essential meetings requiring significant participation at local Trust level, such as cancer and other multidisciplinary teams (MDT) have to continue.
As a result, there has been an exponential rise in the use of virtual meeting technology including such platforms as Microsoft ® Teams, GoToMeeting ® , PowWowNow ® to name just a few. When confidential conversations are taking place such as those relating to patient care, it is important to ensure that the platform being used is secure.
The use of video-communication is not new and has considerable benefits for connecting individuals in diverse locations, reducing travel time and expense. Over 25 years ago, researchers investigated various factors that improve one’s presence on teleconferencing including how cameras are set up and positioned to ensure eye contact with other participants.
However, limited bandwidth can result in major shortcomings, frustration, reduced performance and less effective action planning when compared to standard face to face meetings. Speaking time also increases during virtual meetings and various non-verbal communication gestures that occur during face to face meetings might be difficult or impossible to convey to others thereby reducing decision making quality. The authors have attended and chaired many virtual meetings in the last few weeks. Our experiences have been variable, encountering many issues supporting the findings of a 2013 study that concluded virtual technology was unlikely to replace the traditional face-to-face cancer MDT. Broadband and login issues, long arduous meetings, and difficulties in agreeing outcomes that are more readily achievable in face-to-face meetings prompted review of human factors (HF) knowledge and experiences to develop suggestions to improve the virtual experience.
Before discussing these issues, it is important to emphasise that adequate preparation is a prerequisite to any committee or meeting and members should have read the relevant circulated papers and agenda before the meeting itself.
What human factors are important at virtual meetings?
Setting the agenda
Some meetings may be conducted by video technology, or if not available, by teleconference. Video links can utilise significant bandwidth, leading to connectivity issues, slurring of images and sound problems, all of which can result in potential boredom or disengagement.
It is important that the chair or leader of the meeting begins by setting a clear agenda and format, discusses timings and ensures that everyone is equally valued. It must be emphasised that only one participant should speak at any time. As with face-to face meetings, one or more loquacious individuals may dominate virtual meetings, which can be counterproductive or even disruptive for the rest of the attendees. While all individuals must be allowed to appropriately voice their opinion or expertise, the chair should provide clarity from the outset of the time constraints and need for brevity as well as inclusivity.
When using video conferencing, we recommend that all attendees other than the chair and current speaking participant turn off their cameras to reduce bandwidth usage and improve sound quality. The additional advantage of this technique is that it can alert the chair when someone else wishes to speak, akin to the raising of a hand during a face-to-face meeting.
Taking breaks
While not relevant for short meetings of perhaps less than 90 minutes, during those lasting for a half day or longer, we believe it is important to build in breaks within the virtual meeting agenda. It can be even more difficult to concentrate when participating in remote discussions compared to face-to-face interactions, particularly for the chair who is denied non-verbal communication clues and other committee dynamics that can help the effective running of meetings. Lack of concentration can lead to agenda items being missed, or improperly understood and discussed in a similar way to loss of situational awareness leading to potential error. Furthermore, it is much harder for committee members to look out for each other or prompt the chair if they are missing something important or going off track. We recommend a minimum 10-minute break every 90 minutes, with a longer break of at least 20 minutes after three hours. Participants can remain logged in or connected to the hosting platform or dial in number. During this time, just as in clinical practice, it is important to rehydrate and eat regularly. A cup of coffee and comfort break may make longer virtual meetings more enjoyable than shorter but more intense face-to-face meeting where breaks and drinks are considered unnecessary ( Fig. 1 ).
