Virtual Events in the Era of COVID-19: Perspectives From a Virtual Interdisciplinary Wound Care Symposium

Travel restrictions during the coronavirus disease-19 (COVID-19) pandemic have made in-person conference attendance difficult, if not impossible; however, the need for organized events remains. Conferences serve as important events for exchanging knowledge, learning new skills, and socializing with peers.¹ Virtual conferences have been adopted for academic events outside of the medical field and serve as an alternative to in-person events that allow people to gather despite travel restrictions.^2,3 As restrictions continue to be lifted and in-person events resume, the fate of virtual events becomes unclear. While in-person conferences and symposiums had been the norm before 2020, they require abundant time commitment, cause jet lag, and produce significant carbon emissions from distant travel.^4,5 Attendee capacity is limited due to physical space, and accessibility limitations exist due to the cost of travel and accommodations.^1,6

Virtual conferences have their own unique drawbacks, such as lack of opportunities to interact organically with peers, and difficulties with technology that result in limited participation in all aspects of a conference.^7,8 These negatives notwithstanding, virtual conferences eliminate many of the drawbacks of in-person conferences because they do not require attendees to travel, and participants can attend from a phone, tablet, or computer wherever they have Internet access.⁹ Mitigation of potential drawbacks from using a virtual platform comes down to planning and facilitation.¹⁰ Conference organizers must find virtual alternatives to allow for socializing among attendees and with speakers. Facilitators must also be available to provide tech support during the conference. Before conference organizers decide whether they will continue to use virtual platforms as COVID-19 restrictions continue to be lifted, they should consider their target audience’s preferences for the in-person versus virtual format.

Virtual events during the COVID-19 pandemic have been received with mixed reactions. Previous articles discussing attendee perceptions regarding virtual events have reported a broad range of results in terms of attendee preference. In 1 study (N = 81), internal medicine (62%) and emergency medicine (38%) residents were surveyed to determine preference between in-person and online lectures after the abrupt switch during the COVID-19 pandemic. The survey found that there was equal preference for in-person (38%) and online (38%) formats for standard lectures; however, respondents preferred the in-person format (58%) for interactive lectures, for engaging with the presenters (80%), and for with interacting with peers (85%).¹¹

Another cross-sectional study (N = 141) that surveyed emergency medicine residents (64%) and faculty (48%) from 5 programs representing major geographic regions in the United States during the COVID-19 pandemic found that both faculty (51%) and residents (54%) were more likely or much more likely to attend virtual conferences over in-person conferences. The survey also found that residents perceived the faculty’s effectiveness in answering questions was the same or better (77%) than that of in-person lectures, and faculty engagement (82.5%) and attendance (92.6%) was the same or better.¹²

A 2021 survey (N = 245; 77% residents, 12% attending physicians, 5% fellows, 6% medical students) focused on a virtual conference for a national orthopedic trauma association held during the COVID-19 pandemic. In their survey responses, 96% of participants rated the conference as either similar quality or better relative to prior in-person conferences. The survey also found that 57% and 35% of respondents said that, compared with in-person conferences, they learned more or as much at the virtual conference, respectively.¹³

In another web-based survey (N = 650) assessing internal medicine resident perceptions of virtual morning rounds implemented during the COVID-19 pandemic, 42% of respondents preferred in-person rounds, 18% preferred virtual, and 40% felt they were equivalent. Additionally, 72% of respondents felt that the virtual format should remain an option in the future.⁷

Surveys assessing perceptions on virtual educational events implemented during the COVID-19 pandemic have revealed that respondents are often split between preferring in-person formats and finding virtual formats equivalent or preferable to in-person attendance. To determine if the virtual format should continue to be used, feedback must be elicited from a wide variety of conference types and audiences. The aim of the current study was to examine post-conference survey responses from 2 consecutive years of an annual wound care symposium in Hempstead, New York, to gauge participant perceptions of the virtual format. The authors hypothesized that perceptions would be overall positive, and that participants would not have a difference in preference between in-person and virtual conference formats. These findings may help to determine if the virtual format has the potential to remain a part of future conferences.

In November 2020, the seventh annual Shining a Light on Wound Care symposium at the Donald and Barbara Zucker School of Medicine in Hempstead, New York, was held virtually for the first time. The following year, in June 2021, the eighth annual Shining a Light on Wound Care symposium was again held virtually. The conferences covered such topics as techniques for wound debridement, wound care treatment plan formulation, topical wound therapies, chronic wound care, dressing management, guidance for wound care in patients with diabetes, and other related topics relevant to physicians, nurses, podiatrists, and other health care professionals. Attendees to the seventh and eighth annual interdisciplinary virtual wound care symposiums were surveyed to assess their perceptions on the virtual format. Survey responses were collected over the 2 weeks following each conference. In 2020, 170 of 318 (53%) participants responded to the 21-question web-based post-symposium survey; in 2021, 113 of 221 (51%) participants responded to the same 21-question survey.

Of the 21 questions asked, 6 survey questions directly asked about the virtual format. Of these, 1 question allowed for both a multiple-choice response and a free text response, whereas the other 5 questions only allowed multiple choice responses. A seventh question on the survey broadly asked for comments or suggestions. The other survey questions asked about the respondent’s field of practice, perceptions on individual lectures, symposium takeaways, and overall symposium quality (Table 1, Part 1 and Table 1, Part 2).

Responses to the 2020 and 2021 post-symposium surveys were aggregated, and proportions for multiple choice responses to questions that were specific to the virtual format were obtained. Free text responses from the 2020 and 2021 surveys were categorized based on whether they were compliments, issues, or suggestions, and subcategories were established to group responses based on themes.

Across both 2020 and 2021 surveys, most respondents (73%) identified as either registered nurses or nurse practitioners. The remaining respondents (27%) identified as either medical doctors, physician associates, doctors of podiatric medicine, physical therapists, doctors of physical therapy, or other (Table 2). Respondents overwhelmingly said that the virtual platform was either good (37% in 2020 and 27% in 2021) or excellent (48% in 2020 and 62% in 2021) in learning conduciveness. In both 2020 and 2021, 80% of respondents said they would like to continue future conferences virtually. Respondents who had previously attended the conference in person were split on which format was better; respectively in 2020 and 2021, 23% and 31% said virtual was better than live, 21% and 14% said live was better than virtual, and 20% and 26% said there was no difference.

Respondents overwhelmingly felt that having access to recorded symposium sessions improved their opportunities for learning (85% in 2020 and 91% in 2021). Responses were somewhat split, however, on whether attendees felt the virtual conference helped them to interact with the exhibitors; respectively in 2020 and 2021, 42% and 35% felt there was no change, 33% and 37% felt the virtual format did not help with interaction, and 25% and 27% felt the format did help. Finally, of those who attempted to communicate with friends or socialize with new people, 70% in 2020 and 68% in 2021 felt they were able to do so effectively.

Free text responses relevant to the virtual format were collected in 2 of the 21 questions. One question asked about the extent to which the virtual platform was conducive to learning and allowed for both a multiple-choice response and a free text response. A total of 20 comments were made by respondents for this question across both the 2020 and 2021 surveys. Comments were categorized as either “issues” (12/20) that respondents had with the virtual format or “compliments” (8/20) of the format. Among the issues identified, 6 were issues with technology, 2 referenced environmental distractions that made it difficult to focus on the symposium talks, 2 referenced dissatisfactions with how talks were organized, 1 was general 

unspecified dissatisfaction with the symposium, and 1 referenced excessive screen time and an inability to ask questions that arose while viewing recordings after the conference. Compliments mainly referred to the recordings that were available for 30 days after the conference (4/8), but ease of attendance was also referenced (1/8), as well as general compliments of the conference overall (3/8) (Table 3, Part 1 and Table 3, Part 2).

The survey also had a dedicated question that asked for general comments or suggestions. A total of 30 responses were recorded across the 2020 and 2021 surveys; they were each classified as either “compliments” (17/30) or “suggestions” (16/30), with 3 responses classified as both compliments and suggestions. Most compliments were general, referring to the conference overall (13/17), whereas the remaining compliments (4/17) referred to the recordings that were available for 30 days after the event. Three suggestions referred to combining virtual and in-person formats, and the remaining suggestions varied and did not have any unifying themes (Table 4, Part 1 and Table 4, Part 2).

The COVID-19 pandemic forced many activities and events to switch to a virtual format.¹⁴ Academic events in health care have been able to successfully use virtual platforms to continue running events.¹⁵ In this survey of the seventh and eighth annual wound care symposiums, respondents had overwhelmingly positive perspectives of the virtual format. An important benefit identified by the authors’ survey was the availability of recorded sessions after the symposium, which is facilitated by the virtual platform.

Unlike previous studies, most of the respondents in these surveys who wanted to socialize did not feel like they were hindered by the virtual platform.^6-8 While this finding provides evidence that virtual platforms can provide people with the opportunity to effectively socialize, only limited recommendations can be made based on these surveys alone. While the surveys effectively assessed participant perceptions, they did not thoroughly elicit the reason for why people responded the way they did. Providing a free text comment field that asks respondents to briefly explain why they selected a particular multiple-choice option is an easy method to implement passively but may not yield the best results. In these surveys, one question allowed for free text comments or suggestions and one question allowed for a free text comment along with a multiple-choice response; in both instances, fewer than 20 of the 170 survey respondents over two conferences opted to provide a free text response. More resource-intensive methods, such as live interviews, may need to be used to get a better sense of participant opinions.

Dedicated networking events have been received positively in previous studies. One 2021 survey study collected feedback from attendees at a virtual networking event for the American Neurological Association where 103 mentees (83% resident level or above) were divided among 26 senior mentors for small-group mentoring sessions. The survey authors found that 99% of mentees felt the event was at least comparable to in-person networking at conferences.¹⁶ Although the study was performed in a slightly different context, it provides a proof of concept. Creating small virtual rooms where people can speak with one another can serve to improve the ease of networking during virtual events. Conference and symposium organizers should also continue to elicit feedback from attendees to determine their needs and wants regarding networking and socialization during virtual events. The sample population for the current study was relatively homogenous, representing mainly nurses and nurse practitioners whose learning and networking needs may be different from those of other health care professionals.

An important consideration for virtual events of any kind is attendees’ comfort with using technology in the context of virtual platforms. Different subgroups of people may have different comfort levels with technology. Studies on generational learning have described Generation Y, the millennial generation, to prefer multitasking and collaborative work, and, more importantly, they are comfortable with technology and the internet.¹⁷ In the present survey, difficulty with technology was the most common theme identified in free text responses (6/12, 50%) for issues with the virtual platform. This aspect of the format should be examined in the future, and measures should be taken by virtual event organizers to provide tech support to attendees. A live chat or phone hotline could be made available to assist with technology issues during the conference, and pre-event platform troubleshooting can be implemented to ensure smooth experiences. Event organizers should also clearly communicate the logistics of the conference to attendees in advance. Efforts should also be made to ensure minimal technological fluency is required for full participation in event activities.

Advantages of virtual platforms are obvious and plentiful. Drawbacks are likely to diminish as virtual event organizers improve the logistics of their events. To perfect the use of virtual platforms, organizers must continue to make efforts to collect feedback from attendees and pilot new event features to improve the event experience. It is foreseeable that in the future, academic conferences could offer attendees the option to attend either in person or via a virtual platform.¹⁸ To that end, attendees need to continue providing their feedback so that these events can continue to improve.

Although 2 years of survey data were analyzed, generalizability of findings is limited because the setting was a local wound care conference with attendees primarily identifying as registered nurses or nurse practitioners. Other health care conference attendees, such as attending physicians, residents, and medical students, may have different opinions given the difference in scope of practice. Conferences covering other topics may have a greater need for in-person settings that allow for things like hands-on participation. Attendees of national or international conferences may also care more about networking since peers are less likely to interact outside of the conference than those at a local conference where more attendees might be from the same city or even the same hospital system.

The COVID-19 pandemic may have played an important role in influencing responses since attendees’ fear of infection might have made the prospect of in-person events less appealing. The pandemic forced the conference to go virtual; however, participation from work or from home may have caused attention to be divided. Although learning conduciveness was highly rated in these surveys, no conclusions can be drawn regarding knowledge retention since this was not measured. Additionally, the virtual format may not be conducive to some learning styles, although the in-person format suffers from the same drawback.

The current study focuses on the perspective of the attendees and therefore, considerations relevant to conference organizers are not discussed. Negative outcomes from the rapid, inexperienced implementation of virtual events at the start of the COVID-19 pandemic may make organizers reluctant to continue using them. Finances are also an important consideration. Although likely partially offset by cost savings from lack of venue fees, reduced revenue from vendor fees may be a new challenge to organizers. This change may strain finances and limit conference offerings.

Overall, respondents had positive attitudes toward the virtual format in both the 2020 survey for the seventh annual symposium and in 2021 for the eighth annual symposium. Interactions with exhibitors seems to have been the only area that respondents identified as lacking. Conferences on similar topics and with similar audiences should strongly consider continuing to use virtual formats in some capacity given the overwhelmingly positive response seen in these surveys. The ability to easily record sessions may be an important benefit of virtual platforms, but mechanisms for participant-exhibitor interaction still need to be improved. Conference organizers should continue to elicit feedback from participants to improve events in the future. Additional work needs to be done to understand the impact of the virtual format on knowledge retention.

Considerations, from budgeting to logistics, must be explored by conference organizers. For example, the price to rent an event space versus the costs of hosting a conference online. Additionally, it is important to consider how industry sponsors who often play an integral role in financing these conferences by paying fees to present their products will react to a shift toward virtual conferences. Ultimately, the popularity of certain aspects of the virtual format should prompt conference organizers to carefully consider how they can implement virtual components to enhance the
conference experience. ν

Jose Palacios, BS¹; Nissim Hazkour, BA²; Amit Rao, MD³; Mary Brennan, RN⁴; and Alisha Oropallo, MD^1,3

¹Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
²SUNY Downstate College of Medicine, Brooklyn, NY.
³Northwell Health System, Department of Surgery, Comprehensive Wound Care Healing and Hyperbarics, Lake Success, NY.
⁴Northwell Health System, Department of Nursing, North Shore University Hospital, Manhasset, NY.

Address all correspondence to: Alisha Oropallo, MD, Donald & Barbara Zucker School of Medicine at Hofsta/Northwell, 500 Hofstra Blvd.,Hempstead, NY 11549; email: aoropallo@northwell.edu.