The COVID-19 pandemic outbreak introduced dramatic changes in all our lives, daily practice, and medical conferences. Dermatology meetings were delayed or cancelled. Most medical centres and dermatologists focused on teledermatology1, urgent care or joined the workforce that was needed to attend SARS-CoV-2-affected patients. In search of a tool to spread dermatologic knowledge during confinement, share experiences in this dystopian time, and instil positive energy to our colleague dermatologists, an online medical meeting was held on April 25th to 26th, 2020.

In this study, we aimed to assess the characteristics, opinion and satisfaction of the attendees to a free-of-charge (both for organisation and attendees) online congress. Secondarily, we intended to explain how this meeting was prepared.

An online survey (using Google® Drive forms online tool) was administered to the attendees to an online congress that took place between April 25th to 26th, 2020. The items of this questionnaire (Table 1) were prepared right after the meeting, were ready by April 28th, and the results were collected from April 28th to 30th. The differences between the distributions of each variable were evaluated using Pearson’s chi-square and Fisher’s exact tests. Statistical significance was established for p-value <0.05. All the statistical analyses were performed using the SPSS statistical package for Windows, version 20.0.

The organisation of the II Dermachat Congress (Fig. 1) is depicted in the following paragraphs. It was the second edition (a first meeting was held on the September 14th, 2019, using the same system)2.

Figure 1.

Congress logo.

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The free tool that was chosen to broadcast the meeting was the Telegram® Messenger App (instead of using the new emerging platforms and apps for virtual meetings, such as Zoom® GoToMeeting®, Microsoft Teams®, etc.). The reason of choosing this platform was the previous existence of an ongoing professional Spanish Dermatology chat (Dermachat), active in Telegram since 2014. Dermachat is composed mainly by Spanish dermatologists and some European and Latin-American colleagues. It is free, with no financial support, and open to any dermatologist under some basic rules. These rules are easy: It is a friendly professional environment in which only Dermatology-related topics can be discussed (difficult cases, interesting clinical findings, surgical advice, etc.) and General Data Protection Regulation and ethical consideration of Lex Artis must be observed. As of April 15th, 2020, there were 500 dermatologist members. Following the invitation to attend the meeting, many colleagues joined the chat that nearly reached one thousand members by April 25th, 2020.

Six weeks before the date of the meeting, an announcement was made in Dermachat asking for volunteers to act as speakers, choosing a topic of their expertise. Thirty-eight women and men attended this announcement. A taskforce chat was created in the same App to serve as the meeting’s organising committee.

Speakers recorded a video presentation with a maximum duration of 10 minutes (in .mp4, .m4v or .mov formats, and with a maximum size of 100 megabytes per file). Topics included many Dermatology & Venereology expertise areas (Table 2). All the 37 presentations were in Spanish, but four of them were also programmed in English and one in Portuguese (Fig. 2). These were uploaded in advance and were programmed to be sent at a scheduled time using a Telegram tool. Therefore, videos were automatically downloaded to smartphones, laptops, tablets or even smart TV screens according to programme. The active presence of the authors at the chat was not even essential during their presentations.

Figure 2.

First slide of one of the presentations regarding the changes in tumour prognosis, particularly in the elderly, during the confinement. This presentation was done both in Spanish and English. It included the results of a study that had been accepted for publication only days before by Tejera A & Nagore E. (Reproduced with permission.)

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The central part of the event was held on April 25th 2020, from 9:30 to 20:30, divided into four distinct sections (with coffee-breaks and time for lunch (Table 2)). No delay between presentations was possible, as they were pre-programmed. Some real-time online interaction at the chat was allowed during the few minutes between presentations, mainly to congratulate the speakers. Questions were channelled through each of the moderators to the speakers the same day. On April 26th, 2020, from 10:30 to 13:30 and managed by the same four moderators, a directed discussion was made. Speakers could prepare in advance their answers, but real-time interaction was also possible. The speakers addressed the attendees mainly using ≤60-second, fast Telegram-videos (Fig. 3).

Figure 3.

Chat screenshot during the debate on April 26th, 2020. The questions were formulated during the presentations the previous day, and the speakers sent their answers to the moderators beforehand, using ≤1-minute videos that continued one to another in smooth and efficient transitions. (Reproduced with permission.)

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There is no actual congress without two important items: the welcome cocktail and the certificates of presentation for the speakers. A live online Zoom® cocktail was held on Saturday at 8:30 p.m. Furthermore, every speaker received a certificate of their presentation (the organising committee automatically delivered it to their Telegram inboxes).

From a total of 954 dermatologists who attended the congress, 349 of them (36.6%) completed the survey (Table 3). Their ages ranged from 25 to 78 years (mean: 45.2 years; standard deviation: 11.8). There was a female (62.2%) predominance. Most of the survey respondents (96.3%) lived and worked In Spain. Two were from Germany (1.1%), two from Portugal (1.1%), and nine from different Latin-American countries (2.6%). Most respondents had joined Dermachat more than one year ago (59.6%) and followed the congress via their laptops (29.8%), mobile phones (27.2%), or a combination of devices (22.9%).

The opinion and future perspectives of the attendees may also be found in Table 4. All considered that this format had a bright present and future, with 17.8% of the respondents thinking that it would become a suitable replacement for the face-to-face meetings. 61.6% of the participants considered this meeting format superior to regular meetings. The respondents showed high levels of satisfaction, giving high scores to the overall conference, the speakers, and the moderators. The highest score (mean: 9.8 over 10) was given to the fact that the congress was free-of-charge. Around one-third of the participants (34.1%) would have liked some additional areas of the speciality to be covered during the meeting. Finally, 14.9% of the respondents stated that they had missed some participation of the pharmaceutical industry during the conference.

Analyses of these opinions and their relationship with traits of the surveyed dermatologists yielded the following statistically significant results:

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  Those with ages comprised in the upper quartile expressed more frequently (35.5%) that this format would be a suitable replacement of traditional meetings (p = 0.001). The desktop computer was more often used among those with ages in the two upper quartiles (representing 80% of individuals who referred to use only these devices to follow the meeting; p = 0.002). However, this was referred as the only device were used by merely 8.6% of the attendees and there were no evident differences in the overall use of the rest of devices.

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  Women represented 76.7% of those who joined the forum directly to attend the congress and 65.4% of those who joined less than one year before (p = 0.002). We noted that women assigned generally higher scores to the overall meeting (Fisher's exact test, p = 0.007), to the fact that it was free of charge (p < 0.001), to speakers (p = 0.005) and to moderators (p < 0.001). They also stated more frequently that the online meeting was equivalent or superior than face-to-face traditional meetings (p = 0.006).

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  Regarding the setting of the usual healthcare activity, those involved in private practice exclusively or predominantly over public healthcare settings represented 78.6% of those who stated that online formats such as the one described would be superior to traditional ones (p = 0.001).

The satisfaction of the speakers and attendees was very high. All participants considered that this format had a great present and future, and most of them rated it as superior to regular meetings. These results were better to those described by Kim et al. after analysing the satisfaction of 1091 attendees to a medical conference at Las Vegas3, and similar to those obtained by the attendees to two Workshops Without Walls hosted by the NASA Astrobiology Institute in 20104. It has been previously described that motivation plays a central role in the development of satisfaction5,6, and this has been identified as a mediating factor on the relationship between sense of community and future intentions3,7. Dermachat has a great sense of community that clearly influenced the results of the survey (the majority of respondents had been in the chat for more than one year ago).

The attendee’s type of practice and gender have been shown to moderate the relationship between motivation to attend the meeting and perceived experience2. This agreed with the results of our survey. Women assigned generally higher scores to the overall meeting and most dermatologists involved in private practice exclusively or predominantly over public healthcare settings stated that online formats would be superior to traditional ones.

The completely free-of-charge format obtained the highest satisfaction score. No financial support was needed, and all coordinators and speakers were volunteers. No pharmaceutical or aesthetical/cosmetic industry was present (14.9% of the respondents stated that they had missed some participation of the pharmaceutical industry during the meeting). There was no time spent on travelling, no money spent on hotel nights, no need to buy foods or drinks. It was also eco-friendly: no paper and no carbon-footprint were generated beyond some electric consumption. In 2008, Green estimated that the impact of travel to conferences would be 6 billion person air miles or 600.000 tonnes of carbon each year8.

Since all the videos remained uploaded at the scheduled time in the stream of the chat, they could be easily downloaded and re-watched later. We believe this allows to tailor the congress to the attendee’s needs and supports family conciliation, with no fear of missing out (unlike webinars and videoconferences, that usually cannot be watched after the scheduled time)9,10.

The COVID-19 pandemic has forced the cancellation of most scientific gatherings. Some authors have seen this as an excellent opportunity to change conferences for the better, encouraging medical societies and organisations to lead the change to virtual meetings11,12. However, one limitation of virtual meetings is the lack of real contact. Education involves skills and attitudes, and we will not influence attitudes just by haranguing people through a video link8. Even though confinement did not allow real contact, our online meeting showed it was possible to ensure interaction and participation between attendees, moderators and speakers. Unlike e-mail, instant messaging could provide prompt feedback on essential issues during the discussion13.

The primary objective was largely achieved: Dermatologists enjoyed some dermatologic science during the COVID-19 pandemic, even despite the disruption of their daily clinical practice. Most of them felt they were participating in something new and compelling that many felt superior to traditional meetings.