Christie Farrer is a research manager at the University of Calgary.
Karen Born is an assistant professor the University of Toronto and Knowledge Translation Lead for Choosing Wisely Canada.
Emily Daze is a research assistant at the University of Calgary.
Colleen Cuthbert is an assistant professor at the University of Calgary and Canada Research Chair in Patient and Family Centered Cancer Survivorship.
The COVID-19 pandemic has had a substantial impact on our research operations and activities, as it has for many other research programs. Prior to the pandemic, our group was in the midst of organizing the final stage of a two-year long priority setting partnership. Priority Setting Partnerships (PSPs) bring together clinicians, patients and carers to identify and prioritize unanswered questions related to specific areas of health and care that could be addressed by future research. Our project was based on the PSP methodology developed by the James Lind Alliance, a UK non-profit. PSPs have been undertaken on diverse clinical topics for the past decade and published in peer-reviewed journals including CMAJ Open. Our project set out to determine priorities for early stage (I-III) colorectal cancer research. Participants included a mix of clinicians, patients, and caregivers, who all brought a unique perspective to the decision-making process. As per PSP methodology, we had originally intended on holding an in-person meeting with approximately 30 attendees from across Canada in fall 2020. But in March 2020 we made the decision to transition to a virtual meeting. After nearly a year of living within the COVID-19 pandemic and the reality of ‘Zoom fatigue’, we can offer key lessons from our experience that may assist other researchers, especially those undertaking deliberative processes involving members of the public and patients, to adapt to a virtual format.
We were mindful of the principles of our research methodology, which was equitable engagement of diverse stakeholders. In preparation for hosting a full day virtual meeting, our primary concern was minimizing screen fatigue while maximizing participant engagement, and supporting patients and carers who may not be as conversant in using virtual meeting technologies. To prepare our participants for the virtual meeting, we created a prework package including background reading, a short introductory video (recorded using Zoom), participants bios, and workshop expectations and deliverables. We offered test calls to ensure each participant had the necessary technology, and provided a virtual conferencing etiquette handout, including an overview of video, audio and chat box features. Privacy considerations were addressed in the participant consent forms. Clear communication with participants in advance of the meeting, including checklists for them to follow in the prework packages, was an essential component in our planning process.
We organized the agenda into several 60- to 90-minute moderated blocks, with breaks throughout the day during which participants were encouraged to step away from their screens. This format was used to mimic what would have occurred in person and to facilitate engagement. A key component of the PSP methodology is to encourage equality amongst participants and ensure patients and carers have the same opportunity to share their lived experiences as do clinicians and researchers. Zoom breakout rooms included facilitators to keep discussion on topic and support all voices being heard. In addition, a team member was assigned as logistical support for the day acting as liaison between the participants and the facilitators, troubleshooting participant technology issues, and managing the breakout rooms. Having a team member in a dedicated logistical support role was particularly important in enabling patient and carer participation.
Immediately following the workshop, we sent out a survey requesting feedback. The responses were overwhelmingly positive, with the key takeaway being the importance of prework and clear communication between the participants and hosts.
Key lessons learned
What we did not anticipate was the end of the day feeling “anti-climactic” for some participants. In the future, we plan to follow up sooner with our knowledge translation plans to provide concrete next steps to the workshop participants.
While adapting an in-person event to a virtual format required several extra resource considerations, it also had its advantages. First, the movement to enhance patient and public involvement in research has underscored the need for travel reimbursements to cover costs. We were able to remove barriers of costs and expenses and time needed for travel. Second, we were able to recruit participants who otherwise would not have been able to participate due to health, personal factors and other geographic barriers which would have precluded travel to a one-day meeting. Finally, the virtual format reduced the carbon footprint of our research.
Planning for a virtual meeting forced us to refine our agenda to maximize time effectively and develop creative solutions for maintaining engagement with a diverse group of stakeholders. Overall, we were able to achieve the same deliverables as an in-person event, minimize costs, and keep our research project on track, a feat in itself in 2020.