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The Building Bridges in Medical Science Society, University of Cambridge, received an IME grant for their conference, Mar '20. Their report (below) highlights the challenges they faced following their decision to convert to a virtual event due to Covid-19

The Next Decade of Medical Innovation

Cambridge, 13th March 2020

The Building Bridges in Medical Science (BBMS) society recognises the need for interdisciplinary approaches to tackle the biomedical and global health challenges of the 21st century. This year our committee, a group of motivated medical and graduate students at the University of Cambridge, elected to take the opportunity in the 12th annual BBMS conference to examine the next decade of medical innovation. We invited experts from research, medicine, industry and policy to speak to early researchers and medical students about their own experience of medical innovation. A particular aim of the committee for this year's conference was to highlight the ethical implications of advancing artificial intelligence and technological devices. We wanted to extend the BBMS platform further and use it to encourage and help attendees to begin questioning how we champion and discuss the forefront of medical research. With the increased spread of coronavirus days before the conference's due date, the committee itself had its own ethical dilemma to weigh up and had to innovate to deliver a conference virtually in only a day.

The Speakers

The format of the digital conference was a series of lectures streamed online to our delegates with questions encouraged through the chat function available. The day was split into sessions addressing different elements of innovation.

In our session on medical devices, we featured speakers who had recognised problems that could be solved by developing technological tools. We began in the lab where Professor Tuomas Knowles had developed an innovative approach to his research on protein folding diseases. Dr Nick Skaer shared his biomaterial innovations and their implications for the future of orthopaedics, raising issues around cost-effectiveness in the NHS and developing a product that gives an improvement that is significant enough to justify the extra cost that it may incur. David Fried, who has developed a virtual rehabilitation tool for stroke patients, highlighted the current need for improved continuity of care and help in the community for patients and the potential and limitations of using digital solutions for this purpose. Dr Martina Di Simplicio, a consultant psychiatrist, spoke about her experience developing an app that provides episodic stimulation-based self-harm reduction. In particular, she spoke about the reaction of the medical world to such a suggestion and the balance of using a tool as an adjunct and not to replace good quality medical care.

Our next session focused on the use of artificial intelligence in healthcare. Dr Michael Thornton has a start-up developing an artificial neural interface and Dr Dafydd Loughran has developed a digital consent platform using AI that aims to reduce errors in the process. In particular, consent is a fundamental ethical pillar in medicine and it raised an interesting issue of using AI to ensure that information that is appropriate to the situation can be easily found but in addition the requirement that this information is unbiased and complete enough for a sufficient and self-determined decision to be made.

Additional interesting talks were delivered by Araceli Camargo and Dr Julian Huppert. Araceli took a unique angle, thinking about how our habitat impacts upon our health for example in depression and diabetes and how these considerations should factor into the construction of cities. Julian has substantial experience campaigning for science in politics and provided an insight into how decisions are made at policy level and the process and implications of developing regulations.

Our Audience

Our delegates came from a wide variety of backgrounds including PhD students, post-graduates, undergraduates, medical students and practising doctors. Across the course of the conference speakers had a changing audience of between 40-60 delegates with different individuals attending throughout the day. A strong aim of the conference was to engage and inspire our audience. The committee organised a poster presentation session during the conference to enable early-career researchers to have an opportunity to summarise their own research in the field and be able to present to an engaged audience. With the advent of a digital conference and a chat function we found that we actually received a greater number of questions and people felt more able to engage with our speakers as evidenced from responses in our post-conference feedback.

Going digital during the coronavirus pandemic

One of the unique challenges of organising the BBMS conference this year was converting from a physical to a virtual conference in less than a day. In the beginning days of March, the number of people infected by SARS-CoV-2 (Coronavirus) was increasing and both the university and the government were considering its approach. Though no official guidance dissuading against large gatherings was in place, the implication was that it would be imminently and even without an imposed regulation the committee was faced with an ethical dilemma as to whether we, in hosting a physical conference, would put a large group of individuals and their loved ones at risk.

In making a decision about the future of the conference we had to take several things into consideration. Firstly, and most importantly, we assessed the risk to the safety of our delegates and speakers. At the time of early March there had been coronavirus infections in the UK, however only a couple had occurred in the Cambridgeshire area and the majority were focused in London. We knew our audience itself to be mostly young individuals, who were not in the at-risk demographic then reported. The committee thoroughly investigated the ways we could minimise risk of spread at the conference including liaising with our hosting college to produce a plan of the steps to isolate a conference-attendee who exhibited symptoms and further ordering the constituents of hand-sanitiser for our chemistry PhD committee members to bulk make for the day (innovating in light of the hand sanitizer shortage.)

However, though it was early days in what was to become a pandemic, we already had knowledge of asymptomatic spread and the potential of indirectly putting our delegates' contacts at risk. Our COVID questionnaire, that had been sent out to all speakers and delegates, revealed a high number of individuals who had been recently abroad. Our speaker profile had been in constant flux in the days before as speakers pulled out for coronavirus related emergency meetings or their own personal situations. Indeed, at least one of our speakers, although still wishing to attend, had an immunocompromised family member and was depending on government guidance updating. In light of the knowledge that some our speakers deemed the risk to be too high and our own reservations, we had to consider whether hosting a physical conference was an inappropriate endorsement and whether falling back on the free-choice of our attendees to make the risk assessment for themselves was sufficient for an activity that we were responsible and accountable for. As a result of these reflections, we realised that for us hosting a physical conference was no longer acceptable.

Our second dilemma was what was the alternative to a physical conference? We discounted cancelling the conference as we felt like we had an important and unique message to deliver and by cancelling at this stage we would be letting down our audience who had wished to attend and undermining the hard work of the committee in the prior year. However, postponing seemed impossible due to the degree of uncertainty about the length of time till it would be possible to host a physical gathering and if our speakers would be able to come together again at the same time. Hosting a virtual conference was at first a joking suggestion- the committee taking our own small step towards medical innovation. However, we then seriously considered the advantages of our speakers and delegates being able to present and listen from anywhere, without risk of added risk of infection against the drawbacks of the huge practical effort for us and access to the conference becoming dependent on having a computer and WiFi which are luxuries.

On the day before the conference, the committee made the difficult to decision to host the event virtually. The majority of our prior arrangements had to be disregarded and the change required extensive communications with our speakers as well as a new publicity drive. On the day itself we experienced technical issues for the first hour which threw into doubt whether we should continue with the conference at all. However, instead of abandoning the day we preserved, changed our online platform, overcame the challenges and delivered a conference we are proud of.

The current coronavirus pandemic is an exceedingly difficult time for all. It has changed our daily lives and put much medical research and education on hold and yet it is also a time where there is a need to continue to have informed ethical discussions and a need to continue to pursue medical innovation, albeit requiring a very rapid adjustment to new digital platforms in order to do so.

Appendix:

The BBMS 2020 webinar can be found online here.

 

Or via our website.