The history and evolution of 'webinars' and their role in urology: the modern way of training, education and communication.

The COVID-19 pandemic has had a significant impact on all domains of urology. Annual educational conferences by prominent urological bodies were suspended, due to the inability of conventional conference to adhere to social distancing stipulations. Innovative methods of healthcare delivery were therefore required to mitigate some of financial, health, training and research implications. Webinars is now a very popular method of communication and dissipation of knowledge with increasing adoption in medical education, training and also has been included in the curriculum of elite universities. The term 'webinar' is a combination of web and seminar, meaning a presentation, lecture, or workshop that is transmitted over the web. Webinars have proven to be convenient, flexible, cost-effective and reduce the carbon footprint. Furthermore, it is likely that webinars have a wider global audience reach and individual delegates have the ability to access more meetings from the comfort of their homes. The Urology community has been one of more prominent adopters of webinars in delivering educational activity during the pandemic. An estimated 400 urology webinars have been listed on DocMeetings since the onset of the COVID-19 pandemic. However, webinar is not without limitations. The didactic nature of webinars allows for minimal interpersonal interaction and constructive debate with the audience. It is however likely with potential technological advancements this going to be less of an issue in the future. It seems that the journey of webinars has just begun and will have an impact on training, education, communication and conferences for the foreseeable future. Copyright by Polish Urological Association.

INTRODUCTION

The COVID-19 pandemic has had a significant impact on all domains of urology. A recent survey by the UroSoMe Working Group reported a reduction in 28% of outpatient clinics, 30% of outpatient investigations and procedures. Additionally, the study reported 31% of urological surgeries had a delay of >8 weeks [1]. Annual educational conferences by prominent urological bodies were suspended, due to the inability of conventional conference to adhere to social distancing stipulations. Conventional face to face communication especially in large gatherings is now considered unacceptable. Innovative methods of healthcare delivery were therefore required to mitigate some of the financial, health, training and research implications of the pandemic. This need accelerated the entry of healthcare professional into the digitalised virtual world. Webinars are now a very popular method of communication and dissipation of knowledge with increasing adoption in medical education, training and have also has been included in the curriculum of elite universities [2].

The term ‘webinar’ is a combination of web and seminar, meaning a presentation, lecture, or workshop that is transmitted over the web. Webinars have proven to be convenient, flexible, cost-effective and reduce the carbon footprint. Furthermore, it is likely that webinars have a wider global audience reach and individual delegates have the ability to access more meetings from the comfort of their homes [3].

The concept of webinars is however, not new. In 1960 the “Programmed Logic for Automated Teaching Operations (PLATO)” was developed by the University of Illinois and Control Data Corporation, representing the earliest prototype for webinar software (Figure 1). PLATO had multiple features such as an online chat, web forum, email, instant messaging, remote desktop, and voice communication available on a single platform. In 1961, PLATO II included two users at the same time and this number increased to 100–150 participants by 1975 while modifications continued till 2006. The main limiting factor to its widespread adoption was local network connection [4]. In the late 1980’s when internet was evolving, real-time text messaging apps, like Internet Relay Chat (IRC) were being developed. Subsequently web conferencing was born in the early 1990’s, using software that allowed international communication with real-time interaction. Web-based chat and internet messaging software also evolved during this time. It was in this decade, due to the affordable global data transmission channels based on TCP/IP protocols, webinar again rose into prominence. In 1992, InSoft Inc. launched the software Communique. Communique had the ability to support 10 users with audio, video and data conferencing features. Networked users were able to share and modify graphical files using simple paint software.

Figure 1

History and evolution of webinars with important supporting platforms.

A major breakthrough in remote learning and education was the CU-SeeMe videoconferencing product. CU-SeeMe was used as part of the Global School Net project to integrate U.S. general education schools [5]. The next major landmark came in 1995 with the launch of LiveShare Plus for Windows based computers developed by PictureTel, later acquired by Poly in 2001. It allowed the facilities of remote desktop, text messaging and transfer of data files with an affordable pricing of $250. In 1996, Microsoft launched NetMeeting which made the first public web conference possible. The major advantage was that it was incorporated as a part of Internet Explorer 3.0 and did not require additional purchasing. The features were similar to LiveShare but neither provided the component of voice communication. This limitation was overcome with the launch of PlaceWare by Xerox PARC in 1997 with a licencing purchase of $150. Apart from the features of data sharing, chat messages, vote and poll, it also allowed more than 1000 users to participate live in the same webinar for the first time in history. A similar webinar service WebEx Meeting Center was launched in February 1999 by ActiveTouch which was later renamed to WebEx in September 1999 and acquired by Cisco in 2007. Currently more than 50 webinar services are available for use [5].

The Urology community has been one of the more prominent users of webinars in delivering educational activity during the pandemic. An estimated 400 urology webinars have been listed on DocMeetings since the onset of the COVID-19 pandemic. More recently, large-scale conferences such as the European Association of Urology (EAU) have used webinars successfully to deliver conferences. Additionally, there have been numerous educational webinars run by individual institutions, national bodies and independent bodies. The themes in urological webinars have mostly been on academic topics. Independent bodies such as i-TRUE have run non-academic themes titled ‘Today’s Women, Tomorrow’s Leaders’ celebrating success of women in urology. The British Association of Urological Surgeons (BAUS) collaborative webinar had a viewership of over 900 people and has made preliminary attempts at addressing issues such as gender parity within the speciality globally [6]. This also demonstrated the wide reach and impact of webinars. Similarly, BAUS have also started a series of educational webinars on sub-speciality topics with the forthcoming FRCS (Fellowship of the Royal Colleges of Surgeons) viva course also being done via virtual sessions.

Webinars, however, are not without their limitations. The didactic nature of webinars allows for minimal interpersonal interaction and constructive debate with the audience. Additionally, concerns have been raised with webinar fatigue with the growing number of webinars. There are technical challenges associated with this platform on a periodic basis. It is however likely that with potential technological advancements this will be less of an issue in the future. The COVID-19 pandemic has compelled us to transition into the digitized platform with webinars. The pandemic has highlighted a number of benefits with webinars and the future of academic large-scale urological conferences is likely to be a hybrid amalgam of existing conventional conferences and futuristic webinars. It seems that the journey of webinars has just begun and will have an impact on training, education, communication and conferences for the foreseeable future.