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Journal of Indian Association of Pediatric Surgeons, Vol. 10, No. 1, January-March, 2005, pp. 31-36 Original Article What do we discuss at IAPS meetings? An appraisal of free paper sessions at the 30th annual conference Raveenthiran V. Division of Pediatric Surgery, Rajah Muthiah Medical College, Annamalai University Code Number: ip05008 Abstract Background: The traditional belief that attending medical conferences would further one's knowledge needs to be examined critically. Although analytical reports on the effectiveness of conferences have been published from Western countries, such studies have never been conducted in India.Materials and Methods: The author prospectively analyzed 100 free papers presented at the 30th National Conference of the Indian Association of Pediatric Surgeons. Papers were categorized as original works, case reports, audit reports, innovations and theoretical papers. They were assessed for their scientific value, nature of conclusion, quality of discussion by authors and quality et quantity of audience interaction. Results: "Original works" and "innovations" frequently contributed additional information to the existing knowledge while most of the case reports, audit reports and theoretical papers were redundant. Nearly 40% of all papers had inappropriate conclusions. Only one author conferred all the five components of discussion while 32% of authors discussed nothing useful. Case reports, audit reports and theoretical papers topped the list of papers with inappropriate conclusion and poor discussion. About 24% of papers did not evoke any audience interaction. There was no significant difference in the enthusiasm of audience to interact with contributing versus redundant papers. Conclusion: Majority of case reports, audit reports and theoretical papers are found to be unsuitable for free paper session. To improve the quality of deliberations, the number of free papers should be reduced and the time allocation for each of them should be increased. Authors must be educated and reminded of the various components and importance of discussion. Whether audience at IAPS meetings react appropriately to free papers need to be evaluated further. Key words: Medical meetings, Quality assessment, Organizing conferences, Free papers INTRODUCTION Scientific conferences have unique place in the dissemination of new thoughts. Aird[1] remarked that new concepts would take several years before they appear in textbooks and would take several months before they are published in journals. He suggested that the only way to know some new concepts really early is by regular attendance at a medical society meeting. Papers presented at conferences are instantly "peer reviewed" by several hundred experts present in the hall. Therefore, they are probably superior to articles published in peer-reviewed journals where only one or two experts will be involved in the evaluation process. Unlike a journal in which a reader can respond only once through the ′letters to editor′ section, conferences provide ample opportunity for interactions between author(s) and audience. Thus, diverse views on a controversial topic can be conferred at length.
Materials and methods The investigation took place during the 30th National Conference of the IAPS at Jabalpur on 28-31 October 2004. As all the papers were presented in the same hall (Tarang Auditorium), it was possible for a single author to personally evaluate all of them. To avoid bias, the author has refrained himself from presenting any paper or from participating in any debate thereof. Only free papers were considered for analysis.There were 29 guest-lectures, 2 orations, 1 award paper and 90 posters. After excluding these, there were 121 free papers scheduled in 13 sessions over 3 days. The average number of papers per session was 9 and it ranged from 4 to 16. Out of the scheduled 121 papers, 15 presentations (12%) were dropped out and one was abruptly stopped in the middle because of exceeding the time limit. The evaluating author could not assess 5 papers due to his preoccupation such as lunch and transport. The remaining 100 papers were considered for analysis. Nature of papers, quality of discussion by authors and quantity et quality of audience interactions were assessed. No attempt was made to evaluate the quality of slides or the style of presentation.[6] Papers were categorized as defined in [Table - 1]. Papers were judged as "contributory" or "redundant" depending upon whether they advance the existing knowledge. This was decided by comparing the conclusion of a paper against any one of the standard textbooks of pediatric surgery. If the conclusion of a study was found already mentioned in a textbook, such papers were stamped as "redundant". To avoid semantic confusion, hereafter, the word "discussion" is restricted to mean what the author of a paper argued and the word "interaction" is limited to what the audience talked about the presented paper. Discussion of authors were assessed for five components namely strengths and weaknesses of the study, comparison of results with previously published studies, explanation of any discrepancies (or interpretation of observed facts) and future directives based on the extrapolation of results. Strengths and weaknesses of a study are clearly distinguished from the strengths and weaknesses of a technique presented therein. Conclusions were categorized as "appropriate" or "inappropriate" depending upon whether they were supported by the presented data or not respectively. At the end of presentation, number of audience who interacted was noted for each paper. Nature of interaction was graded as "complimentary" if they praised the work, "supplementary" if they added some valuable personal experience and "critical" if they questioned the study details. Specific comments made by chairpersons were also counted along with that of audience; however, general introductory or concluding remarks made by them were excluded. Several participants made sub-comments to a comment and it was difficult to draw a dividing line between them. Therefore, no attempt was made to count the number of comments made by each participant. Consequently, when any one member made several comments, only one in the order of "criticism - supplement- compliment" was taken into consideration. Number of occasions on which the chairperson denied opportunity of interaction to audience was also noted. Results were analyzed using chi-square test. SPSS statistical software version 7.5 for Microsoft Windows 2000 was used for calculations. P value < 0.05 was considered significant. Results Among the analyzed papers, there were 19 original works, 9 innovative papers, 49 audit reports, 19 case reports and 4 theoretical papers. Two third of papers were graded as redundant (64%) while 36% of papers contributed additional knowledge. About 80% of audit reports and 84% of case reports were redundant while only 26% of original works were redundant (Table 2). Only 61% of audits and 53% of case reports had appropriate conclusions. In contrast to this 66% innovations and 79% of original works had appropriate conclusions (Table 3). More than one third of all papers had inappropriate conclusions. About 54% of appropriately concluded papers were redundant while 79% of inappropriately concluded presentations were redundant (Figure 1)Only one author presented all the five components of discussion. Nearly 32% of authors discussed nothing useful (Figure 2). Audit reports, theoretical papers and case reports topped the list of paper without any useful discussion. ′Strength of a study′ was discussed in 14% of papers and ′weakness′ in 11%. Nearly 38% authors compared their results with that of others and 18% explained any discrepancy thereof. As much as 44% authors extrapolated their results and contemplated future implication of their work (Table 4). Authors of original works and innovations more often extrapolated their results than those of case reports and audit reports. Authors of original work and case reports frequently explained discrepancies. However, there was no difference between various category of papers as regard to discussion of strengths, weaknesses and comparisons. None of the theoretical presentations had any useful discussion except one paper, which extrapolated theoretical assumption. Over the 3 days, 226 audience took part in interactions. Audit reports attracted considerable interaction (54.4%) than case reports (13.3%), innovations (11.9%), original works (15.5%) and theoretical presentations (4.9%). There were no audience interaction for 12 audit reports, 6 case reports, 5 original works and 1 theoretical presentation. Among the 226 audience, 137 (61%) were critical in their approach, while 68 (30%) supplemented author′s discussion and 21 (9%) complimented the presentation. Critical interactions of audience did not compensate the deficiencies of the authors′ discussions. Audience neither criticized a work for its weaknesses and unexplained discrepancies nor did they verify the claims of strengths of a study (Table 5). There was no significant difference in the enthusiasm of audience to interact with contributory versus redundant papers (Table 6). On 14 occasions, chairpersons denied the opportunity of interaction to some members. Chairpersons denied further interactions when already considerable number of audience (four or more) had responded to the paper (Figure 3). Discussions Oxford English Dictionary defines science as the perception of truth by systematic study rather than relying on traditional faiths and intuitions. It is true of scientific congresses too. The conventional belief that attending a conference would further one′s knowledge, needs to be examined scientifically. Although such studies are available for medical conferences held in European,[3] American[5] and Australasian[2], [4] countries, the present study appears to be the first of its kind from India.Results of the study clearly show that case reports and audit reports were largely redundant. Nearly 80% of audit reports and 84% of case reports were of poor scientific value. Authors of these category of papers also faired very poorly in discussing their views, thus making them unfit for oral presentation. They can either be rejected or accommodated as posters. Authors of theoretical papers may be asked to submit their views as articles for the congress souvenir-book. Time gained by reducing the number of orally presented papers can be used for unhurried interactions of original works and innovative papers. It is to be remembered that the worthiness of a congress is not in the quantity of papers but in the quality of presented works and discussions.[10] Tight schedules of too many papers will only promote mental fatigue of audience. This will shun audience from listening to all the papers or will reduce the quality of their interaction.[10], [11] Total time allotted for the scheduled 121 free papers was 819 minutes with an average of 6.8 minutes per paper. The frequently followed pattern of time allocation for each paper was 5 minutes for presentation and 2 minutes for interaction. This is too short a period for any useful discussion or interaction. As Skelton and Edwards[9] remarked, one can take the science out of rhetoric but not the rhetoric out of science. Confirming to the style of guest lectures, if 20 minutes is allotted for each free paper (12 minutes for presentation and 8 minutes for interaction) 41 papers can be accommodated in the scheduled time of 819 minutes. In other words, we will have time only to confer the contributing papers that are of high scientific value (Table 2) and we will not be wasting much of our precious time with redundant papers. During this conference, 24% of papers did not evoke any interaction of audience. In such situation, one may question whether increasing the interaction time will be beneficial. The author believes that the lack of enthusiasm among the audience was probably secondary to mental fatigue of listening too many papers, vexation with redundant conclusions and dissuasion by poor discussion of authors. The reaction of audience at Jabalpur was perplexing. One would anticipate more interaction during the presentation of contributing original works than during redundant audit reports. Contrary to this more number of audience participated in the discussion of audit reports and redundant papers. Similarly, the audience failed to compensate the deficiencies of authors′ discussions. This phenomenon can be explained by two possibilities. (1) Audience at Jabalpur were less serious and they need to be more involved in the proceedings of the conference. (2) There are factors other than the scientific worthiness of a paper that determines the enthusiasm of audience to interact. The average number of audience interacted per paper was 2.26 within the allotted interaction-time of 2 minutes. Further two-third of them offered critical comments and one-third supplemented details. These data indicate that the involvement of audience was satisfactory. Tsakraklides et al have noted that the enthusiasm of audience to interact was directly proportional to efficiency of chairpersons and authors′ style of presentation.[3] Unfortunately, these two aspects were not evaluated in this study. Moreover, in the present study, only the number of audience interacted were taken into account and not the number of comments made by each of them. This methodological snag could have introduced errors in the interpretation of the performance of audience. The major drawback of this study is that it is concerned only with free papers. As other components of a congress (such as guest lectures, workshops and posters) will also be educative,[7] their omission in this study may distort the true merits of the conference. Nevertheless, the format and style of discussion of these various sessions are diverse and hence inclusion of all of them in the same study would only add confusion and hardship in comparison of results. Moreover, guest lectures and orations are delivered by pioneers of the concerned topic and it will be inappropriate to evaluate the worthiness of their lectures. Similarly, award papers and workshops are conducted for a different purpose. Free paper session is the one in which the expertise of the speaker varies widely ranging from junior resident to senior professor. Consequently, scientific worthiness of papers in this session will also be diverse. For these reasons only free papers were analyzed. Published studies of medical meetings held elsewhere3],2] have also evaluated only free papers for similar reason. Another possible weakness of the present study may be the strict application of the five criteria for the evaluation of discussions. Docherty and Smith[8] originally suggested that the discussion of a scientific paper should include: (i) Statement of principal findings, (ii) Strengths and weaknesses of the study, (iii) Strengths and weaknesses in relation to other studies, discussing particularly any discrepancies, (iv) Possible mechanism, implication and meaning of the study and (v) Unanswered questions and future research. However, during a conference it will be difficult to assess some of these components and for this reason the original proposal was slightly modified. Many authors[9] criticized even the original suggestion of Docherty and Smith for structured discussion in scientific journals. They opined that the function of discussion is to discuss and it should therefore be discursive.[9] Omitting one or more component of discussion cannot be considered as demerit. For example, innovative works cannot be compared with previous works and they possibly cannot have strength or weakness. Appropriateness of wrapping the discussion under five headings is not clear at present. However, it is true that such compartmentalization will certainly discipline authors and may improve the quality of discussions. Evaluation of usefulness of a conference is more appropriately done by subjective assessment of the delegates.[5] However, objective analysis done in this study is only a beginning. In this regard, comparison of IAPS conferences with that of foreign associations such as the British Association of Pediatric Surgeons (BAPS) will be interesting. Future studies should also correlate the audience enthusiasm with the performance of chairpersons and the style of presentation. Alternatives of free paper sessions such as PEARLS (personally arranged learning sessions) need to be explored.[12] In conclusion, scientific committee of IAPS should delete as many audit reports and case reports as possible from free paper sessions. Alternatively, they may be accommodated as posters. To distinguish between audit reports and original works, authors may be asked to clearly state the hypothesis or the research-question at the time of submission of abstract. All theoretical papers may be redirected as souvenir articles. Less number of free papers with more time for discussions and interactions is desirable. Authors should be educated and reminded of the essential components of discussion.[13] Audience need to be encouraged to critically approach the presented paper. Active research on the organization of conferences will certainly improve the utilitarian value of them. References
Copyright 2005 - Journal of Indian Association of Pediatric Surgeons The following images related to this document are available:Photo images[ip05008t6.jpg] [ip05008f3.jpg] [ip05008t2.jpg] [ip05008t5.jpg] [ip05008t4.jpg] [ip05008f2.jpg] [ip05008t3.jpg] [ip05008f1.jpg] [ip05008t1.jpg] |
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