Vision
What if we could build a community of medical education researchers that can collaborate regardless of time and location?

Scenario
Dr. Maartje de Groot steps up to present at the first Global Medical Education Research Symposium, a half-day launch event for this community of researchers. Rather than standing in front of colleagues in a hotel ballroom, though, she is in a conference room down the hallway from her office at the University of Maastricht. As she looks up at the three video screens in front of her, she sees familiar faces from Ann Arbor, Seattle, Toronto, Dundee, and Beijing. Respectively, each of the remote sites sees Dr. de Groot and all the other remote site participants. In fact, as the video connection has been live for 30 minutes prior to Dr. de Groot's presentation, some participants arrived early and were instant messaging with their colleagues and holding side audio conversations across the video conference link in a virtual "hallway conversation" mode.

When Dr. de Groot is ready to start, her PowerPoint presentation appears on the screens in the remote conference rooms. At one point, de Groot wants to show a video from a student's interaction with a standardized patient----so she launches the video, which opens in another window on the screen.

Because the videoconference is TV quality, Dr. de Groot can see the faces of the distributed participants clearly. She, therefore, notes a scowl by one of the Seattle participants when she makes a point. Asking him about his reaction, she finds that he hadn't understood a Dutch colloquialism that she had used. She was able to quickly clarify and move on.

At the University of Toronto, most faculty members are gathered in a conference room to participate. But a couple of physicians, because it is clinic day for them, can only participate for an hour, which they must do from their offices. The other content (video, PowerPoint, graphics) they will access from the on-demand archive, available immediately after the symposium ends in both TV-quality video and at a lower quality, suitable for streaming to home or even to PDAs. Due to the time zone differences for this event, most Beijing observers will view the recorded content rather than the live presentations, but with the chat room and shared web publishing areas, they are able to contribute to the discussion within the next day.

After de Groot's formal presentation, Dr. Gordon Fraser from Dundee wants to share with the group an idea he has about a multisite educational trial. Dr. Fraser opens an electronic whiteboard application on his tablet PC and sketches out his idea. His screen is visible across all the presentation screens. Dr. Fraser then invites Dr. Carla Henne in Ann Arbor to comment. Dr. Henne pulls out her tablet PC and annotates Dr. Fraser's drawing, with the results immediately visible to all participants. Dr. Vijay Kumar in Toronto recently wrote a paper on this topic that he thinks is relevant. He pulls up the abstract on the screen for everyone to see and registers the URL in the online resources area so that people can later retrieve the full article. He thinks his data supports Dr. Fraser's point about the potential impact on patient outcomes. So, Kumar accesses the data from his local server, runs it through SPSS to graph the point he's trying to make, and displays the results on the remote screens.

Following a break with more opportunity for virtual hallway conversations, the formal presentations continue until the event closes and the participants are invited back for next month's symposium. A breakout group sticks around to continue their work on a joint proposal to a foundation. Due to the confidential nature of this discussion, encryption is turned on to ensure that only those participating may see and hear the conversations. Mid-way through the discussion, it's desired to bring in a consultant to answer a particular question. That person has a PC and a phone, but no video connection. A phone call is made from Ann Arbor that brings the person into the full group conversation along with access to the data for 15 minutes. The call is terminated and the confidential discussion continues.

Behind the Scenes
The technology to produce this event exists and is in use on our campuses. However, it will take work to package the technology together in a way that it is not itself the focus of attention----such that the ease-of-use allows the participants to focus on the content of the presentations. Testing in advance among technical support staff will be necessary. Presenters will need to adapt their content to this distributed scenario, perhaps directly inviting participation until the audience becomes more comfortable with the environment and engages more freely with colleagues across the network.

What's Next
Possible next steps could include the following:

• Further document the scenario, and add other scenarios, to build a more detailed objectives and requirements document.
• Seek planning grant funding to explore the opportunity and start building the community of interest.
• Prototype the scenario through a short series of seminars and informal discussions that, over four to six months, would validate the requirements.
• Seek funding and/or a business model for a sustained network of medical education researchers.