Discussion

The ‘First Brazilian Congress of Clinical Evidence on COVID-19’ represented the effort of a motivated group of volunteers in disseminating the main evidence and updates on COVID-19. In a country which was severely hit by the pandemic and ravaged by fake news, the event successfully reached over 28 000 participants, including healthcare practitioners, health managers and the general population. It is possible to point out several lessons learnt from this experience, which are important for the pandemic and post-pandemic era.

Planning and organising an event in 28 days would not be possible without effective leadership, teamwork and motivation. Competent leadership was vital to enable the full potential of each member of the team; team engagement and motivation of volunteers, the majority of them undergraduate students, to bring knowledge and help to the population in such a short period’s notice, working overtime, were key to make the events successful.

According to the Hersey-Blanchard Situational Leadership Theory, leaders can change their leadership styles based on the maturity of the people they are leading and the details of the task.7 Therefore, in our point of view, choosing the Situational Leadership framework was the right decision, as the team was heterogeneous, some of them more motivated and faster learners than others. An example of how the framework was applied was through group division according to the volunteer’s characteristics and abilities; therefore, people who presented more knowledge on technology were responsible for the social media and event platforms/transmission. Besides that, tasks were divided according to the volunteer’s maturity and knowledge; therefore, undergraduate students in the beginning of their courses were responsible for creating more simple social media posts, such as showing the appropriate use of face masks. Meanwhile, those who were concluding their degrees created more complex social media posts, such as combating fake news on the use of chloroquine and hydroxychloroquine for COVID-19 treatment. Also, as the volunteers developed, more complex tasks were required from them. For team members, the event was also a great opportunity for the development of leadership and management skills, such as communication skills, networking, team management and leadership skills, which was outstanding for undergraduate medical students,8 as most of whom had no previous idea of their capacity to change society. Constructive feedback was key in this context.9

In times of explosion of fake news and even decreased trust of the population in science,10 university’s support was essential to gain trust and confidence of the target audience, as well as to guarantee adequate structure for conference’s online transmission. It emphasised the importance of academia (universities, research institutions and researchers) taking the lead in promoting educational activities for healthcare professionals and the population about conditions such as COVID-19 pandemic. Since COVID-19 was a new disease and the fact that the population looked up to politicians and public figures to understand what was currently happening, the health matter soon became a battle of political beliefs.11 Therefore, healthcare leaders are key to communicating, in an accessible manner, evidence-based information to the population, healthcare professionals and health managers. In order to do that, it is essential for those leaders to improve communication skills that allow comprehension from the general population.

Technology allowed the participation of renowned speakers, some of whom would never be able to give lectures in person due to restrictions of time and travel costs to Brazil, taking into account the lack of budget for the event; and reached the target audience from all over Brazil and other countries. Besides that, COVID-19 lockdown and governmental travel rules could also be a barrier for speakers’ access to an in-person event. New formats of teleconferences allow interactions by participants through a live chat, accessible from smartphones, tablets and computers, from any location, only requiring an internet connection. There are no limitations in the number of participants, and it can be recorded and accessible for later review and participation of those who could not watch online, increasing the conference’s reach. Technology also enabled organising the conference in a short period of time, during the second COVID-19 wave in Brazil, when those meetings were restricted due to quarantine measures. With that in mind, technology also allowed shared international learning in a vulnerable moment: the COVID-19 pandemic.

The fact that such a large event did not receive any funding from the pharmaceutical industry and was totally free of charge and from conflicts of interest was outstanding and was key to engage a large audience, giving the congress an innovative characteristic and inducing reflections about other conferences’ charges, which in several instances were not reduced during the pandemic, even being in online format, what reduces significantly the costs. In times of financial crises induced by COVID-19 pandemic, it is of utmost importance to take this into account.

As for our limitations in the leadership strategy used, as there was a short period of time to organise the event to meet the needs imposed by the second wave of the pandemic and the explosion of fake news, even taking into account the different levels of motivation and conducting frequent online meetings, teamwork failed for some tasks, as well as effective communication of those who felt overloaded. The leaders felt that limitations imposed by online meetings could have been a barrier in this sense. Further studies should analyse if this hypothesis holds true for other instances.

In conclusion, this experience showed that leadership, teamwork, motivation and technology enabled the dissemination of accessible scientific evidence on COVID-19 to a large audience through a free online event.