Hybrid Activities at The Permanente Medical Group – Then and Now

This session will provide a brief history of the hybrid CME learning format at Kaiser Permanente Northern California and take-home lessons on how to apply our learnings in practice. We will discuss a checklist of factors to consider when deciding if the hybrid model is a good option for your activity as well as a checklist for preparing a seamless hybrid activity. Participants can expect to gain a simple hybrid conference model that can be adapted for use in their own program. This session may be of interest to all members and organizations doing or planning to do hybrid activities.

Videoconferences: Originally, The Permanente Medical Group offered continuing education to its thousands of geographically far-flung physicians by broadcasting videoconferences (VCFs) from the studio in its regional office. Participants would gather in viewing rooms at their medical centers to watch together and could submit questions orally via the two-way VCF connection, as well as interact with each other in the room. As we gained the ability to host virtual meetings and webinars, the sessions were simultaneously broadcast via WebEx so physicians who couldn’t attend the group viewings could join from their computers wherever they were. They were able to submit questions via the chat function on the Webex meeting, allowing much greater participation across the medical group

2016 Thyroid Fine Needle Aspiration Practicum: This 3-hour live activity was offered to TPMG endocrinologists and pathologists and consisted of a two-hour lecture, followed by a one-hour practicum. There was interest from physicians wanting to listen to the lecture portion only. We set up a WebEx so that they could join by audio only. The conference room at the regional offices had a “spider phone” to connect to the audio. The mixed modality model (webinar + live) made it challenging to meet the needs of both the live audience as well as the webinar audience (live audience made too much noise/side comments/typing noises that interfered with the audio for webinar listeners.) We will share the outcomes as well as other learnings from this hybrid activity from 2016 before the wide use of Zoom and video cameras.

2023 Sports Medicine: In May of 2023, we presented our first fully hybrid activity, a sports medicine conference for physicians, physician assistants, and physical therapists. It was a live, in-person conference at a hotel conference center that was simultaneously broadcast virtually via Microsoft Teams Meetings. This allowed participants to come together and experience the collegiality so important in a group practice while still including the many who were not able to or did not want to travel to the conference.

We captured the speaker on camera and their slides by opening a laptop to the Teams meeting on the lectern and sharing the slides both on the screens in the room and via Teams. All interactivity, questions and comments were conducted using the Teams chat. Participants in the in-person meeting were able to submit questions in the same way and into the same feed as the remote participants. This gave all questions the same weight (i.e., those in person were not prioritized over remote participants) and avoided the need for the moderator to manage questions from two different sources. In addition, the discussion in the chat continued throughout the meeting, some presenters answering questions and reacting with participants after their talk was over. The chat for the meeting still endures and is accessible to all participants, serving as a reinforcement tool for the activity. The Teams meeting format allowed us to record the presentations with transcription. These recordings, as well as PDFs of slides, are available to participants as further reinforcement.

We will share checklists that the audience can use when considering or planning hybrid conferences for their program. A sample:

Checklist of things to consider when considering a hybrid format:

1. What do you hope to gain by presenting an activity in a hybrid format?


2. What are potential downsides to using a hybrid format?


3. Where is your target audience and what is their access to both the in person and the remote version of the activity?


4. What are your cost considerations?


5. Will you need breakout sessions?


6. Will online and in-person learners be able to have the same level of engagement? If not, how will you communicate this before they register?

Checklist of things to have in place for a successful hybrid activity:

1. Dependable Wi-Fi in the venue


2. The ability to feed audio from lectern mic to the laptop




1. Using the lectern laptop mic may cause feedback if there is an audio system in the room




3. The ability to project slides for in-person participants


4. Enough staff to run slides, record talks, adjust lectern laptop for different speakers and monitor the in-person and online meeting feed


5. Practice/dry run with venue AV staff is required

Depending on the number of attendees, we plan to have an interactive activity for the audience to share their experience with hybrid format and any best practices.

Unlock Your Potential : This session will allow learners to expand their ability to share an activity across a broader range of platforms, increasing accessibility and reach. Learners will gain valuable insights about the hybrid format and walk away with tools they can use in practice.