The COVID−19 pandemic transformed education, for better or for worse. The initial response to social distancing requirements was to transition to online-only remote education wherever possible, using video teleconferencing platforms. As public health restrictions eased, in-person educational activities gradually resumed. However, realization of the benefits of online education has resulted in a third “hybrid” educational format, in which some learners, as well as educators, attend in person and some attend remotely.

While the initial shift to online education after COVID-19 was out of necessity, subsequent studies identified certain benefits to online education. Accessibility and flexibility are cited by both learners and faculty as the primary advantages of online education [1,2,3,4,5]. Residents and fellows from multiple specialties surveyed on the virtual conference format have reported increased time for sleep and wellness and improved work-life balance with a transition to online didactics during the COVID-19 pandemic. Specifically, they appreciate saving time on commuting or being able to perform concurrent tasks such as household chores, childcare, or exercise during online didactics [2, 3, 5]. Given the high rates of burnout in graduate medical training, these are not trivial considerations. Trainees also appreciate access to lecture recordings [2, 3, 5].

Although surveys of both university students and medical trainees have shown that many learners support a hybrid approach to educational activities with virtual attendance as a continued option, students also tend to view hybrid education more favorably than teachers [3,4,5,6]. In the post-pandemic university setting in which online class attendance remains an option, faculty have expressed disappointment in decreased live lecture attendance rates [7]. University faculty who have experienced teaching both in-person and online report feeling detached when lecturing remotely and a desire to return to fully in-person teaching in an ideal world [8]. However, in a post-pandemic graduate medical education survey of 88 clinical pediatric attendings, only 12% of faculty reported preferring entirely in-person education [5].

Studies of university students suggest that online class attendance is not necessarily inferior to in-person attendance. In a study of 273 students enrolled in two hybrid courses with the option to attend in-person or online, there was no statistically significant difference in student engagement scores, measured by class attendance and participation in active learning activities during lectures, or course performance between the two modes of attendance. However, there was a correlation between course performance and engagement (r = 0.38–0.65) in both groups of students [6]. Of the 189 survey respondents in this study who reported using the hybrid learning platform, 86% found at least one feature of the hybrid platform helpful to their learning, with lecture recordings being the most popular feature [6]. Another study of over 17,000 university students also showed lack of a clear relationship between course performance and mode of class attendance, whether attending in-person, attending online synchronously, or watching lecture recordings asynchronously [7]. Survey results from this study suggested that students were making conscious decisions about their mode of attendance based on their personal goals and needs; for example, some students reported choosing not to attend classes in-person because they felt more distracted in the lecture hall [7].

Multiple authors have published strategies for remote radiology education, and some radiology programs with residents working at multiple sites already relied on remote education prior to COVID-19 [1]. However, to our knowledge, the hybrid conference format in radiology residency and fellowship training programs has not been examined in the radiology education literature. The smaller setting and different learning needs involved in graduate medical education compared with undergraduate education require special considerations when designing hybrid conferences. An article in the Harvard Business Review described hybrid meetings as “vastly more complex” than completely in-person or virtual meetings, as it is all too easy for remote attendees to be treated as second-class participants when other attendees are physically together in a room [9]. In this article, we discuss the unique challenges associated with running an effective hybrid radiology conference and present strategies to support a positive experience for both learners and educators.