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Swimming against the stream: the fishbowl discussion method as an interactive tool for medical conferences: experiences from the 11th European Lupus Meeting
  1. Johanna Mucke1,
  2. Hans-Joachim Anders2,
  3. Martin Aringer3,
  4. Gamal Chehab1,
  5. Rebecca Fischer-Betz1,
  6. Falk Hiepe4,
  7. Hanns-Martin Lorenz5,
  8. Andreas Schwarting6,
  9. Christof Specker7,
  10. Reinhard E Voll8,
  11. Matthias Schneider1
  1. 1 Policlinic and Hiller Research Unit for Rheumatology, University Clinic Duesseldorf Heinrich-Heine-University, Duesseldorf, Germany
  2. 2 Medizinische Klinik and Poliklinik IV, University of Munich, Munich, Germany
  3. 3 Internal Medicine III, Medical Faculty, Technical University of Dresden, Dresden, Germany
  4. 4 Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
  5. 5 Department of Hematology, Oncology and Rheumatology, Internal MedicineV, University Hospital of Heidelberg, Heidelberg, Germany
  6. 6 Division of Rheumatology and Clinical Immunology, University Hospital Mainz, Mainz, Germany
  7. 7 Department for Rheumatology and Clinical Immunology, St Josef Krankenhaus, University Clinic, Essen, Germany
  8. 8 Department of Rheumatology and Clinical Immunology, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg, Freiburg, Germany
  1. Correspondence to Dr Johanna Mucke, Policlinic and Hiller Research Center, University Clinic Duesseldorf Heinrich-Heine-University, Duesseldorf 40225, Germany; johanna.mucke{at}

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Based on both historical development and functional advantages, such as in emergencies, hierarchical aspects dominate all levels of medicine. Doubtlessly, the high degree of respect for experts and their opinions may impede exchange between different levels of hierarchy. At medical conferences, discussions usually take place between experts, while patients, young doctors and students only listen and rarely actively participate.

For the 11th European Lupus Meeting in Düsseldorf in March 2018, we have tried the fishbowl method to increase participation at all levels. Fishbowl is an interactive and dynamic technique with a group of discussants sitting in an inner circle that contains an additional empty chair and surrounded by the audience in an outer circle.1 The empty chair can be occupied by any member of the outer circle at any time to join the discussion immediately. After the additional discussant of the auditorium has made his/her statement, he or she will leave the chair again to create an opportunity for another member of the audience (figure 1).

Figure 1

The fishbowl method. A group …

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  • Handling editor Josef S Smolen

  • Contributors JM, MS and MA participated in the conception of the study and data interpretation and drafted the manuscript. H-JA participated in the conception of the study and data interpretation. GC and RF-B conceived the study and interpreted the data. H-ML, AS, CS and REV participated in the conception. All authors participated actively in the discussions and had a prior methodological training. All gave substantial intellectual contributions, and read, revised and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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