INTRODUCTION
The World Café method is designed to foster collaborative dialogue around meaningful questions within a community or organization, providing opportunities to share knowledge and generate new possibilities for action (Brown & The World Café Community, 2006). The method typically involves several rounds of discussion in groups of three to four people to address shared areas of concern and convergence, collecting key insights and perspectives through notetaking (Brown & The World Café Community, 2006). Seven design principles guide the World Café method: (1) set the context; (2) create hospitable space; (3) explore questions that matter; (4) encourage everyone’s contribution; (5) cross-pollinate and connect diverse perspectives; (6) listen together for patterns, insights, and deeper questions; and (7) harvest and share collective discoveries (Brown et al., 2005).
The global incidence of cancer among older adults is continuing to increase (Ferlay et al., 2024; Pilleron et al., 2019). There is growing evidence to support implementation of geriatric assessment and management into the care of older adults with cancer to inform treatment decision making and inform supportive interventions to optimize care (Anwar et al., 2023; Dale et al., 2023; Hamaker et al., 2022; National Comprehensive Cancer Network, 2024). Optimal implementation of geriatric oncology initiatives often depends on effective interdisciplinary collaboration (teamwork among health providers of different specialties, e.g., geriatrics and oncology) and interprofessional collaboration (teamwork among health providers of different professions, e.g., nurses, physicians, pharmacists, occupational therapists, physical therapists, social workers, etc.) (Bagayogo et al., 2020; Martin et al., 2022; Okoli et al., 2021). However, there is often little opportunity to share challenges and effective strategies while developing a vision for further development of interprofessional/ interdisciplinary collaboration in geriatric oncology.
In 2024, the International Society of Geriatric Oncology (SIOG) Nursing, Allied Health, and Scientists (NAHS) Interest Group and the Canadian Association of Nurses in Oncology (CANO/ACIO) Oncology and Aging Special Interest Group (OASIG) joined together to host two interactive World Café sessions to foster discussion about interdisciplinary/interprofessional collaboration in geriatric oncology. The first session was held virtually in February 2024. The second was held in person at the SIOG 2024 Annual Conference in Montréal, Québec, Canada, in October 2024. As a planning committee involving members from each group, we chose the World Café method for these sessions because of its focus on collaborative engagement and identification of key insights to foster movement towards action (Brown & The World Café Community, 2006; Table 1). In this reflection, we discuss how we adapted the World Café method to each of these unique situations, reflecting on the strengths of the World Café method and lessons learned. We hope this information will be used by others to inform effective use of this World Café method for collaborative engagement on various topics in similar virtual and in-person conference settings in the future.
Table 1.
When to use the World Café method
The World Café format is flexible and can be adapted to many different circumstances. They can stand alone or serve as part of a larger meeting or conference. The method is especially useful
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Adapted with permission from The World Café: A resource guide for hosting conversations that matter (p.7) by J. Brown and the World Café Community, 2006, Whole Systems Associates (www.theworldcafe.com).
ADAPTING THE WORLD CAFÉ METHOD
We tailored the World Café method to two unique situations: (1) a virtual session involving international members of the SIOG NAHS and CANO OASIG, and (2) an in-person session at the 2024 SIOG annual conference open to all conference attendees. Each of these situations offered unique constraints and opportunities (Table 2). In the following section, we describe how we accommodated the World Café method to these conditions (Table 3).
Table 2.
Constraints and opportunities for each World Café session
| Virtual Session – February 2024 | In-Person Session – October 2024 | |
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| Constraints |
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| Opportunities |
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Table 3.
Overview of sessions: Planned and actual schedules, questions, and recording tools
| Virtual Session – February 2024 | In-Person Conference Session – October 2024 | |
|---|---|---|
| Schedule | Planned (90 minutes)
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Planned (75 minutes)
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| Small Group Questions | Each small group focused on a different question. Participants rotated through all three questions. 1. Group 1 From a clinical perspective, what could nurse/allied health-led geriatric oncology initiatives look like? 2. Group 2 From a research perspective, what evidence is needed to support the development of nurse/allied health-led geriatric oncology initiatives? 3. Group 3 From a health services perspectives, what are the challenges/risks and the facilitators/risk mitigation strategies for the development and implementation of nurse/allied health-led geriatric oncology initiatives? |
All small groups were given the same questions, answering the questions from the perspective specified for their group (clinical, research, health services, education).1,2 1. Exploring perspectives
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| Large Group Questions |
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| Recording Tools Used |
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Questions adapted with permission from the Alberta Cancer Diagnosis Initiative, Cancer Strategic Clinical Network, Cancer Care Alberta, Alberta Health Services.
Full questions and with all provided prompts can be found in Strohschein et al. (submitted for publication).
Virtual Session
Planning and preparation
To foster discussion and interaction among SIOG NAHS and CANO OASIG members from around the world, we first planned for a 90-minute virtual World Café discussion via Zoom Workplace (Version 6.2.7; https://www.zoom.com/) as the online audiovisual collaboration platform (Table 3). Five SIOG NAHS members participated as group hosts. A facilitator from the SIOG head office assisted us with setting up the meeting in Zoom Workplace. We met prior to the session for a dry run. The session was advertised through the SIOG NAHS and CANO OASIG email lists, as well as the SIOG NAHS communication portal on the SIOG website.
Hosting the session
Seven SIOG NAHS/CANO OASIG members joined the virtual World Café session. With group hosts, this resulted in a total of 12 participants, the minimum suggested for World Café sessions (Brown & The World Café Community, 2006). We began with an introduction to the aims of the session and format of the World Café method and then moved into small group discussions. Each small group focused on a different question (Table 3). Attendees were randomly assigned to breakout rooms for the small group discussions with the designated group hosts. The SIOG facilitator organized the breakout rooms during the session and moved the group hosts to the next group at the allotted time. All attendees rotated through all three questions, remaining in the same small groups but with different group hosts, and then we returned to the large group. We initially planned for 20-minute discussion rounds; however, because we had fewer attendees than expected, we modified this to 15-minute discussion rounds, allowing for more large-group discussion at the end.
Harvesting collective insights and discoveries
During the introduction, all participants were asked for their consent to record the discussion. We recorded the small and large group discussions using Zoom Workplace. Due to the functionality of Zoom Workplace, the group hosts had to individually manage the recording of their small group discussions. We saved the recordings for two of the three small group discussions and the large group discussion; the third small group recording was lost due to technical difficulties.
We also facilitated collaborative note-taking using the Mural (https://mural.co/), an online visual platform for collaborative notetaking. All participants had access to Mural. We introduced Mural at the beginning of the session and then group hosts and attendees added notes to a shared Mural “canvas” during the small group discussions. This resulted in a single “canvas” that captured notes from all groups.
Conference Session
Planning and preparation
We were provided with a 75-minute session within the main scientific program of the conference to host the World Café discussion (Table 3). Ten SIOG NAHS and CANO OASIG members and one patient partner served as group hosts, seven of whom had been involved in the virtual World Café session. Group hosts met for three virtual planning meetings prior to the conference and were provided with an outline of the session, which included guidelines for facilitation and note-taking.
Prior to the session, group hosts moved the chairs from rows into circles of five to six, forming 10 groups. Each group was provided with a 25″ x 30″ easel notepad, markers, 3″ x 3″ sticky notes, and pens and was labeled with one of the following perspectives: clinical, education, health services, or research. We planned for two groups of each perspective. In addition, two group hosts were able to facilitate in French, so we planned for one French group focusing on clinical/research perspectives and the other focusing on education/ health services perspectives.
Hosting the session
As attendees entered the room, they were welcomed by the group hosts and asked to join a small group of their choice. A slide projected onto the screen at the front of the room also instructed attendees to “join a group with a focus of your choice.” When everyone was settled into a group, the session began with an introduction to interprofessional/ interdisciplinary collaboration within geriatric oncology, highlighting levels of collaboration (Weaver, 2021), models of interprofessional/interdisciplinary care in geriatric oncology (Battisti & Dotan, 2020; Hamaker et al., 2022), factors affecting collaboration (Barrault- Couchouron et al., 2022; Reeves et al., 2010), and composition of interprofessional teams in geriatric oncology practice (Presley et al., 2020). The presenter then explained the aims, format, and agenda for the World Café session.
We planned for two 20-minute rounds of discussion in ten groups of four to five people, with discussion focusing on the first two questions (exploring perspectives and sharing stories) in the initial round and on the last two questions (imaging possibilities and looking more closely) in the second round (Table 3). However, attendees gravitated towards six larger groups ranging from five to eight people, including group hosts. When time came to switch groups, many groups were still introducing themselves and exploring perspectives. We, therefore, chose to stay with the same groups for all four sets of questions, giving attendees the opportunity to deepen collaborative conversation.
After the small groups, participants were given several minutes to reflect on the discussion and collect their thoughts, before we began the large group discussion with opportunity to share key insights.
Harvesting collective insights and discoveries
During the session introduction, participants were invited to complete questions using Mentimeter (https://www.mentimeter.com/), an online tool for interactive polls and audience engagement, to indicate their profession (patient partner, family partner, occupational therapist, physical therapist, psychologist, scientist, physician, pharmacist, social worker, nurse, or other), their discipline (oncology, geriatrics, geriatric oncology, or other), and the levels of interprofessional and interdisciplinary collaboration within their team (Weaver, 2021). At the end of the session, we included two evaluation questions. Attendees wanting to receive updates about this session and other initiatives related to this topic were invited to provide their email address. Paper forms were provided for those without Mentimeter access. The questions and responses are summarized as a supplement to Strohschein et al. (submitted for publication). Key insights from the discussion were captured through notetaking in the small groups and audio recording of the large group discussion.
Information about the type of data that would be collected and what would be done with that data was provided on an introductory slide and on sheets available to participants. Attendees were invited to ask their group host(s) any questions or express concerns about how the data would be collected or used. Participation in the session was taken as implied consent.
After the conference, the notes and audio-recording were transcribed. Identifiable information was removed. The group hosts met to debrief the session and reflect on how it might be improved in the future. All group hosts contributed to the writing of the meeting report, including a description of the participants, a summary of key insights related to each perspective, an overview of common themes identified across groups, and a summary of the evaluation (Strohschein et al., submitted for publication), as well as this reflection on the methods. Attendees who had provided their email address were invited to review the meeting report and provide feedback based on their group experience.
STRENGTHS OF THE WORLD CAFÉ METHOD
In both situations (virtual and in-person), World Café resources and guidelines provided rich insights and a practical framework to inform the planning and organization of the sessions (Table 4). Participants in both sessions (virtual and in-person) expressed important interest in learning about the practices in other settings, actively asking one another to share experiences, a key opportunity provided by the World Café method. In both sessions, the discussion generated excitement for and engagement with the topic, with participants expressing a desire for action and commitment to involvement in next steps (Strohschein et al., Submitted Jan 2025).
Table 4.
Strengths of World Café method in virtual and in-person conference sessions
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LESSONS LEARNED
In this section, we discuss key learnings to inform effective future World Café sessions in similar situations. These learnings are summarized in Table 5.
Table 5.
Key Lessons Learned and Related Benefits
| Key learnings | Benefits |
|---|---|
| Provide pre-registration for participants. | Allows facilitators to plan the appropriate number of groups and number of participants per group, ensure that the focus of the groups appropriately reflects the perspectives of participants, and ensure diversity within groups. |
| Improve preparation for group hosts. | Ensures group hosts with varying experience in group facilitation feel adequately prepared to guide the discussion. |
| Allow time for practice run prior to virtual sessions. | Ensures familiarity with technology prior to session and ensures small group organization is consistent with the limitations of the technology. |
| Consider room set up (size of room/noise level) for in-person sessions. | Ensures participants can hear discussion without disruption from other groups. |
| Provide clear explanation of session aims and small group perspectives before dividing into groups. | Ensures participants are clear on what they are being requested to do, the focus of the small groups, and how they can engage meaningfully. This also allows for even distribution of participants among the groups, accounting for latecomers. |
| Consider having two hosts per group. | Allows one host to focus on the discussion, and the other to focus on notetaking. This also supports hosts who may be less comfortable with facilitation. |
| Incorporate group for patient/family perspectives and intentionally invite more patient/family partners. | Strengthens patient and family voices, ensuring alignment with the patient- and family-centred approach of geriatric oncology. |
| Ensure adequate time, particularly for in-person sessions. | Allows for more in-depth discussion of topic and for the rotation of groups to support greater networking. |
| For shorter time, limit the number of questions. | Provides clear focus for small group discussion, ensuring each participant contributes to answering each question. |
| Allow time for participants to share their experiences. | Enables participants to gain insight into common challenges and strategies they may be able to use in their own settings. |
| Ensure diversity of perspectives, settings, and regions are represented within small groups. | Strengthens opportunities for networking as well as sharing ideas and experiences across settings. |
| Ensure familiarity with technology if recording during virtual sessions. | Supports the harvesting of collective insights. |
| Use collaborative notetaking programs for virtual sessions. | Generates common place for hosts and attendees to add their insights, which is easily saved after the session. |
| Ensure demographic / evaluation questions are not repeated between interactive PowerPoint and paper forms. | Avoids duplication of responses that confuse interpretation of responses. |
Pre-registration for participants
In both virtual and conference World Cafe sessions, an important challenge was not knowing the participants in advance of this session. The group hosts agreed that it would be beneficial to provide an opportunity for pre-registration for the session, including a brief description of their role/perspective. At the same time, we would not want registration to be a limitation to participants joining on the day who may learn about the session at the conference. Knowing the number and roles/perspectives of participants would allow facilitators to plan for an appropriate number of groups and form initial groups that would include diverse participants prior to the meeting, while allowing for the few who may express interest and want to join last minute, if space allows. For virtual sessions, knowing the participants in advance would also allow the facilitator to pre-organize the breakout rooms in Zoom Workplace.
Preparation of group hosts
Consistent with the World Café approach, which does not view group hosts as facilitators in the traditional sense but understand World Café conversations to be largely self-managing and self-organizing (Brown & The World Café Community, 2006), we took an informal approach to group facilitation and preparation of group hosts. However, given the varying levels of comfort and skill with group facilitation among group hosts, several suggested that it may have been helpful to have more preparation about how to host the small group discussions prior to the sessions. Some suggested having a dry run or demonstration of how to stay on track during the discussion.
Room Set-Up
For the virtual session, Zoom Workplace facilitation required significant advance preparation. The functionality of breakout rooms in Zoom Workplace part determined how we would organize and rotate the small groups. For example, choosing to randomly assign attendees to groups and rotate the hosts, rather than attendees choosing their own groups. It was critical to have a person focused solely on the technology for the breakout groups, so the group hosts could focus on the discussion. During the session, the technology worked seamlessly, with smooth transition between groups.
For the conference session, group hosts, and one participant, noted that the room was small and too noisy for the number of groups. In some groups, participants had difficulty hearing one another over the discussion from other groups. Therefore, it was suggested that future conference World Café sessions be held in a larger room, or several small rooms, where groups could be farther apart.
Explanation of session aims and group perspectives
Due to the time limitation in the conference session, we asked participants to join a small group as they were entering the room. However, this was somewhat confusing as they had not yet been oriented to the aims of the session. Given a longer time frame, it would have been more effective to have attendees go through the introduction to the session together before breaking into small groups. This would allow the participants to make a more informed decision about the perspective of the group they wished to join. Also, a clear explanation of the aims of the session may streamline the discussions and ensure consistent focus on the primary topic.
In addition, some people had different definitions for the group perspectives, particularly the term “health services.” As a result, the diversity of perspectives in this group introduced challenges for the discussion. Group hosts suggested providing brief definitions of the terms in advance to provide attendees with clarity regarding the focus of each group.
Distribution of participants among groups
As people were entering the room for the conference session, we had the impression that the numbers were smaller than expected, so groups joined together. When latecomers joined, however, the groups became larger than planned. Therefore, starting as a large group would also have allowed for a more appropriate distribution of attendees among the small groups.
As a result of groups joining together, many groups had two hosts. The group hosts found this beneficial, allowing one to focus on guiding the discussion and the other on taking notes. Group hosts may have played a greater role in guiding the discussion because of limited time in the session to orient participants to the World Café method.
Patient and family perspectives
On the conference session evaluation, a participant noted that all the groups represented professional perspectives. While patient partners integrated their perspectives into the groups which they joined (e.g., discussion about patient education in the “Education” group), having a patient/family partner group, facilitated by a host who could draw out insights related to interprofessional/ interdisciplinary collaboration from their experiences, and specifically inviting more patient/family partners, may strengthen patient and family voices in the discussion.
Another patient partner expressed that she felt she was able to participate because of her educational background and professional experience within cancer care organizations, wondering if it may have been difficult for other patients and family members to participate in the discussion. We discussed that it may have been beneficial to intentionally invite patient and family attendees to participate in the discussion, and to have a separate group that focused specifically on patient and/or family perspectives related to interprofessional/ interdisciplinary collaboration in care of older persons with cancer.
Time and number of questions
In the conference session, the allotted time was less than suggested in World Café resources (Brown & The World Café Community, 2006). As noted above, it became clear during the session that changing groups would detract from the flow of the conversation. Having more time would have been beneficial in allowing participants opportunity to rotate to at least one more group. There was also general agreement among the group hosts that there were too many questions for the allotted time. In the future, longer sessions or fewer questions may facilitate more focused discussion.
During both the virtual and conference sessions, participants expressed a strong interest in learning how things are done in other settings and in developing new collaborations. It became evident that allowing time for sharing experiences was important.
Diversity of perspectives within groups
In both sessions, participants described diverse perspectives within the small groups as fostering meaningful conversations and insights. In the virtual session, by chance, one small group was comprised of colleagues from the same organization. This limited the opportunity for networking and sharing ideas across settings. In the in-person conference session, group hosts described how diversity in terms of both profession and region added richness to the discussion. As noted above, this could be facilitated by pre-registration and some advance organization of groups.
In the conference session, the World Café was scheduled as a concurrent session. Therefore, other sessions happening at the same time may have impacted World Café attendance. Considering the conference schedule and concurrent sessions, or planning the World Café as a pre-conference activity, may promote diversity of attendees in conference settings.
Capturing data to harvest collective insights and perspectives
During the virtual session, the functionality of Zoom Workplace impacted data collection. First, as noted above, the small groups had to be recorded separately by the group hosts and could not be managed by the session facilitator. The location of the saved files was not clear, and one small group recording was lost. In addition, we chose to use Mural for collective virtual note-taking because the functionality of the Whiteboard tool in Zoom Workplace was more challenging over multiple breakout rooms.
During the in-person conference session, demographics and evaluation data was collected through Mentimeter, with the option to complete them on paper. Some participants, however, completed both, resulting in an uncertain number of duplicates that made it difficult to obtain an accurate count of responses. Although the demographic questions worked well on Mentimeter, participants provided longer, more thoughtful responses to the evaluation questions on the paper forms. In addition, one group host noted that recording of small groups would have taken pressure off notetakers. Another suggested that giving everyone sticky notes and pens may have encouraged more notetaking by group members.
CONCLUSION
The World Café method was effective in fostering meaningful conversations about interprofessional and interdisciplinary collaboration in the care of older adults with cancer among diverse groups of professionals and patient partners. We were able to adapt the method to virtual and in-person conference settings. Lessons learned highlight opportunities to strengthen the use of this method to extend the discussion on this topic and others in future sessions.
ACKNOWLEDGEMENTS
We would like to thank the SIOG NAHS members, CANO OASIG members, and SIOG 2024 conference attendees who participated in these sessions, sharing their rich perspectives and experiences. We would also like to thank the SIOG 2024 Scientific Programme Committee and Conference Secretariat (K.I.T Group) for their support of this session as well as the CANO Executive and Board of Directors for their financial and instrumental support of this session.
We also thank the Cancer Strategic Clinical Network, Cancer Care Alberta, Alberta Health Services, for their permission to adapt the topics and questions used for this World Café from those used for a World Café within the Alberta Cancer Diagnosis Initiative.
Dr. Strohschein’s work on this project was supported in part by a Canadian Institutes of Health Research Health Impact Postdoctoral Fellowship in collaboration with the Cancer Strategic Clinical Network, Cancer Care Alberta, Alberta Health Services. Dr. Haase is supported by a Scholar Award from Health Research BC. Dr. Pilleron is supported by the Luxembourg National Research Fund (FNR), Project n°16731054. Dr. Puts is supported by a Tier 2 Canada Research Chair in the care for frail older adults.
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