Japan has a high diagnostic rate of early gastric cancer (EGC), and doctors worldwide are eager to learn advanced tips and skills from Japanese experts. The Telemedicine Development Center of Asia has carried out endoscopy-themed teleconferences, to educate overseas doctors about diagnosing EGC, from which video data are analyzed. The number of comments made varied based on the participant’s role in the teleconference. The experts and chair made more comments than the audience participants. Because in-depth discussion about each case study with the experts is important in learning advice for EGC diagnosis, in this paper, we further analyzed the reasons why there were so many silent participants and how to activate discussion by them. We learned that most hesitated when the discussion was concentrated between the experts. Live polling was added to the teleconference to increase activation. Although a direct increase in the number of comments was not seen, the proportion of participants who had questions but remained silent decreased by 53%, and 88% of participants stated that the live polling increased the quality of the discussion. We found that live polling provides valuable feedback to the chair so that the discussion could incorporate the participants’ opinions, and thus, it increased the quality of the discussion phase.