Educational Videos: An Effective Tool to Improve Training in Interventional Breast Procedures

Enhancing speech-language pathology head and neck cancer service provision in rural Australia: Using a plan, do, study, act approach

PURPOSE

People with head and neck cancer (HNC) require ongoing speech-language pathology (SLP) services into the post-acute recovery phase of care. However, there are recognised service inequities/barriers for people from rural areas who are unable to access SLP services locally, necessitating travel to metropolitan centres. This study implemented strategies to assist rural speech-language pathologists to work to full scope of practice and support post-acute rehabilitation services for people with HNC.

METHOD

The study involved five SLP departments within a rural health referral network (one tertiary cancer centre, four rural sites). It involved a Plan-Do-Study-Act (PDSA) method, across two six month cycles, to achieve implementation of a model to support local SLP delivery of HNC care. Data collected included service activity, consumer feedback from people accessing local care, staff perceptions of the model and changes to local SLP service capabilities.

RESULT

Staff identified four objectives for change across the two PDSA cycles including resource development, upskilling/training and improving communication, and handover processes. In cycle 1, multiple resources were developed such as an eLearning program for training and skill development. In cycle 2, a pilot trial of a shared-care model was implemented, which successfully supported a transfer of care to local services for eight people with HNC. The majority of consumers accessing HNC care locally were satisfied with the service and would recommend future people with HNC receive similar care.

CONCLUSION

The PDSA process supported development and implementation of a model enabling local speech-language pathologists to offer post-acute care for people with HNC. This model helps rural people with HNC to access care closer to home by supporting rural clinicians to work to full scope of practice.

Use of Videos by Health Care Professionals for Procedure Support in Acute Cardiac Care: A Scoping Review

BACKGROUND

Cardiology procedures are often life-saving and time-critical, but some are so infrequent that health care staff may have rarely encountered them in practice or need to refresh their skills rapidly. Videos demonstrating procedures have the potential to assist health care professionals and support safe patient care. This scoping review explores the research literature involving the use of video by health care professionals in hospitals.

AIM

To identify what is known from research regarding the use of video to support clinical procedures in hospitals or health care facilities.

METHOD

The Joanna Briggs Institute Scoping review methodology guided our systematic search of peer-reviewed evidence related to video use to support procedures in a hospital or health care facility. Data sources included the electronic databases: ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Excerpta Medica dataBASE (EMBASE), Scopus, and PubMed.

FINDINGS

Seventeen (17) studies that met the inclusion criteria were included in the review, all published between 2012 and 2022. Since 2005, YouTube has become the dominant platform for publishing or sourcing videos related to clinical procedures. Studies to date can be summarised under five themes: 1) video content and purpose, 2) target audience, 3) video hosting site-internal websites versus YouTube, 4) curated versus original 'homegrown' video content, and 5) video development process.

DISCUSSION/CONCLUSION

Research on the development and utility of videos to support clinical procedures is emerging, with the ability to host videos on platforms such as YouTube becoming more accessible in recent years. All videos were designed to enhance health care professionals' existing knowledge and skills within their scope of practice. The available literature suggests that video can be a valuable clinical resource for both simple and skilled procedures. Video resources can help clinicians perform or assist with rare procedures, providing 'just in time' patient safety prompts and information.

The Role of Online Videos in Teaching Procedural Skills in Postgraduate Medical Education: A Scoping Review

OBJECTIVE

The purpose of this scoping review was to outline the extent of available literature including the prevalence of video quality appraisal tools, characterize how online videos were used, and identify the gaps in the literature with implications for future research.

DESIGN

The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR). Six databases were searched: (1) MEDLINE (Ovid), (2) EMBASE, (3) Cochrane, (4) ERIC, (5) CINAHL PLUS, and (6) Google Scholar for Medical Subject Headings terms online videos, postgraduate health education, and health professional/s.

RESULTS

A total of 6948 articles were identified, of which 78 were included in the review. The articles included were primarily either experimental or observational studies, with most being from North America. Twelve concepts were identified: (1) procedural skills teaching; (2) video assessment; (3) validation of an assessment tool; (4) video feedback; (5) coaching; (6) broadcasting; (7) learner characteristics; (8) video characteristics; (9) video quality; (10) a quality assessment tool; (11) platforms and video library; and (12) health information governance.

CONCLUSIONS

While there is a diverse and growing body of literature on this area, information is lacking about the quality appraisal of online videos.

Neuroendovascular Training Using Multisource Video-Recording System in a Hybrid Operating Room

BACKGROUND

Increasing restrictions over trainees' working hours and the recent coronavirus disease 2019 pandemic warrant new educational methods of surgical skills. We assessed a novel video-recording system for neuroendovascular skill education, developed with the installation of a hybrid operating room (OR) at our institution.

METHODS

A single-plane angiography unit with a large flat display (FlexVision XL; Philips Medical Systems) was installed in our OR. All media sources in the OR, including live fluoroscopy and ceiling-mounted camcorders, were connected to a video switcher. This video switcher laid up to 8 video images into one big image, which was transferred to the large display and the professional-use Blu-ray recorder. The recording was performed continuously during the procedure. This recording system was evaluated retrospectively with a questionnaire administered to the 5 trainees.

RESULTS

Using this system, 68 interventional procedures were recorded. Among the potential merits, the trainees assigned the greatest value to the simultaneous recording of the operator's hand motions and the fluoroscopy images. Among the potential limitations of the system, the prolonged time and the increased volume of the video data bothered the trainees the most. The recorded video looked like a live demonstration.

CONCLUSIONS

Our "selfie" video recording system was useful for skill training of neuroendovascular interventions.

Cardiopulmonary Bypass Video Is an Effective Learning Tool

Background: Surgical procedures require the collaboration of medical personnel with multiple skill sets who have different levels of training. Someone new to surgical procedures, such as a medical student, faces a steep learning curve. Studies have shown that video-assisted learning is associated with improved learning of surgical procedures.

Methods: During their surgical rotation orientation, third-year medical students were invited via email to participate in a learning study featuring a cardiopulmonary bypass video. Study participants took a pretest, reviewed the locally developed video, and took a posttest and an attitudinal questionnaire after viewing the video.

Results: A convenience sample of 31 third-year medical students participated in the study. Overall knowledge scores improved from pretest to posttest (36.9% vs 79.6%, P<0.001). In the posttest attitudinal questionnaire, students reported that they preferred video-assisted learning to reading written protocols (90.3% strongly agree/agree) and that they were more knowledgeable about the function of the cardiopulmonary bypass machine (80.7% strongly agree/agree) after viewing the video. Students also reported that the video would be useful during their surgical clerkships (90.4% strongly agree/agree).

Conclusion: Video-assisted learning was associated with comprehension of the material immediately after viewing the video, and medical students considered it to be appropriate and useful. This educational video may benefit other learners who are entering the cardiopulmonary bypass operating room for the first time.

Acquiring Clinical Knowledge from an Online Video Platform: A Randomized Controlled Experiment on the Relevance of Integrating Anatomical Information and Clinical Practice

Basic subjects in medical education, such as anatomy, are often taught through teaching formats that do not always sufficiently demonstrate the relevance of this basic information for clinical practice. Accordingly, it is a recent trend in anatomy education to link anatomical information more explicitly to clinical practice. This article presents an online video platform (Tuebingen's Sectio Chirurgica [TSC]) as one means of explicitly integrating preclinical anatomical knowledge and clinical application. The purpose of the study presented here was to examine the effects of videos through which medical students were educated about Anterior Cruciate Ligament reconstruction. A TSC video about this surgical procedure was compared to a video with a traditional lecture providing the identical information. Participants (n = 114) perceived the TSC video to be superior in comprehensibility of the presentation (P = 0.003) and conceivability of the surgical procedure (P = 0.027), and to be more entertaining (P < 0.001). Moreover, participants in the TSC condition acquired more clinical knowledge than in the lecture condition (P = 0.043) but did not differ in their acquisition of anatomical knowledge. Mediation analyses indicated that the effect on the acquisition of clinical knowledge was mediated by comprehensibility, conceivability, and entertainment. These findings are discussed regarding their implications for medical education in terms of contributing to the general trend of linking preclinical anatomical knowledge to clinical application. A discussion about the limitations of the study and suggestions for future research are also provided.

Deploying Clinical Process Improvement Strategies to Reduce Motion Artifacts and Expiratory Phase Scanning in Chest CT

We hypothesized that clinical process improvement strategies can reduce frequency of motion artifacts and expiratory phase scanning in chest CT. We reviewed 826 chest CT to establish the baseline frequency. Per clinical process improvement guidelines, we brainstormed corrective measures and priority-pay-off matrix. The first intervention involved education of CT technologists, following which 795 chest CT were reviewed. For the second intervention, instructional videos on optimal breath-hold were shown to 245 adult patients just before their chest CT. Presence of motion artifacts and expiratory phase scanning was assessed. We also reviewed 311 chest CT scans belonging to a control group of patients who did not see the instructional videos. Pareto and percentage run charts were created for baseline and post-intervention data. Baseline incidence of motion artifacts and expiratory phase scanning in chest CT was 35% (292/826). There was no change in the corresponding incidence following the first intervention (36%; 283/795). Respiratory motion and expiratory phase chest CT with the second intervention decreased (8%, 20/245 patients). Instructional videos for patients (and not education and training of CT technologists) reduce the frequency of motion artifacts and expiratory phase scanning in chest CT.

GoPro Hero Cameras for Creation of a Three-Dimensional, Educational, Neurointerventional Video

Neurointerventional education relies on an apprenticeship model, with the trainee observing and participating in procedures with the guidance of a mentor. While educational videos are becoming prevalent in surgical cases, there is a dearth of comparable educational material for trainees in neurointerventional programs. We sought to create a high-quality, three-dimensional video of a routine diagnostic cerebral angiogram for use as an educational tool. A diagnostic cerebral angiogram was recorded using two GoPro HERO 3+ cameras with the Dual HERO System to capture the proceduralist's hands during the case. This video was edited with recordings from the video monitors to create a real-time three-dimensional video of both the actions of the neurointerventionalist and the resulting wire/catheter movements. The final edited video, in either two or three dimensions, can serve as another instructional tool for the training of residents and/or fellows. Additional videos can be created in a similar fashion of more complicated neurointerventional cases. The GoPro HERO 3+ camera and Dual HERO System can be used to create educational videos of neurointerventional procedures.

Video-Based Teaching of Image-Guided Breast Interventions: Stereotactic Core Biopsy Using a Prone Table

INTRODUCTION

The introduction of new technologies and teaching strategies to educate the digital learner creates the potential for a better and more standardized training experience across programs. Thus, we sought to create an instructional video on stereotactic core breast biopsy that simulates best practices and could be readily accessed by training programs to improve and standardize resident education.

METHODS

At our institution, we use the video and questions as part of a flipped classroom educational activity. Residents are requested to complete the questions at home and watch the video. They then take the posttest questions during the lecture period, at which time the answers are reviewed and there is additional discussion of the procedure. The tests contain both video-related questions and control questions.

RESULTS

After viewing the video, there was a 30% mean improvement in the video-related questions compared to a 0% improvement in the control set of questions.

DISCUSSION

An instructional video on stereotactic core biopsy was created with associated assessment questions that can be used at any institution for the purposes of improving and standardizing training in breast imaging procedures. This resource can be especially useful for programs where trainees have limited procedure exposure.