Educational Value of YouTube Surgical Videos of Pediatric Robot-Assisted Laparoscopic Pyeloplasty: A Qualitative Assessment

Is YouTube a reliable tool for approaching robotic assisted transabdominal preperitoneal surgery? A critical review of the available resources

INTRODUCTION

The robotic transabdominal preperitoneal approach (rTAPP) is a relatively recent technique for the treatment of inguinal hernia. To achieve optimal results, the 10 golden rules described must be followed. Surgeons in training often review videos to familiarize themselves with new techniques, YouTube being one of the most used platforms. The objective of this study is to carry out an evaluation of the 10 most viewed videos on YouTube of inguinal hernia repair by transabdominal preperitoneal approach (rTAPP) to determine if the 10 golden rules are met.

METHODS

Identify and evaluate the 10 videos with the highest number of views related to rTAPP. Three experienced Surgeons evaluated compliance with the 10 golden rules using a Likert scale. Data were analyzed in Excel (Microsoft) and plotted with Tableau (Tableau Inc). The consistency between evaluators was determined using Cronbach's alpha, considering a value >0.7 acceptable.

RESULTS

The average overall evaluation was 3.63 with a range of 2.6 to 4.9. The scores related to compliance with the rules 1, 2, 9, 10 were satisfactory; on the other hand, rules 3, 4, 5, 7 and 8 were weak, particularly rule number 7. Internal consistency was observed between raters with a Cronbach's alpha of 0.98.

CONCLUSIONS

The lack of compliance with the 10 golden rules in most of the videos demonstrates that the use of videos (YouTube) is not an adequate resource for learning robot-assisted inguinal hernia cure.

Suprapubic catheter change: Evaluating YouTube videos as a resource for teaching junior doctors

Objectives

The objectives of this study are to assess the current level of experience and teaching practices for SPC change at our institution and, second, to assess the quality of YouTube videos as an educational tool for teaching SPC change.

Methods

A survey was conducted of 40 JMOs at our institution regarding SPC change. The first 20 YouTube videos on SPC change were included for analysis. A JAMA and DISCERN score was calculated for each video. Using linear regression, the association between collected variables and the assigned JAMA and DISCERN scores were determined.

Results

The survey showed that 18 (45%) of JMOs had done an SPC change. None had received formal teaching. The consensus was that the quality of the YouTube videos was poor. There was a statistically significant positive correlation between the score assigned to videos by each scoring system (Pearson's r 0.81, p < 0.001). There was no statistically significant association between video quality as measured by either of the scoring systems and number of views. No association between any video characteristic and JAMA and DISCERN score was found.

Conclusion

An SPC change is often a requirement of JMOs; however, this skill is not formally taught. The quality of YouTube videos describing an SPC change is poor.

Quality Assessment of YouTube Videos as an Information Source for Bowel Management in Children

PURPOSE

This study aims to evaluate the quality and reliability of YouTube videos about bowel management in children.

METHODS

On April 6th, 2023, the search results for "bowel management in children" on YouTube were rated independently by two authors. JAMA Benchmark Criteria (score 0-4) and a modified DISCERN tool (score 16-80) used for quality and reliability assessment. Data was analyzed by Chi-square test and one-way analysis of variance (ANOVA).

RESULTS

Out of 48 videos included, 15 (31.2%) videos were intended for professionals and 33 (68.8%) for the public. The mean number of views was 144.806 and duration was 22 ± 28.4 min. The respective mean duration of videos for professionals 57.7 ± 21.4 min and median number of views was 404.5 (17-8.840) and those for public was 5.7 ± 10.7 min and 8400 (8-5.175.975) (both, p < 0.005). The respective mean DISCERN and JAMA scores of the videos for the public was 45.30 ± 13.18 and 2.93 ± 1.07, and for professionals 75.73 ± 6.52 and 3.8 ± 1.06 (both, p < 0.05).

CONCLUSION

Although the reliability of the videos uploaded for the professionals about pediatric bowel management was higher than for public, duration of the videos was longer and the viewing rates were lower. Shorter but comprehensive and easy-to-understand guidance videos for the public may be of help.

TYPE OF STUDY

Descriptive study.

LEVEL OF EVIDENCE

IV.

A systematic review of video-based educational interventions in robotic surgical training

As robotic surgical procedures become more prevalent in practice, there is a demand for effective and efficient educational strategies in robotic surgery. Video has been used in open and laparoscopic surgery to instruct trainees in the acquisition of operative knowledge and surgical skill. Robotic surgery is an ideal application of video-based technology given the access of video recording directly from the console. This review will present the evidence base for video-based educational tools in robotic surgery to guide the development of future educational interventions using this technology. A systematic review of the literature was performed using the key words "video" "robotic surgery" and "education". From a total of 538 results, 15 full text articles were screened. Inclusion criteria were the presentation of an educational intervention using video and the application of this intervention to robotic surgery. The results of 10 publications are presented in this review. Analysis of the key concepts presented in these publications revealed three themes: video as technology, video as instruction, video as feedback. All studies showed a video-based learning had a positive effect on educational outcomes. There are limited published studies looking specifically at the use of video as an educational intervention in robotic surgical training. Existing studies primarily focus on the use of video as a review tool for skill development. There is scope to expand the use of robotic video as a teaching tool through adaptation of novel technology such as 3D headsets and concepts of cognitive simulation including guided mental imagery and verbalisation.

The educational value of thyroidectomy YouTube videos for surgical trainees

OBJECTIVE

To evaluate the usefulness of thyroidectomy videos posted on YouTube for surgical training.

METHODS

The following keywords were searched on YouTube: "thyroidectomy", "conventional thyroidectomy", "hemithyroidectomy", and "thyroid lobectomy". The first 30 videos from each search were selected for a total of 120 videos. Included videos were those displaying a conventional approach to thyroidectomy and real, non-animated patient surgery. Two independent reviewers assessed each video using the LAParoscopic surgery Video Educational Guidelines (LAP-VEGaS) and a thyroidectomy-specific grading score (TSS).

RESULTS

The search yielded 22 videos that met the selection criteria. The inter-rater agreement was excellent for the grading systems (ICC = 0.910). The average LAP-VEGaS score was of medium quality (8.82 ± 3.56 standard deviation (SD)). The highest average score (11.00 ± 1.68 SD) was assigned to videos published from academic institutions. There was no statistically significant difference in LAP-VEGaS scores when comparing the type of publisher between videos (p = 0.132). The majority of the videos (12/22, 55 %) did not include all hallmarks of thyroidectomy according to the novel TSS score. There was a significant positive correlation between TSS markers and the overall LAP-VEGaS score (r = 0.577, p = 0.005).

CONCLUSION

YouTube videos as an educational resource for thyroidectomy instructions vary in quality. Most of the thyroidectomy videos were medium quality according to the LAP-VEGaS score. YouTube sourced thyroidectomy videos should be used to supplement traditional educational methods.

Educational Quality of YouTube Cholesteatoma Surgery Videos: Areas for Improvement

Otolaryngology surgical education continues to evolve where trainees increasingly use videos to learn technical skills. Trainees commonly use YouTube, but no study to date has evaluated the educational quality (EQ) of otologic surgical videos on YouTube. We aim to assess the EQ of cholesteatoma surgical videos. Cholesteatoma surgical videos were queried using YouTube search terms, assessed using LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS), a validated assessment tool for publication, and categorized into low (0-6), medium (7-12), and high (13-18) EQ groups. In total, 74 videos were identified (mean LAP-VEGaS score = 9.6 ± 4.0) and 44.6% had medium EQ. Videos commonly lacked graphic aids to highlight anatomy (71.6%) and postprocedural outcomes (68.9%). LAP-VEGaS scores were greater in videos originating from US surgeons compared to non-US surgeons (12.4 ± 3.4 vs 8.0 ± 3.5; P < .001). Our study highlights that otolaryngology trainees may experience difficulty finding high-EQ cholesteatoma surgery videos on YouTube. Areas for improved EQ content are discussed. Level of evidence: IV.

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.

Comprehensive assessment of the quality and reliability of the ten most-viewed YouTube videos on thoracoscopic lobectomy in children: a comparison from the available videos on a peer-reviewed platform

BACKGROUND

Surgery residents often consider learning from the operative videos on YouTube, however, the quality of these videos is questionable. We aim to compare the quality and reliability of operative videos on thoracoscopic lobectomy (TL) in children available on YouTube (YT) and WebSurg (WS).

METHODS

Using a defined search strategy, the most-viewed YT videos and all available WS videos on TL in children were identified. The quality and reliability of the two groups of videos were compared using the video popularity index (VPI), Journal of American Medical Association (JAMA) benchmark criteria, and LAP-VEGaS quality assessment tool. On the basis of the LAP-VEGaS score, the videos were divided into acceptable quality (score ≥ 11) or poor quality (score < 11).

RESULTS

Ten most-viewed YT videos were compared with six relevant videos on WS. The median %VPI among the WS and YT videos were 83.3 (range 71.5-404.4) and 49.4 (range 0-270), respectively (p = 0.017). The median JAMA score of the WS videos was also significantly higher than the YT videos (p = 0.0003). In terms of the LAP-VEGaS scores, all WS videos versus only three YT had an acceptable quality.

CONCLUSIONS

As compared to the WS videos, the quality and reliability of the YT videos on TL were significantly poorer.

Quality Assessment of YouTube Videos on Laparoscopic Pyloromyotomy Using a Validated Tool: An Appeal to Trainees to Follow the Peer-Reviewed Videos for Learning Purposes

Background: Surgical trainees often resort to operative videos on the internet during preparation for surgery; YouTube is the most commonly explored video source by them. However, the quality of these videos is often questioned. This study was performed to assess the quality of available YouTube videos on laparoscopic pyloromyotomy (LP). Materials and Methods: The term "laparoscopic pyloromyotomy" was searched on YouTube on June 2, 2021, and 20 most-viewed videos on LP were included. A reference video on LP from WebSurg was also selected. The laparoscopic surgery video educational guidelines (LAP-VEGaS) tool was utilized for quality assessment of these videos. Descriptive variables, including the surgeon's details; year of video upload; duration of the video; view, like, and dislike counts; number of ports used; and instruments used for pyloromyotomy, were recorded and their relationship with video quality was studied. Results: The majority of videos were from the United States and India, and a surgeon could be identified in 90% of them. The median (range) video duration and view, like, and dislike counts were 2.89 (0.68-8.80) minutes, 2308 (1102-23,682), 5 (0-59), and 0 (0-11), respectively. The LAP-VEGaS score of the reference video was 17. In contrast, the scores of YouTube videos ranged from 1 to 14. The quality of these videos was poor in 5/9 domains. None of the descriptive variables showed a significant association with high video quality. Conclusion: Compared with the reference video, the overall quality of YouTube videos on LP was poor. Therefore, until a screening tool is available for selection of high-quality YouTube videos, trainees must resort to peer-reviewed video platforms.

Quality of YouTube Videos on Laparoscopic Pyeloplasty in Children: An Independent Assessment by Two Pediatric Surgeons

Background YouTube (YT) is the most common video platform accessed by surgical trainees for the preparation of surgery. However, the quality of the YT videos has been questioned time and again. This study was performed to comprehensively assess the quality of the available YT videos on pediatric laparoscopic pyeloplasty (LP). Materials and Methods The term "laparoscopic pyeloplasty in children" was searched in YT on June 3, 2021, and ten most-viewed videos on LP were included. The percentage video power index (%VPI), the Journal of American Medical Association (JAMA) benchmark criteria, and the laparoscopic surgery video educational guidelines (LAP-VEGaS) video assessment tool were used to assess the video popularity, the quality of medical information, and the overall quality of the included videos respectively. Videos were defined as acceptable (score of 11 or more) or poor quality (score <11) based on LAP-VEGaS scores. The inter-observer agreement, in terms of the LAP-VEGaS scoring, was observed among two surgeons using the kappa statistics. Results The median values of the %VPI and JAMA scores of the included YT videos were 68.1 (range 0-13570) and 2 (range 1-2) respectively. The median LAP-VEGaS score of these videos was 6.75 (range 2-16.5) with only two videos having acceptable quality. The quality of these videos was poor in 7/9 domains of the LAP-VEGaS tool. A moderate inter-observer agreement (kappa=0.542) was observed in terms of the LAP-VEGaS scores assigned to the videos (p<0.0001). Conclusion A comprehensive assessment of the ten most-viewed YT videos on pediatric LP revealed poor overall quality. The included videos depicted sub-optimal presentation of the medical information and weak conformity to the LAP-VEGaS guidelines.

Assessment of the Educational Value of Distal Hypospadias Repair Videos on YouTube

OBJECTIVE

To evaluate the quality of YouTube videos depicting distal hypospadias repair.

METHODS

The search terms "distal hypospadias repair" were used to identify surgical videos on YouTube. Videos were sorted by view count and the top 34 videos were reviewed for baseline video characteristics, key surgical steps covered, and conformity to a modified LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) checklist. All videos were reviewed and discussed for conformity by 2 attending pediatric urologists and a urology resident.

RESULTS

Of the 34 videos reviewed, 16 videos were excluded due to content. The median length of videos was 9.94 minutes (range, 2.57-99.12 minutes). Video quality was deemed of high quality in only 39% of videos. The most common type of hypospadias procedures described were tubularized incised plate urethroplasty (n = 13) and meatal advancement and glanuloplasty incorporated (n = 2). The median view count was 7828.5 (range, 1,133-58,619 views). Only 1 video met all modified LAP-VEGaS criteria (range of 33%-100%), and only 2 videos showed every surgical step of distal hypospadias repair (range 33%-100%). Modified LAP-VEGaS score, surgical step score, or quality of the video was not associated with a higher view count.

CONCLUSION

Despite being a common procedure, there is a paucity of high-quality videos on YouTube describing distal hypospadias repair techniques. It is unclear how learners select videos for study purposes and the most utilized videos on YouTube are not the most educational videos.

Educational value of YouTube Surgical Videos of Thulium Laser Enucleation of The Prostate (ThuLEP): the quality assessment

Background

To assess the educational value of YouTube surgical videos of thulium laser enucleation of the prostate (ThuLEP).

Methods

A comprehensive search of “ThuLEP” or “thulium laser enucleation of the prostate” was performed on YouTube on October 31, 2020. According to the LAParoscopic surgery Video Educational GuidelineS, we created a checklist to assess the educational value of these videos. The checklist included 20 options. Each option represented one point. The total score was the sum of all the points. The higher score represents the higher educational value.

Results

A total of 70 videos were included. The average number of views were 1,366 (range, 11–30,884). The mean video length was 16.59 mins (range, 1.20–70.35 mins). Only 22.9% (16/70) videos had audio or/and written commentary in English language. Although 67.4% (47/70) videos were present step by step, only 21.4% (15/70) videos did the detailed explanation of critical steps. The mean score of the videos was 5.5 points (range, 1–15). No videos met all the points of the checklist. The mean percentage conformity of the videos was 28% (range, 5–75%). The educational score of the videos had no significant positive correlation with the number of views.

Conclusions

The majority of ThuLEP videos on YouTube platform have low educational value. Videos often lack important and detailed explanations about surgical procedures. The ThuLEP learner should watch these videos selectively. These findings remind us that a global effort should be made to improve the educational value of YouTube surgical videos, and more reporting guidelines about urological endoscopic surgery are still needed.

Evaluation of educational value of YouTube videos addressing robotic pyeloplasty in children

BACKGROUND/INTRODUCTION

Ureteropelvic junction obstruction (UPJO) is the most frequent obstructive uropathy of the upper urinary tract in children. Video-sharing platforms have become a significant source of visual information for health care providers. Among these platforms, YouTube® (www.youtube.com), contains a high number of videos free of charge and represents one of the most important and known websites of video-sharing. YouTube® is a widely used open-access video sharing website that allows us to watch an unlimited number of video content, and to upload an infinitive number of videos.

OBJECTIVE

This study aims to evaluate the educational quality of videos related to robotic pyeloplasty in pediatric age because an increasing number of videos addressing these procedures is now available on YouTube®.

STUDY DESIGN

We performed a search on YouTube® by using the following keyword: "robotic pyeloplasty in children" on July 9, 2020. The first 50 videos were analyzed. The videos were classified according to the source in 1) academic (author/s was/were affiliated with a university), 2) physician (author/s who was/were not affiliated with a university), 3) patient, 4) commercial. All the videos were evaluated also according to the content in 1) surgical technique, 2) information about the surgery and disease 3) patient personal experience 4) advertisement. Duplicated videos and videos not in English were excluded. The search for videos was done based on the website's default settings in order of the proposed relevance. The reliability was evaluated using DISCREN and JAMA scores. The Global Quality Score (GWS) was used to assess the educational value. Time since upload, run time, like, dislike and number of views were recorded.

RESULTS

The first 50 videos were analyzed. Seven videos (14%) did not meet our criteria and were excluded (three videos were duplicated while 4 out of seven were not in English). The mean DISCERN was 32.47 ± 12.24 (range 15-78). The mean JAMA Score was 2.1 ± 0.9 (range 0-4). Mean GQS was 2,12 ± 0.9. DISCERN and JAMAS and GQS scores of academic/physician sourced videos were significantly higher than the patient sourced videos (p = 0.037, p = 0.023, p = 0.017 respectively). Regarding content, the surgical technique had significantly higher DISCERN, JAMAS and GQS scores than videos based on patient experience (p = 0.012, p: 0.021, p = 0.023 respectively).

CONCLUSIONS

Videos uploaded by Physicians and Academic Institutions show higher DISCERN and JAMAS and GQS compared to other sourced videos and should be considered more suitable for teaching respect to those originating from patients or non-physicians.