YouTube as a potential training method for laparoscopic cholecystectomy

YouTube as a Source of Information in Trauma Management for ATLS (10th Edition) Guidelines: Evaluation of Trauma Management Videos on YouTube

Background: Trauma is one of the leading causes of mortality worldwide, and online platforms have become essential sources of information for trauma management. YouTube can play a significant role in helping people access medical information. Methods: YouTube was searched using the keywords management of trauma and assessment of trauma to identify relevant videos. Two authors independently evaluated the videos according to the ATLS (10th edition) guidelines, the modified DISCERN (m-DISCERN) scale, and the Global Quality Scale (GQS) criteria. The videos that met the study criteria were evaluated based on the provider, video length, and view count. Results: Out of 939 videos, 667 were excluded resulting in 272 videos included in the study. According to the ATLS (10th edition) guidelines, the median score for videos was 8 (IQR 7-8). Videos uploaded by official institutions and healthcare professionals received higher scores than from uncertain sources (p = 0.003). According to the GQS, 86% of the videos were low or moderate quality; uncertain sources uploaded 78% of low-quality videos. Conclusion: YouTube is an information source about trauma management that contains videos of varying quality and has a broad audience. Official institutions and healthcare professionals should be aware of this evolving technology and publish up-to-date, accurate content to increase awareness about trauma management and help patients distinguish helpful information from misleading content.

Quality and Educational Value of YouTube Surgical Videos of Transurethral Resection of the Prostate: A Descriptive Cross-Sectional Study

Introduction The aim of the study is to evaluate the quality and educational value of surgical videos on YouTube (Alphabet Inc., Mountain View, CA) demonstrating transurethral resection of the prostate (TURP). Methods A thorough YouTube search for "TURP" or "transurethral resection of the prostate" was performed. Each video's uploader, content, duration, date of upload, time since upload, views, comments, likes, and dislikes, and Video Power Index (VPI) scores were recorded and evaluated. Video analysis and rating followed the LAParoscopic Surgery Video Educational Guidelines (LAP-VEGaS) recommendations, which constitute nine items with values from 0 (absence) to 2 (complete presence). The guidelines' overall score can be 0 to 18. A higher score is indicative of a better level of educational value. Results There were a total of 43 videos included, 10 (23.3%) of which were academic publications. The average LAP-VEGaS score was 6.58, with 22 (51.2%), 18 (41.8%), and three (7%) videos classified as having low, medium, and high educational quality, respectively. None of the videos satisfied all the requirements outlined in the checklist. There was no statistically significant positive correlation observed between the educational score and the number of views. Conclusion A significant proportion of transurethral resection of the prostate (TURP) videos available on the YouTube platform exhibit limited educational value. Videos frequently lack comprehensive and in-depth descriptions of surgical operations. Those seeking information on TURP should carefully choose which videos to view. It is recommended that academic institutions establish comprehensive criteria aimed at enhancing the educational value of surgical videos on the YouTube platform.

Freely available, online videos to support neurological physiotherapists and students in task-specific training skill acquisition: a scoping review

BACKGROUND

Videos to support learning of clinical skills are effective; however, little is known about the scope and educational quality of the content of freely available online videos demonstrating task-specific training (TST). This review aimed to determine the extent, characteristics of freely available online videos, and whether the content is suitable to guide skill acquisition of task-specific training for neurological physiotherapists and students.

METHODS

A scoping review was conducted. Google video and YouTube were searched in December 2022. Videos that met our eligibility criteria and were explicitly designed for (TST) skill acquisition were included in the report.

RESULTS

Ten videos met the inclusion criteria and were difficult to find amongst the range of videos available. Most were presented by physiotherapists or occupational therapists, originated from the USA, featured stroke as the condition of the person being treated, and involved a range of interventions (upper limb, constraint induced movement therapy, balance, bicycling). Most videos were created by universities or private practices and only two used people with a neurological condition as the participant. When the content of videos and their presentation (instruction and/or demonstration), was assessed against each key component of TST (practice structure, specificity, repetition, modification, progression, feedback), five of the videos were rated very suitable and five moderately suitable to guide skill acquisition. Most videos failed to demonstrate and provide instruction on each key component of TST and were missing at least one component, with feedback most frequently omitted.

CONCLUSIONS

There are many freely available online videos which could be described as demonstrating TST; very few are suitable to guide skill acquisition. The development of a standardised and validated assessment tool, that is easy to use and assesses the content of TST videos is required to support learners to critically evaluate the educational quality of video content. Guidelines based on sound teaching theory and practice are required to assist creators of online videos to provide suitable resources that meet the learning needs of neurological physiotherapists and students.

Cricothyrotomy Online: Quality Assessment of Educational Videos on YouTube

BACKGROUND

Medical learners may use YouTube® videos to prepare for procedures. Videos are convenient and readily available, but without any uploading standards, their accuracy and quality for education are uncertain. We assessed the quality of emergency cricothyrotomy videos on YouTube through an expert panel of surgeons with objective quality metrics.

METHODS

A YouTube® search for "emergency cricothyrotomy" was performed and results were filtered to remove animations and lectures. The 4 most-viewed videos were sent to a panel of trauma surgeons for evaluation. An educational quality (EQ) score was generated for each video based on its ability to explain the procedure indications, orient the viewer to the patient, provide accurate narration, provide clear views of procedure, identify relevant instrumentation and anatomy, and explain critical maneuvers. Reviewers were also asked if safety concerns were present and encouraged to give feedback in a free-response field.

RESULTS

Four surgical attendings completed the survey. The median EQ score was 6 on a 7-point scale (95% CI [6, 6]). All but one of the individual parameters had a median EQ score of 6 (95% CI: indications [3, 7], orientation [5, 7], narration [6, 7], clarity [6, 7], instruments [6, 7], anatomy [6, 6], critical maneuvers [5, 6]). Safety received a lower EQ score (5.5, 95% CI [2, 6]).

CONCLUSIONS

The most-viewed cricothyrotomy videos were rated positively by surgical attendings. Still, it is necessary to know if medical learners can distinguish high from low quality videos. If not, this suggests a need for surgical societies to create high-quality videos that can be reliably and efficiently accessed on YouTube®.

Critical View of Safety in Laparoscopic Cholecystectomy: A Systematic Review of Current Evidence and Future Perspectives

BACKGROUND

The Critical View of Safety (CVS) has been increasingly recognised as the standard method for identification of the cystic structures, to prevent vasculobiliary injuries during laparoscopic cholecystectomy, however, its adoption has been anything but universal. A significant proportion of surgeons has a poor understanding of the three requirements. To bridge this gap between theory and practice, we aimed to summarise the available evidence on CVS, emphasising on current debates and future perspectives.

METHOD

We systematically reviewed the literature (1995-2021), to identify studies reporting on the CVS. Eligible articles were classified according to methodology and key idea. A quantitative analysis was performed to evaluate effectiveness of the CVS in preventing bile duct injury (BDI).

RESULTS

150 relevant articles were identified, focusing on six main points, (1) safety and effectiveness, (2) intraoperative documentation, (3) complementary imaging techniques, (4) bail-out alternatives, (5) adoption among surgeons, and (6) education and training. The quantitative analysis included 11 studies, with 10,938 cases. Overall, the CVS was achieved in 92.5%. Conversion rate was 4.8%. CVS-related BDI was 0.09% (0.05% technical errors and 0.04% misidentification errors).

CONCLUSION

Routine application of the CVS reduces BDI, but does not eliminate them altogether. Besides operative notes, the CVS should be documented by an imaging modality of sufficient quality. When the CVS cannot be safely established, the threshold for bail-out alternatives or complementary imaging should be low. Adoption by the surgical community worldwide shows great variability and focus should be placed on training through structured educational modules.

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.

Assessment of Esophagectomy Videos on YouTube: Is Peer Review Necessary for Quality?

INTRODUCTION

Various online platforms, such as YouTube, are used for surgical education. Esophageal surgery is sophisticated and surgical videos may help reduce the time it takes for surgeons to learn these complicated operations. There is no clear consensus regarding the quality and reliability of esophagectomy videos on YouTube. We aimed to evaluate esophageal surgery videos published on YouTube in terms of quality and reliability.

METHODS

The keywords "esophagectomy" and "surgery" were both searched on YouTube and the first 150 results were evaluated. Eighty two videos were included in the analysis. The quality and reliability of the videos were determined using the esophagectomy scoring system (ESS) developed by the authors, the Journal of the American Medical Association benchmark criteria, and the video power index.

RESULTS

A total of 82 videos were reviewed. About two-thirds of the videos demonstrated the Ivor Lewis technique and included surgeries performed using the thoracoscopic/laparoscopic method. The videos were analyzed as per the source of the upload: academic (25.7%), industry-sponsored (9.7%), or individual (64.6%). When the scores were compared by the origin of the videos, industry-sponsored videos scored significantly higher than the videos produced by individuals and academic centers (P = 0.01). While the ESS and Journal of the American Medical Association benchmark criteria scores were significantly correlated (P = 0.00), no correlation was found between video length, video power index score, and ESS score.

CONCLUSIONS

Conducting a professional evaluation of videos before they are published on YouTube may enhance video quality. Moreover, valuable videos of better quality can be produced by improving the ESS and by assessing more videos.

YouTube as an Information Resource for Persons Interested in Septoplasty and/or Turbinoplasty

Background and Objectives

YouTube is a widely used web site. In general, many people search for medical information on YouTube. We evaluated the septoplasty and turbinoplasty videos on YouTube from an expert's point of view.

Methods

We used "septoplasty," "turbinoplasty," and "septoplasty turbinoplasty" to search YouTube. Of the 150 videos, we eventually viewed 83. Two researchers assessed the sources, lengths, and numbers of likes, dislikes, and views. The videos were classified as "excellent," "moderate," or "poor" in terms of utility; we also evaluated the uploaded material and content.

Results

Of the 83 videos, 18 (21.7%) were excellent, 27 (32.5%) were moderate, and 38 (45.8%) were poor. We found no significant differences in length and mean likes, dislikes, and views between the groups classified as useful. Fifteen (39.5%) of 38 poor videos were by patients, and 13 (34.2%) of 38 poor videos were by physicians. When organized by content type, videos on personal experiences were significantly longer than the others. Of 20 videos on personal experiences, 15 (75%) were poor and all 5 advertisement videos (100%) were poor.

Conclusion

Information from YouTube on septoplasty and turbinoplasty is not yet adequate. However, since YouTube content cannot be controlled, it is necessary to upload objective and accurate videos for patients and experts in professional groups such as the medical society. Such videos should be promoted and used actively.

Can "YouTube" help healthcare workers for learning accurate donning and doffing of personal protective equipments?

INTRODUCTION

Healthcare workers have a high risk of cross-infection during the care of Covid-19 cases. Personal protective equipment can reduce the risk. However, healthcare workers must be trained for the proper use of personal protective equipment to decrease exposure risk. This study aimed to investigate whether videos available on YouTube, presenting procedures of donning and doffing personal protective equipment, can be a useful learning resource for healthcare workers.

METHODS

A search of YouTube was conducted using the keywords "Covid-19, personal protective equipment, donning, doffing". Two investigators reviewed each video and collected the basic video information. Total videos were assessed independently as educationally useful and non-useful categories using a valid tool. The relationship of each video's usefulness with viewers' preferences and the upload source were analyzed.

RESULTS

A total of 300 videos were assessed; 66 (22%) fulfilled the inclusion criteria. Total video scores of educationally useful videos were higher than non-useful ones; the differences were significant. Healthcare/government agencies and hospitals mostly created educationally useful videos, e-learning platforms, and individuals mainly created non-useful videos. Significant correlations were observed between the video's usefulness and the total view and views per day.

CONCLUSIONS

During a pandemic, YouTube might be a resource for learning donning and doffing of personal protective equipment for healthcare workers if an appropriate selection process applied for determining educationally useful videos.

YouTube and Radiology: The Viability, Pitfalls, and Untapped Potential of the Premier Social Media Video Platform for Image-Based Education

RATIONALE AND OBJECTIVES

There are several popular radiology channels on YouTube, reinforcing studies showing interest among medical students and trainees in video education and suggesting the potential use of YouTube for radiology education.

MATERIALS AND METHODS

The CTisus YouTube channel, dedicated to radiology education and based in the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins Hospital, has 25,000 subscribers. The benefits of this social media platform for radiology education were analyzed. The most popular videos (n = 484) from July 1, 2017 to June 30, 2020 were categorized into "case clips" (short displays of case images); "Facebook Live" (15-20 minute discussions later posted to YouTube); "lectures" (weekly PowerPoint lectures); and "quizzes" (10-question quiz discussions posted monthly). The number of days videos were available from July 2017 to June 2020 were counted and median views per 30 days were recorded. Lecture content was used to determine which of the following topics were more popular (received the most views) than others: Artificial intelligence, chest, gastrointestinal, genitourinary, musculoskeletal, neuro, physics, technique (such as protocols and contrast), technology, and vascular.

RESULTS

Facebook Live videos had the highest median views per 30 days (236.9), the highest median likes per 30 days (2.5), the highest median shares per 30 days (2.0), and the highest median subscribers gained per 30 days (0.7). Unlike video type, there was no obvious favorite lecture topic among viewers.

CONCLUSION

Viewers were most engaged with longer videos, with interaction and watch time indicating greater interest than simple clicks/views. YouTube is an easy-to-use and valuable platform for hosting video content. It reaches a global audience and provides what many radiology trainees and professionals are looking for: video instruction.

An ultrashort video can teach residents to perform a fingertip injury repair

BACKGROUND

Acute fingertip injuries are common. Providers in rural and underserved areas often transfer these patients due to lack of comfort and skill with treating these injuries. Current learners prefer short and high-density educational material. It is unknown if basic hand procedures can be taught using ultrashort training videos. This study investigates whether fingertip repair can be taught using a 60-second educational video viewed immediately prior to performing the procedure.

METHODS

A standardized cadaveric fingertip injury model was developed. Twenty-three emergency medicine residents each having minimal experience with fingertip injury repair were randomized into one of three study arms: A) no video, B) standard-length (8-minute) video, and C) ultrashort (60-second) video. Each subject was presented with an injured cadaveric finger and asked to prepare for and perform the repair within a 30-minute time frame. The repair was graded on a 10-point scale following a standard rubric. Time to completion, preparedness, and subjects' confidence were also assessed. Results were analyzed by one-way ANOVA and Kruskal-Wallis tests.

RESULTS

Mean repair scores for the standard-length video group (9.5 ± 0.3) and the ultrashort video group (9.2 ± 0.3) were significantly higher than those of the no video group (4.0 ± 0.3, p < 0.05 for both comparisons). Mean time to completion of the exercise was significantly shorter in the ultrashort video group (19 ± 2 minutes) than in the standard-length video group (26 ± 2 minutes). Subject-reported outcomes (median preparedness, median post-repair confidence, and median change in confidence following the procedure) were all significantly higher in the standard-length video group and the ultrashort video group than in the no video group (p < 0.05 for all comparisons).

CONCLUSION

A 60-second educational video viewed immediately prior to performing a fingertip injury repair can effectively teach an emergency medicine resident to correctly perform the procedure.

Are YouTube Videos a Reliable Training Method for Safe Laparoscopic Cholecystectomy? A Simulated Decision-Making Exercise to Assess the Critical View of Safety

Background  The present study assesses the educational value of laparoscopic cholecystectomy videos on YouTube regarding the correct application of the critical view of safety (CVS), and evaluates… surgical trainees' perceptions of the CVS criteria in a simulated, operative decision-making exercise.

Methods  YouTube was systematically searched for laparoscopic cholecystectomy videos, explicitly reporting a satisfactory CVS. The top 30 most popular videos, by number of views, were identified and scored on the 6-point scale by three experienced consultants. After watching a training module on CVS rationale and criteria, 10 trainees, blinded to the consultants' assessment, were instructed to view the videos, score each criterion and answer the binary question “Would you divide the cystic structures?” by “yes” or “no.”

Results  An inadequate CVS was found in 30% of the included videos. No statistical association was noted between number of views, likes, or dislikes with successful CVS rates. Inter-observer agreement between consultants and trainees ranged from minimal to moderate ( k  = 0.07–0.60). Discrepancy between trainees' CVS scores and their simulated decision to proceed to division of the cystic structures was found in 15% of assessments, with intra-observer agreement ranging from minimal to excellent ( k  = 0.27–1.0). For the CVS requirements, inter-observer agreement was minimal for the dissection of the cystic plate ( k  = 0.26) and triangle clearance ( k  = 0.39) and moderate for the identification of two and only two structures ( k  = 0.42).

Conclusion  The CVS is central to the culture of safety in laparoscopic cholecystectomy. Surgical videos are a useful training tool as simulated, operative decision-making exercises. However, public video platforms should be used judiciously, since their content is not peer-reviewed or quality-controlled.

Evaluation of YouTube laparoscopic hysterectomy videos as educational materials during the COVID-19 era using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) and LAP-VEGaS video assessment tool

With increasing numbers of laparoscopic hysterectomies, surgical trainees are compelled to learn more about endoscopy. Owing to coronavirus disease-related social distancing requirements, online education has gained prominence. Here, we aimed to investigate the laparoscopic hysterectomy video quality on YouTube using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). YouTube was searched on June 7, 2020 using 'laparoscopic hysterectomy'. Three examiners evaluated videos using Global Operative Assessment of Laparoscopic Skills (GOALS). Subsequently, videos were assessed for their conformity to the LAP-VEGaS and LAP-VEGaS Video Assessment Tool. Interobserver reliability was estimated using intraclass coefficients and Cronbach's alpha. Cochran's Q test was used to determine correlations among quantitative data. The median GOALS score was 21.50. The observers' GOALS scores were significantly correlated. The results showed low conformity to the LAP-VEGaS. YouTube is the most used platform among trainees. The low YouTube video educational quality highlights the necessity for peer review, as trainees increasingly seek such resources during the pandemic.IMPACT STATEMENTWhat is already known on this subject? YouTube is the most commonly used online resource for educational material among surgical trainees. Online videos usually do not undergo a peer-review process. The LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) may be used to assess the educational quality of surgical videos.What do the results of this study add? To our knowledge, this is the first study on the quality of laparoscopic hysterectomy videos available on YouTube and the first study to evaluate YouTube laparoscopic surgery videos using the LAP-VEGaS Video Assessment Tool (VAT). Our study revealed the low educational quality of YouTube laparoscopic hysterectomy videos. The LAP-VEGaS VAT seems to be a valid and practical tool for assessing online laparoscopic hysterectomy videos.What are the implications of these findings for clinical practice and/or further research? Medical communities, especially tertiary care or academic centres, may upload educational peer-reviewed videos for trainees seeking this type of resource, especially during the coronavirus disease pandemic, as surgical education alternatives are limited.

The Content Quality of YouTube Videos for Professional Medical Education: A Systematic Review

PURPOSE

To evaluate the content quality of YouTube videos intended for professional medical education based on quality rating tool (QRT) scores and determine if video characteristics, engagement metrics, or author type are associated with quality.

METHOD

The authors searched 7 databases for English-language studies about the quality of YouTube videos intended for professional medical education from each database's inception through April 2019. To be included, studies had to be published in 2005 (when YouTube was created) or later. Studies were classified according to the type of QRT used: externally validated, internally validated, or limited global. Study information and video characteristics and engagement metrics were extracted. Videos were classified by video author type.

RESULTS

Thirty-one studies were included in this review. Three studies used externally validated QRTs, 20 used internally validated QRTs, and 13 used limited global QRTs. Studies using externally validated QRTs had average scores/total possible scores of 1.3/4, 26/80, and 1.7/5. Among the 18 studies using internally validated QRTs, from which an average percentage of total possible QRT score could be computed or extracted, the average score was 44% (range: 9%-71%). Videos with academic-physician authors had higher internally validated QRT mean scores (46%) than those with nonacademic-physician or other authors (26%; P < .05).

CONCLUSIONS

The authors found a wide variation in QRT scores of videos, with many low QRT scores. While videos authored by academic-physicians were of higher quality on average, their quality still varied significantly. Video characteristics and engagement metrics were found to be unreliable surrogate measures of video quality. A lack of unifying grading criteria for video content quality, poor search algorithm optimization, and insufficient peer review or controls on submitted videos likely contributed to the overall poor quality of YouTube videos that could be used for professional medical education.

Quality of YouTube Videos on Laparoscopic Cholecystectomy for Patient Education

Background

Surgical patients frequently seek information from digital sources, particularly before common operations such as laparoscopic cholecystectomy (LC). YouTube provides a large amount of free educational content; however, it lacks regulation or peer review. To inform patient education, we evaluated the quality of YouTube videos on LC.

Methods

We searched YouTube with the phrase “laparoscopic cholecystectomy.” Two authors independently rated quality of the first 50 videos retrieved using the JAMA, Health on the Net (HON), and DISCERN scoring systems. Data collected for each video included total views, time since upload, video length, total comments, and percentage positivity (proportion of likes relative to total likes plus dislikes). Interobserver reliability was assessed using an intraclass correlation coefficient (ICC). Association between quality and video characteristics was tested.

Results

Mean video quality scores were poor, scoring 1.9/4 for JAMA, 2.0/5.0 for DISCERN, and 4.9/8.0 for HON. There was good interobserver reliability with an ICC of 0.78, 0.81, and 0.74, respectively. Median number of views was 21,789 (IQR 3000–61,690). Videos were mostly published by private corporations. No video characteristic demonstrated significant association with video quality.

Conclusion

YouTube videos for LC are of low quality and insufficient for patient education. Treating surgeons should advise of the website's limitations and direct patients to trusted sources of information.

Contribution of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Videos on YouTube to the Learning Curve in COVID-19 Pandemic Process

INTRODUCTION

YouTube is a free video-sharing platform, which is watched by residents or specialists in order to catch up on their skills, see new techniques, and have information. In this study, our purpose is to evaluate whether or not these videos are an appropriate educational source for surgeons by analyzing their quality and content, in an environment of reduced elective operations due to the COVID-19 pandemic.

METHODS

YouTube video search was performed by entering keywords such as CRS and HIPEC, cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, cytoreductive surgery, and HIPEC. A total of 115 videos were found. Videos were divided into two groups as those containing operation videos and those that do not (slides, congress presentations, and informative videos). And then, for evaluating operation videos, a scoring system was defined based on CRS + HIPEC steps as defined by Sugarbaker and video quality.

RESULTS

There were 45 operation videos and 70 videos of other content. The total number of views, number of views per day, and the total number of likes and comments were all significantly higher in the operation video group (p values 0.003-0.002-0.004-0.002). No statistically significant difference was found in the median values of the number of views, likes, and dislikes; the number of views per day; the number of comments; and the dates of uploads within different video-scoring system groups.

CONCLUSION

Our study shows that there is an increasing interest in CRS + HIPEC videos on YouTube. On the other hand, when the educational value of these videos that are receiving attention is considered, we believe it is not right to adjudicate due to the fact that the numbers are very low.

Reliability and Quality of YouTube Videos on Ultrasound-Guided Brachial Plexus Block: A Programmatical Review

BACKGROUND

Ultrasound-guided regional anesthesia has gained popularity over the last decade. This study aimed to assess whether YouTube videos sufficiently serve as an adjunctive tool for learning how to perform an ultrasound-guided brachial plexus block (BPB).

METHODS

All YouTube videos were classified, based on their sources, as either academic, manufacturer, educational, or individual videos. The metrics, accuracy, utility, reliability (using the Journal of American Medical Association Score benchmark criteria (JAMAS)), and educational quality (using the Global Quality Score (GQS) and Brachial Plexus Block Specific Quality Score (BSQS)) were validated.

RESULTS

Here, 175 videos were included. Academic (1.19 ± 0.62, mean ± standard deviation), manufacturer (1.17 ± 0.71), and educational videos (1.15 ± 0.76) had better JAMAS accuracy and reliability than individual videos (0.26 ± 0.67) (p < 0.001). Manufacturer (11.22 ± 1.63) and educational videos (10.33 ± 3.34) had a higher BSQS than individual videos (7.32 ± 4.20) (p < 0.001). All sources weakly addressed the equipment preparation and post-procedure questions after BSQS analysis.

CONCLUSIONS

The reliability and quality of ultrasound-guided BPB videos differ depending on their source. As YouTube is a useful educational platform for learners and teachers, global societies of regional anesthesiologists should set a standard for videos.

Evaluation of the Quality, Educational Value and Utility of the Videos on YouTube for Laparoscopic Low Anterior Resection

BACKGROUND

Minimally invasive surgery is a rising trend in colorectal surgery and is on its way to becoming the gold standard due to the benefits it provides for patients. This study aims to test the efficacy for educational purposes by evaluating the videos published on YouTube (www.youtube.com) channel for low anterior resection procedure in rectum surgery.

METHODS

We searched YouTube on October 17, 2020 to choose video clips that included relevant information about laparoscopic low anterior resection (LAR) for rectal cancer.

RESULTS

We included 25 academics and 75 individual videos in this study. The teaching quality of the videos was evaluated according to academic and individual videos, and it was seen that the teaching quality scores of academic videos were higher and this result was statistically significant (P = .03). The modified Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) criteria were found that the score was higher in individual videos (P = .014). The median Video Power Index (VPI) value was 1.50 (range .05-347) and the mean ratio was 7.01 ± 3.52. There was no statistically significant difference between the 2 groups (P = .443).

DISCUSSION

Video-based surgical learning is an effective method for surgical education. Our study showed that the video quality and educational content of most of the videos about the low anterior resection procedure on YouTube were low. The videos of academic origin seem more valuable than individual videos. As far as video popularity is concerned, YouTube viewers are not selective. For this reason, training videos to be used for educational purposes must be passed through a standardized evaluation filter.

LIVE FM (lecture improvised with video elements in forensic medicine): does a video worth a thousand pictures? A comparative study in medical education

Forensic education should be fully conversant with a scientific theory of how students learn. By and large, the traditional model of education is widely accepted. 'Difficult-to-learn' areas in forensic medicine are the challenges to students as well as teachers. An innovative modality 'lectures improvised with video elements' was used by authors in the undergraduate medical education program of Forensic Medicine in order to facilitate active learning. Evaluation of this approach has established a positive impact on student's spatial ability, reasoning ability, and memory skills. Intrinsic cognitive load on working memory was reduced to a certain extent. With compare to the static pictures, video usage significantly helps to comprehend the difficult content of the learning. Students found the experience interesting and very ardent to use it again.

Can "YouTube" help healthcare workers for learning accurate donning and doffing of personal protective equipments?

INTRODUCTION

Healthcare workers have a high risk of cross-infection during the care of Covid-19 cases. Personal protective equipment can reduce the risk. However, healthcare workers must be trained for the proper use of personal protective equipment to decrease exposure risk. This study aimed to investigate whether videos available on YouTube, presenting procedures of donning and doffing personal protective equipment, can be a useful learning resource for healthcare workers.

METHODS

A search of YouTube was conducted using the keywords "Covid-19, personal protective equipment, donning, doffing". Two investigators reviewed each video and collected the basic video information. Total videos were assessed independently as educationally useful and non-useful categories using a valid tool. The relationship of each video's usefulness with viewers' preferences and the upload source were analyzed.

RESULTS

A total of 300 videos were assessed; 66 (22%) fulfilled the inclusion criteria. Total video scores of educationally useful videos were higher than non-useful ones; the differences were significant. Healthcare/government agencies and hospitals mostly created educationally useful videos, e-learning platforms, and individuals mainly created non-useful videos. Significant correlations were observed between the video's usefulness and the total view and views per day.

CONCLUSIONS

During a pandemic, YouTube might be a resource for learning donning and doffing of personal protective equipment for healthcare workers if an appropriate selection process applied for determining educationally useful videos.

IVORY Guidelines (Instructional Videos in Otorhinolaryngology by YO-IFOS): A Consensus on Surgical Videos in Ear, Nose, and Throat

Objectives/Hypothesis

Otolaryngology instructional videos available online are often of poor quality. The objective of this article was to establish international consensus recommendations for the production of educational surgical videos in otolaryngology.

Study Design

DELPHI survey.

Methods

Twenty‐seven international respondents participated in this study from 12 countries. Consensus was reached after three rounds of questionnaires following the Delphi methodology. The proposals having reached the 80% agreement threshold in the third round were retained.

Results

The main recommendations are as follows: 1) Ethics: patients must be anonymized and unrecognizable (apart from plastic surgery if necessary). A signed authorization must be obtained if the person is recognizable. 2) Technical aspects: videos should be edited and in high‐definition (HD) quality if possible. Narration or subtitles and didactic illustrations are recommended. 3) Case presentation: name of pathology and procedure must be specified; the case should be presented with relevant workup. 4) Surgery: surgical procedures should be divided into several distinct stages and include tips and pitfalls. Pathology should be shown if relevant. Key points should be detailed at the end of the procedure. 5) Organ‐specific: type of approach and bilateral audiometry should be specified in otology. Coronal plane computed tomography scans should be shown in endonasal surgery. It is recommended to show pre‐ and postoperative videos in voice surgery and preoperative drawings and photos of scars in plastic surgery, as well as the ventilation method in airway surgery.

Conclusions

International recommendations have been determined to assist in the creation and standardization of educational surgical videos in otolaryngology and head and neck surgery.

Level of Evidence

5 Laryngoscope, 131:E732–E737, 2021

YouTube as a Source of Information and Education on Hysterectomy

BACKGROUND

Globally, YouTube is one of the most popular websites, and the content is not restricted to entertainment. The purpose of this study was to assess the quality of information in YouTube videos pertaining to hysterectomy.

METHODS

We explored YouTube using the search terms "hysterectomy" and "remove uterus." The videos that appeared were sorted using the filter "sort by view count." Of the initial 100 videos, the top 50 videos for each search term were included for review, as determined by the "relevance" filter based on YouTube's algorithm. After excluding 34 videos for various reasons, 66 were included in the final analysis. Each video rated as "useful" was further analyzed for reliability and completeness of information; a set of pre-determined criteria were modified from a previous study and used to grade the quality of videos.

RESULTS

The top 66 videos on hysterectomy had a total of 4,679,118 views. Based on authorship, the videos were categorized as follows: videos uploaded by patients, 37%; academic videos, 35%; videos uploaded by physicians, 13%; commercial videos, 4%; and videos uploaded by non-physicians, 2%. The type of content was also categorized: 50% of the videos recorded personal experiences, 23% recorded surgical techniques, 21% involved explanations of the surgery, and 4% were commercial videos. The majority of the videos made by patients were negatively biased toward hysterectomy surgery (71.72%), while the majority of those made by academics or physicians were surgical educational videos for doctors, not patients.

CONCLUSION

YouTube is currently not an appropriate source for patients to gain information on hysterectomy. Physicians should be aware of the limitations and provide up-to-date and peer-reviewed content on the website.

The role of online videos in teaching procedural skills to post-graduate medical learners: A systematic narrative review

Objective: Online videos are commonly used in medical education. The aim of this review was to investigate the role of online instructional videos in teaching procedural skills to postgraduate medical learners.Methods: This systematic narrative review was conducted according to the PRISMA guidelines. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, ERIC and Google Scholar were searched. Full texts that applied to online videos, postgraduate medical learners and procedural skills were included without language restrictions. The methodological quality of the studies was evaluated using a validated tool. A thematic analysis of the studies was carried out using a general inductive approach.Results: A total of 785 articles were retrieved and the full text was reviewed for 66 articles that met the inclusion and exclusion criteria of the study. Twenty papers that were relevant to the role of online videos in postgraduate medical education of procedural skills were used for this review. They were heterogenous in the outcomes collected and the evidence was of variable quality. There was strong evidence for the use of online videos for procedural skill knowledge acquisition and retention. Online videos were used for various purposes, such as supervision, assessment, postoperative debriefing, providing feedback, and promoting reflection.Conclusion: Online videos are a valuable educational tool especially for procedural skill knowledge acquisition and retention. Future research needs to be carried out on the appropriate use of platforms in disseminating and using online videos, identifying the factors surrounding the learners, video characteristics, and data protection.

Comparison of New Era's Education Platforms, YouTube® and WebSurg®, in Sleeve Gastrectomy

INTRODUCTION

The Internet is a widely used resource for obtaining medical information. However, the quality of information on online platforms is still debated. Our goal in this quality-controlled WebSurg® and YouTube®-based study was to compare these two online video platforms in terms of the accuracy and quality of information about sleeve gastrectomy videos.

METHODS

Most viewed (popular) videos returned by YouTube® search engine in response to the keyword "sleeve gastrectomy" were included in the study. The educational accuracy and quality of the videos were evaluated according to known scoring systems. A novel scoring system measured technical quality. The ten most viewed (popular) videos in WebSurg® in response to the keyword "sleeve gastrectomy" were compared with ten YouTube® videos with the highest educational/technical scores.

RESULTS

Scoring systems measuring the educational accuracy and quality of WebSurg® videos were significantly higher than ten YouTube® videos which have the most top technical scores (p < 0.05), and no significant difference was found in the assessment of ten YouTube® videos that have the highest technical ratings compared with WebSurg® videos (p 0.481).

CONCLUSIONS

WebSurg® videos, which were passed through a reviewing process and were mostly prepared by academicians, remained below the expected quality. The main limitation of WebSurg® and YouTube® is the lack of information on preoperative and postoperative processes.

Is Youtube a potential training source for total extraperitoneal laparoscopic inguinal hernia repair?

BACKGROUND

The aim of this study is to evaluate the quality of the most commonly viewed total extraperitoneal laparoscopic inguinal hernia repair (TEP) videos on Youtube, which is the largest social and medical media broadcasting service, concerning educational purposes.

METHOD

A search with the keyword "total extraperitoneal laparoscopic inguinal hernia repair" was performed on Youtube. The first 120 videos among the search results were downloaded and 55 of them were included in the study. A scoring system developed by the authors according to the recent literature was utilized for evaluation of the videos. Video demographics were evaluated for the quality and upload source.

RESULTS

Among the enrolled videos, video quality was rated as good in 13 (23.6%), as moderate in 22 (40%), and as poor in 20 (36.4%). Video length, presence of narration, number of likes, and comments were significantly higher in the good group. Upload source was an academic center in 14 (25.5%), a community hospital in 22 (40.0%), and a physician in 19 (34.5%). The mean video score of the academic center group (8 ± 4.095) and community hospital group (8.64 ± 3.259) was significantly higher than the physician group (5.47 ± 2.632) (p = 0.010). Video quality was not correlated with total views or views per day.

CONCLUSION

Total extraperitoneal laparoscopic inguinal hernia repair procedure videos uploaded to Youtube demonstrate considerable heterogeneity in terms of educational quality and the number of good quality videos is significantly low. This heterogeneity is attributed to the lack of peer review process for the evaluation of educational quality of the videos. Therefore, a physician intending to learn and practice a surgical procedure properly (TEP repair in this situation) should not consider a broadcasting service without a peer review process as a reliable training source.

Educational assessment of the major lower limb amputations videos on YouTube

Objective

Videos of surgical procedures are viewed by some as potential training resources for surgeons and residents. However, there is little evidence on the effectiveness of surgical videos on learning and understanding complex three-dimensional surgical procedures. Lower extremity amputation is a complex surgery, and many residents and surgeons have low exposure to this type of procedures. This paper investigates the educational quality of lower extremity amputation videos posted on YouTube.

Methods

The search was limited to the first 100 videos. Full-length videos of any major lower limb amputation or disarticulation were included. Key basic video data such as title, YouTube address (http://), country of origin, channel source, uploading date, video duration time, number of views, number of up-voters and number of down-voters were collected. An educational assessment tool has been developed specifically for limb amputations. It consists in 11 items: three general and eight amputation-specific, each having a maximum score of 2.

Results

In total, 13 videos met the inclusion criteria for final analysis. Four videos reported the surgical technique of above knee amputation, two reported that of knee disarticulation and the remaining seven videos described below knee amputation. The average score (±SD) was 12.77 ± 5.2 yielding an average grade close to “Fair.” A high level of concordance was found between the two assessors ( κ = 0.79). No correlation was found between educational assessment tool score and the pre-set variables (r = 0.6, R2 = 35.4%, F = 1.09, P = 0.4).

Conclusions

Most videos describing lower extremity amputation techniques were found to be of low-to-moderate quality. Only 4 out of 13 (30.7%) had an excellent educational and technical quality. Surgeons and surgical residents should be aware that not all posted videos on YouTube are beneficial. High educational quality videos are needed since many surgeons and residents have a low exposure to such surgeries.

Youtube as a Source of Patients' and Specialists' Information on Hemorrhoids and Hemorrhoid Surgery

BACKGROUND

In the past, most people sought medical information by consulting health care professionals. Nowadays, many people started to use online resources to access medical information.

OBJECTIVE

The study aims to investigate whether YouTube videos on hemorrhoids and hemorrhoid surgery can be a useful e-learning source for the general population, surgical trainees and specialists.

METHODS

A YouTube search was performed in October 2019 using the keywords "hemorrhoids" and "hemorrhoid surgery", and the videos were divided into 2 groups according to the keywords. Three independent researchers assessed the metadata and classified them according to the level of accuracy (hemorrhoid group) and the level of usefulness (hemorrhoid surgery group). Cohen's test and Kappa (K) value were used to evaluate the inter-investigators agreement.

RESULTS

A total of 200 videos were analyzed, 100 for each keyword. Regarding the hemorrhoid group, 43 videos (48.3%) were misleading, 9 were accurate (10.1%), 18 were approximate (20.2%), and 19 were considered a personal experience (21.4%). Regarding the hemorrhoid surgery group, around 60% of the videos were lacking a clear explanation, while about 16% were inaccurate. Only the remaining 24% were considered useful for teaching.

CONCLUSION

Around half of the YouTube videos regarding hemorrhoids topic were found to be misleading or inaccurate and present a risk of harmful consequences. Credible videos with accurate information need to be uploaded by medical professionals and medical institutions and some sort of filtering, using categories by the staff of YouTube, appears to be necessary. Care must be taken to produce clear, high-quality operative clips with proper scientific commentary.

Analysis of the Educational Value of YouTube Laparoscopic Appendectomy Videos

Purpose

To evaluate the educational value of laparoscopic appendectomy (LA) videos on YouTube for surgical trainees.

Methods

The search term “Laparoscopic appendectomy” was used on YouTube. The top 100 videos sorted by the number of views were evaluated. Each YouTube account was analyzed, and only videos uploaded by medical physicians were included in this study. Video quality was evaluated using an arbitrary appendectomy scoring system. Video characteristics and Global Operative Assessment of Laparoscopic Skills (GOALS) scores were analyzed regarding video quality and upload source.

Results

The video quality of 14 (25.0%) videos was graded as good, 36 (64.3%) moderate, and 6 (10.7%) of poor quality. Video characteristic analysis showed no differences in video quality according to the upload source (p=0.573). Video quality and upload source were not related to video length, total views, days online, number of likes, number of dislikes, number of comments, or GOALS score. Among the factors analyzed, only appendicitis severity was found to be associated with video grade (p=0.049).

Conclusion

The quality of LA YouTube videos varied. Categories considered as viewer feedback were not associated with video grade or upload source. Responsible video uploading by academic institutions, and appropriate censorship by YouTube seems necessary. Further research with objective data on actual application to surgical trainees is necessary.

Evaluation of the Reliability, Utility, and Quality of Information Used in Total Extraperitoneal Procedure for Inguinal Hernia Repair Videos Shared on WebSurg

Purpose The Internet is widely used by patients and physicians for obtaining medical information. WebSurg is a valuable information resource that can improve the learning experience of medical professionals if used appropriately. This study aimed to evaluate the quality and accuracy of videos on the total extraperitoneal procedure (TEP) for inguinal hernia repair. Methods We included 32 videos returned by the WebSurg search engine in response to the keyword "TEP." Video popularity was evaluated using the video power index (VPI). The videos' educational quality was measured using the DISCERN score, Journal of American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). Technical quality was measured using the TEP Scoring System (TepSS) by three surgeons who performed TEP routinely. Results All videos were obtained from medical doctors; 12.5% of the videos were uploaded from Belgium; 3.1%, China; 6.3%, Colombia; 6.3%, England; 59.4%, France; 9.4%, Germany; and 3.1%, Korea. No significant differences were noted in terms of the VPI, DISCERN scores, JAMA benchmark criteria, GQSs, and TepSS scores (p > 0.05). The mean VPI, DISCERN score, JAMA benchmark criteria, GQS, and TepSS score were 9454.53 ± 15085.57, 32.75 ± 6.99, 2.31 ± 0.47, 1±0, and 9.25 ± 2.36, respectively. No significant associations were noted between the VPI and DISCERN score, JAMA benchmark criteria, and GQS (p > 0.05). Similarly, there was no significant association between the VPI and TepSS scores (r = 0.100; p = 0.587). Conclusions The online information on TEP is of suboptimal quality. Although limited information is available on preoperative and postoperative processes, the educational potential of WebSurg cannot be ignored.

Does YouTube include high-quality resources for training on laparoscopic and robotic radical prostatectomy?

PURPOSE

Our aim was to assess the educational quality of the YouTube video content related to laparoscopic and robotic radical prostatectomy (RP).

METHODS

An objective scoring tool named as Prostatectomy Assessment and Competency Evaluation (PACE) score was used to measure and quantify seven critical steps in RP including bladder drop, preparation of the prostate, bladder neck dissection, posterior/seminal vesicle dissection, neurovascular bundle preservation, apical dissection, and urethro-vesical anastomosis. A five-point scale was used for grading the seven steps, where a score of 1 and 5 represented the lowest and ideal performance, respectively. Additionally, descriptive statistics including the upload time, video length, view count, number of comments, likes, and dislikes were all recorded.

RESULTS

Of the 1688 videos (551 from laparoscopic RP, 567 from robotic RP, and 570 from robot-assisted RP), 226 videos were analyzed after excluding duplicate and irrelevant videos. Robotic/robot-assisted RP videos were found to be statistically longer than laparoscopic RP videos (p = 0.016). The PACE score of urethro-vesical anastomosis step in robotic RP videos was statistically higher than laparoscopic RP videos (p = 0.021). A weak but significant positive correlation between the video length and total PACE score (rho: 0.51; p = 0.04 for laparoscopic RP and rho: 0.43; p = 0.03 for robotic/robot-assisted RP) was found. A weak but positive correlation was also determined between number of likes and total PACE score (rho: 0.39; p = 0.02) for robotic/robot-assisted RP videos.

CONCLUSIONS

Although YouTube website includes high-quality videos for both laparoscopic and robotic/robot-assisted RP, there is no objective parameter to predict the educational quality of the videos.

YouTube as a learning tool for four shoulder tests

AIM

To analyze the use of YouTube videos as educational tools for four physical examinations of the shoulder: the Neer, Hawkins, empty can, and drop arm tests.

BACKGROUND

Video-based education, which is accompanied by text-based education, can be an effective education method, especially in learning medical skills. Medical students and doctors in training often use YouTube videos to share medical education materials, and more systematic review of the reliability of these videos is required.

METHODS

A search of YouTube was conducted using four keywords: 'Neer test,' 'Hawkins test,' 'empty can test,' and 'drop arm test.' Two physicians reviewed each video and recorded a variety of characteristics (date uploaded, number of views, likes and dislikes, and upload source). In addition, they scored and categorized the videos into four groups: 'very useful,' 'somewhat useful,' 'not useful,' and 'misleading.' Videos containing inappropriate content were classified as 'misleading.' Finally, the correlations of each video's usefulness with viewers' preferences and the upload source were analyzed.

RESULTS

A total of 400 videos were assessed and 200 videos were adopted which yield eligible criteria. Out of 200 videos, 51 videos were very useful and 32 were misleading. Significant correlations were observed between the video's usefulness and the uploaded source, as well as between the video's usefulness and viewers' preferences, such as the number of views, views per day, and number of likes. The proportion of videos classified as 'very useful' was highest (58.6%) among those uploaded by physicians and lowest (12.7%) among those uploaded by individuals. Videos uploaded by individuals had significantly lower values reflecting viewer preferences than did videos uploaded by physicians.

CONCLUSION

YouTube videos could be used as learning sources for shoulder physical examinations after the application of appropriate filtering processes, such as review of the upload source and viewers' preferences.

Concerns of Quality and Safety in Public Domain Surgical Education Videos: An Assessment of the Critical View of Safety in Frequently Used Laparoscopic Cholecystectomy Videos

BACKGROUND

Online videos are among the most common resources for case preparation. Using crowd sourcing, we evaluated the relationship between operative quality and viewing characteristics of online laparoscopic cholecystectomy videos.

STUDY DESIGN

We edited 160 online videos of laparoscopic cholecystectomy to 60 seconds or less. Crowd workers (CW) rated videos using Global Objective Assessment of Laparoscopic Skills (GOALS), the critical view of safety (CVS) criteria, and assigned overall pass/fail ratings if CVS was achieved; linear mixed effects models derived average ratings. Views, likes, dislikes, subscribers, and country were recorded for subset analysis of YouTube videos. Spearman correlation coefficient (SCC) assessed correlation between performance measures.

RESULTS

One video (0.06%) achieved a passing CVS score of ≥5; 23%, ≥4; 44%, ≥3; 79%, ≥2; and 100% ≥1. Pass/fail ratings correlated to CVS, SCC 0.95 (p < 0.001) and to GOALS, SCC 0.79 (p < 0.001). YouTube videos (n = 139) with higher views, likes, or subscribers did not correlate with better quality. The average CVS and GOALS scores were no different for videos with >20,000 views (22%) compared with those with <20,000 (78%).

CONCLUSIONS

There is an incredibly low frequency of CVS and average GOALS technical performance in frequently used online surgical videos of LC. Favorable characteristics, such as number of views or likes, do not translate to higher quality.

Reliability of trauma management videos on YouTube and their compliance with ATLS® (9th edition) guideline

OBJECTIVE

In this study, the reliability of trauma management scenario videos (in English) on YouTube and their compliance with Advanced Trauma Life Support (ATLS^®) guidelines were investigated.

METHODS

The search was conducted on February 15, 2016 by using the terms "assessment of trauma" and ''management of trauma''. All videos that were uploaded between January 2011 and June 2016 were viewed by two experienced emergency physicians. The data regarding the date of upload, the type of the uploader, duration of the video and view counts were recorded. The videos were categorized according to the video source and scores.

RESULTS

The search results yielded 880 videos. Eight hundred and thirteen videos were excluded by the researchers. The distribution of videos by years was found to be balanced. The scores of videos uploaded by an institution were determined to be higher compared to other groups (p = 0.003).

CONCLUSION

The findings of this study display that trauma management videos on YouTube in the majority of cases are not reliable/compliant with ATLS-guidelines and can therefore not be recommended for educational purposes. These data may only be used in public education after making necessary arrangements.

[YouTube as an information source of spinal anesthesia, epidural anesthesia and combined spinal and epidural anesthesia]

INTRODUCTION

Social media as YouTube have become a part of daily life and many studies evaluated health-related YouTube videos. Our aim was to evaluate videos available on YouTube for the conformity to textbook information and their sufficiency as a source for patient information.

MATERIAL AND METHOD

A search of the YouTube website was performed using the keywords "spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia". Firstly, 180 videos were evaluated and the characteristics of the video were noted, and the features of the video too were noted if the video was regarding neuraxial anesthesia. Questionnaire 1 (Q1) evaluating the video quality relating to neuraxial anesthesia was designed using a textbook as reference and questionnaire 2 (Q2) was designed for evaluating patient information.

RESULTS

After exclusions, 40 videos were included in the study. There was no difference in Q1 or Q2 scores when videos were grouped into 4 quarters according to their appearance order, time since upload or views to length rate (p>0.05). There was no statistical difference between Q1 or Q2 scores for spinal, epidural or combined videos (p>0.05). Videos prepared by a healthcare institute have a higher score in both Questionnaires 1 and 2 (10.87±4.28 vs. 5.84±2.90, p=0.044 and 3.89±5.43 vs. 1.19±3.35, p=0.01 respectively).

CONCLUSION

Videos prepared by institutes, societies, etc. were of higher educational value, but were still very lacking. Videos should be prepared in adherence to available and up-to-date guidelines taking into consideration appropriate step by step explanation of each procedure, patient safety and frequently asked questions.

YouTube as a Potential Training Resource for Laparoscopic Fundoplication

OBJECTIVE

To analyze the surgical proficiency and educational quality of YouTube videos demonstrating laparoscopic fundoplication (LF).

DESIGN

In this cross-sectional study, a search was performed on YouTube for videos demonstrating the LF procedure. The surgical and educational proficiency was evaluated using the objective component rating scale, the educational quality rating score, and total video quality score. Statistical significance was determined by analysis of variance, receiver operating characteristic curve, and odds ratio analysis.

RESULTS

A total of 71 videos were included in the study; 28 (39.4%) videos were evaluated as good, 23 (32.4%) were moderate, and 20 (28.2%) were poor. Good-rated videos were significantly longer (good, 22.0 ± 5.2min; moderate, 7.8 ± 0.9min; poor, 8.5 ± 1.0min; p = 0.007) and video duration was predictive of good quality (AUC, 0.672 ± 0.067; 95% CI: 0.541-0.802; p = 0.015). For good quality, the cut-off video duration was 7:42 minute. This cut-off value had a sensitivity of 67.9%, a specificity of 60.5%, and an odds ratio of 3.23 (95% CI: 1.19-8.79; p = 0.022) in predicting good quality. Videos uploaded from industrial sources and with a higher views/days online ratio had a higher objective component rating scale and total video quality score. In contrast, the likes/dislikes ratio was not predictive of video quality.

CONCLUSIONS

Many videos showing the LF procedure have been uploaded to YouTube with varying degrees of quality. A process for filtering LF videos with high surgical and educational quality is feasible by evaluating the video duration, uploading source, and the views/days online ratio. However, alternative videos platforms aimed at professionals should also be considered for educational purposes.

Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos' content and approach to visualization

Background

Direct ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization.

Methods

In order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman’s correlation.

Results

We screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8–14 key points) were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman’s ρ=0.53; P=0.029).

Conclusion

Videos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on YouTube fail to address this particular issue adequately. There is a need for high-quality videos that include relevant points, provide realistic visualization of the examiner’s view, and give particular emphasis on fundus examination.