James M Prieto, MD1, Alicia Gaidry, MD1, Karen Kling, MD2, Ivan M Gutierrez, MD1, Donald J Lucas, MD, MPH1, Robert Ricca, MD3, Stephen Bickler, MD2, Romeo C Ignacio, MD1. 1Naval Medical Center San Diego, 2Rady Children’s Hospital San Diego, 3Naval Medical Center Portsmouth
Introduction: Recent studies indicate that surgical residents commonly use online videos when preparing for operative cases. Among the many resources available, YouTube is the most frequently used. The objective of this study was to evaluate the educational value of online videos of commonly performed pediatric surgical procedures.
Methods: A YouTube search was performed for “Laparoscopic Pyloromyotomy” and “Thoracoscopic Congenital Diaphragmatic Hernia (CDH) Repair”. Videos were filtered in order of their number of views and screened to exclude any irrelevant content. The five with the highest number of views were selected for each operation. Videos were graded on their technical proficiency and educational value using the Global Operative Assessment of Laparoscopic Skills (GOALS) score, and the “Educational Value Score” (EVS). The EVS is operation specific, and was created using the key steps of each procedure as outlined by the SAGES Manual of Minimally Invasive Pediatric Surgery. Videos were rated by six pediatric surgeons and eight general surgery residents who have completed a pediatric surgery rotation as a senior resident. Statistical analysis was performed using the t-test and ANOVA.
Results: The mean educational value score of pyloromyotomy videos was significantly higher than that of thoracoscopic CDH repair videos (26 vs 21, p<0.001). Technical proficiency was also rated significantly higher in the pyloromyotomy category (16.5 vs 13.2, p=0.01). In both operations, the video with the highest number of views had a significantly higher educational value score as compared with the video with the least views (25.5 vs 16.5, p=0.004; 23.6 vs 15.6, p=0.01). There was no statistically significant difference in the way residents and pediatric surgeons scored the videos. Commonly highlighted deficiencies included lack of any audio or text explanations(50%), or failure to discuss any of the operation’s common pitfalls (70%).
Conclusion: There is a high degree of variability in the quality of online videos of pediatric surgical procedures. Based on our preliminary analysis, videos of more technically challenging procedures (i.e. thoracoscopic CDH repair), are likely to be of less quality and educational value. Videos with higher view counts may be more likely to be of higher educational value. A structured format to include audio narration, demonstration of key steps of each procedure, and an explanation of the common pitfalls could enhance the educational value of all surgical videos. A centralized online repository where residents could access videos of common pediatric surgical procedures would be a valuable teaching tool.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93850
Program Number: P410
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster