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Less experienced medical trainees were more likely to overrate the quality and value of laparoscopic cholecystectomy YouTube videos than those with more experience, a researcher said.

In an analysis involving 10 videos for over 50 medical staff to view, over half of the videos were overrated in educational quality, recommendation likelihood, and critical view of safety (CVS) by both medical students (MS 3-4) and junior residents (PGY 1-3) compared to attending surgeons, reported Erik J. DeAngelis, MD, of George Washington University in Washington, D.C.

However, there were no significant differences in assessments by senior residents (PGY 4 and above) and attending surgeons, he said in a virtual presentation at the meeting.

"This study quantifies what many surgical educators suspected and feared; that the quality of the available videos is poor and that less experienced trainees do not recognize this," Jeremy Lipman, MD, of Cleveland Clinic in Ohio, told 木瓜直播.

"In trying to do the right thing and be well prepared for an upcoming operation with which they are unfamiliar, residents are instead being exposed to poor techniques and facing a deeper challenge to separate the errors in these videos from appropriate and safe surgical technique," added Lipman, who was not involved in this study.

To their knowledge, the study is the first to gauge student, resident, and faculty impressions of surgical videos appearing on social media, the researchers said.

"This was a very nicely done study, demonstrating the importance of critical analysis by experts of publicly available surgical technique videos," said Yalini Vigneswaran, MD, of the University of Chicago, who was also not involved with the research. "Other groups have also demonstrated that the most frequent online source trainees use for case preparation is YouTube, yet these videos do not align with expert surgeon recommendations and safe techniques."

For all videos, 4.63 (out of 10) was the mean educational quality, with a mean recommendation likelihood of 2.3 (out of 5) for case preparation.

"Just like any other video that's on YouTube, the actual popularity of the video is driven by the number of views and not anything about the surgical quality of the videos themselves," DeAngelis explained. "However, prior research has identified that there are limitations in terms of the video quality for these popular videos."

Researchers searched YouTube for the top 10 most viewed laparoscopic cholecystectomy videos, which they presented to 55 medical staff members at a single institution.

The cohort included 20 medical students, 29 residents (12 senior, 17 junior), and six attending surgeons, who evaluated the videos using a rubric for educational quality represented by the ability to identify critical procedural anatomic features, technique accuracy, while noting underlining limitations.

Laparoscopic cholecystectomy evaluation rubrics consisted of a task checklist for procedural completion and visual scales assessing user competence and case difficulty. Rubrics incorporated CVS, which provides a score based on Global Operative Assessment of Laparoscopic Skills (GOALS), the group noted. Videos with attending assessments were considered the "gold standard," they added.

DeAngelis and colleagues used Likert scales to measure the likelihood of recommending the videos, subsequent to their educational value.

Four videos did not meet any established CVS criteria, while only one video met all CVS criteria. Videos with the highest number of YouTube hits were unfit for case preparation, presented lower educational value, and did not meet CVS criteria.

"This study should be a call to action for surgical educators and surgical societies to create, vet, and make readily available quality videos of surgical techniques designed with trainees in mind," Lipman said.

Vigneswaran agreed that it is the faculty's duty to guide trainees to the appropriate educational resources.

"Crowdsourcing has become an important part of validating opinions and data in social media even outside of medicine and can be used to help mitigate this critical issue with publicly shared surgical videos," she said. "Although there will always be bias with these forums, this is a form of 'peer review' of videos, if you will."

Limitations of this study include the single institution design and subjective educational quality, which may differ based on increased experience or training.

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