Educational quality of YouTube videos on external versus endoscopic dacryocystorhinostomy surgery

Abstract

Objective: To evaluate whether there is a difference in surgical training quality between endoscopic and external dacryocystorhinostomy (DCR) surgery videos on YouTube with the Laparoscopic Surgery Video Training Guide (LAP-VEGaS) video evaluation tool.
Matherial and methods: A comprehensive search was carried out on YouTube, using the following terms “DCR, External dacryocystorhinostomy, Endoscopic dacryocystorhinostomy’’. Videos with 100 or more views were recorded. The number of views, age, number of likes, number of dislikes, number of comments, length, type of surgery, view ratio, like ratio, viewer interaction, and video power index (VPI) were recorded. Two researchers independently assessed the videos for surgery educational quality according to LAP-VEGaS video assessment tool.
Results: After exclusion criteria, 74 out of a total of 108 videos were included in the study (27: external DCR, 47: endoscopic DSR). After the LAP-VEGaS evaluation, 30 (40.5%) of the videos were found to be of high quality and 44 (59.5%) were of low quality. External DCR videos were statistically significantly more high-quality videos than endoscopic videos (p=0.046). The average LAP- VEGaS score of external DCR videos was 10.65±2.98, and the mean LAP-VEGaS score of endoscopic DCR videos was 8.44±3.70, and the difference between them was statistically significant (p=0.009). Videos performed by ophthalmologists are statistically significantly higher quality videos according to LAP- VEGaS video assessment tool analysis (p=0.017). Concerning the selection of low and high quality videos, there was a significant agreement between two observers (kappa score 0.775).
Conclusions: Most of the DCR videos on YouTube are significantly lacking in case presentations, treatment options, and intraoperative and postoperative complications. In the future, we think that evaluating surgical videos on open access platforms such as YouTube with standard guidelines before they are published, and going through a review process may help increase the educational value of video materials.

Keywords

• YouTube
• external dacryocystorhinostomy
• endoscopic dacryocystorhinostomy
• nasolacrimal duct obstructions
• LAP-VEGaS video assessment tool

Eksternal ve endoskopik dakriyosistorinostomi cerrahisinde YouTube videolarının eğitim kalitesi.

Öz

Amaç: YouTube'daki endoskopik ve eksternal dakriyosistorinostomi (DSR) cerrahi videoları arasında cerrahi eğitim kalitesinde fark olup olmadığını Laparoskopik Cerrahi Video Eğitim Kılavuzu (LAP-VEGaS) video değerlendirme aracı ile değerlendirmek.
Gereç ve yöntem: YouTube'da “DSR, Eksternal Dakriyosistorinostomi, Endoskopik Dakriyosistorinostomi” terimleri kullanılarak kapsamlı bir arama yapıldı. 100 veya daha fazla izlenen videolar kaydedildi. Videoların izlenme sayısı, beğeni sayısı, yorum sayısı, video uzunlukları, ameliyat şekli, ameliyatı yapan cerrah, izlenme oranı, beğenme oranı, izleyici etkileşimi ve video güç indeksi (VPI) kaydedildi. Dakriyosistorinostomi konusunda deneyimli iki araştırmacı, videoları LAP-VEGaS video değerlendirme kılavuzuna göre cerrahi eğitim kalitesi açısından değerlendirdi.
Bulgular: Dışlama kriterlerinden sonra toplam 108 videodan 74'ü çalışmaya dahil edildi (27: Eksternal DSR, 47: Endoskopik DSR). LAP-VEGaS değerlendirmesi sonucunda videoların 30'unun (%40,5) yüksek kaliteli, 44'ünün (%59,5) ise düşük kaliteli videolar olduğu tespit edildi. Eksternal DSR videoları, endoskopik videolardan istatistiksel olarak anlamlı derecede daha yüksek kaliteli videolar idi (p=0,046). Eksternal DSR videolarının ortalama LAP-VEGaS skoru 10,65±2,98, endoskopik DSR videolarının ortalama LAP-VEGaS skoru 8,44±3,70 idi ve aralarındaki fark istatistiksel olarak anlamlıydı (p=0,009). Oftalmologlar tarafından yayınlanan videolar, LAP-VEGaS video değerlendirme aracı analizine göre istatistiksel olarak anlamlı derecede daha kaliteli videolardı(p=0,017). Düşük ve yüksek kaliteli videoların seçimiyle ilgili olarak, iki gözlemci arasında önemli derecede uyum olduğu görüldü (kappa puanı 0,775).
Sonuçlar: YouTube'daki popüler DSR videolarından çoğu sunum, tedavi seçenekleri, intraoperatif ve postoperatif komplikasyonlar açısından önemli ölçüde eksiktir. Gelecekte cerrahi videoların YouTube gibi açık erişim platformlarında yayınlanmadan önce hakem inceleme sürecinden geçirilmesinin videoların eğitsel değerinin artmasına yardımcı olabileceğini düşünmekteyiz.

Anahtar Kelimeler

• YouTube
• eksternal dakriyosistorinostomi
• endoskopik dakriyosistorinostomi
• nazolakrimal kanal tıkanıklıkları
• LAP-VEGaS video değerlendirme aracı.

References

1. 1. A T. Nuovo metodo conservatore di cura radicale delle suporazioni chroniche del sacco lacrimale. Clin Mod Firenzele 1904; 10: 385–389.
2. 2. Baldeschi L, Nardi M, Hintschich CR, et al. Anterior suspended flaps: A modified approach for external dacryocystorhinostomy. Br J Ophthalmol 1998; 82: 790–792.
3. 3. McDonogh M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol 1989; 103: 585–587.
4. 4. GW C. Two new operations for obstruction of the nasal duct, with preservation of the canaliculi and an incidental description of a new lacrimal probe. N Y Med J 1893; 57: 581–582.
5. 5. Marcet MM, Kuk AKT, Phelps PO. Evidence-based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications. Current Opinion in Ophthalmology 2014; 25: 443–448.
6. 6. Huang J, Malek J, Chin D, et al. Systematic review and meta-analysis on outcomes for endoscopic versus external dacryocystorhinostomy. Orbit. Epub ahead of print 2014; 33(2), 81-90 DOI: 10.3109/01676830.2013.842253.
7. 7. Ben Simon GJ, Joseph J, Lee S, et al. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Ophthalmology 2005; 112: 1463–1468.
8. 8. Pugh CM, Watson A, Bell RH, et al. Surgical Education in the Internet Era1. J Surg Res 2009; 156: 177–182.

9. 9. Glass NE, Kulaylat AN, Zheng F, et al. A national survey of educational resources utilized by the Resident and Associate Society of the American College of Surgeons membership. Am J Surg 2015; 209: 59–64.
10. 10. Rapp AK, Healy MG, Charlton ME, et al. YouTube is the Most Frequently Used Educational Video Source for Surgical Preparation. J Surg Educ 2016; 73: 1072–1076.
11. 11. Mota P, Carvalho N, Carvalho-Dias E, et al. Video-Based Surgical Learning: Improving Trainee Education and Preparation for Surgery. J Surg Educ 2018; 75: 828–835.
12. 12. Drozd B, Couvillon E, Suarez A. Medical YouTube videos and methods of evaluation: Literature review. JMIR Medical Education; 20. Epub ahead of print 1 February 2018. DOI: 10.2196/mededu.8527.
13. 13. Celentano V, Smart N, McGrath J, et al. LAP-VEGaS practice guidelines for reporting of educational videos in laparoscopic surgery a joint trainers and trainees consensus statement. Ann Surg 2018; 268: 920–926.
14. 14. Radonjic A, Fat Hing NN, Harlock J, et al. Development and validation of a recommended checklist for assessment of surgical videos quality: the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) video assessment tool. Surg Endosc 2020; 71: 637–644.
15. 15. De’Angelis N, Gavriilidis P, Martínez-Pérez A, et al. Educational value of surgical videos on YouTube: Quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees. World J Emerg Surg 2019; 14: 1–11.
16. 16. Luu NN, Yver CM, Douglas JE, et al. Assessment of YouTube as an Educational Tool in Teaching Key Indicator Cases in Otolaryngology During the COVID-19 Pandemic and Beyond: Neck Dissection. J Surg Educ 2021; 78: 214–231.
17. 17. Chapman D, Weaver A, Sheikh L, et al. Evaluation of Online Videos of Laparoscopic Sleeve Gastrectomy Using the LAP-VEGaS Guidelines. Obes Surg 2021; 31: 111–116.
18. 18. Erdem MN, Karaca S. Evaluating the accuracy and quality of the information in kyphosis videos shared on youtube. Spine (Phila Pa 1976) 2018; 43: E1334–E1339.
19. 19. Ocak U. Evaluation of the content, quality, reliability and accuracy of YouTube videos regarding endotracheal intubation techniques. Niger J Clin Pract 2018; 21: 1651–1655.
20. 20. Romanov K, Nevgi A. Do medical students watch video clips in eLearning and do these facilitate learning? Med Teach 2007; 29: 490–494.
21. 21. Celentano V, Browning M, Hitchins C, et al. Training value of laparoscopic colorectal videos on the World Wide Web: a pilot study on the educational quality of laparoscopic right hemicolectomy videos. Surg Endosc 2017; 31: 4496–4504.
22. 22. Derakhshan A, Lee L, Bhama P, et al. Assessing the educational quality of ‘YouTube’ videos for facelifts. Am J Otolaryngol - Head Neck Med Surg 2019; 40: 156–159.
23. 23. Fischer J, Geurts J, Valderrabano V, et al. Educational quality of YouTube videos on knee arthrocentesis. J Clin Rheumatol 2013; 19: 373–376.
24. 24. Deal SB, Alseidi AA. 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. J Am Coll Surg 2017; 225: 725–730.
25. 25. Wu V, Lee DJ, Vescan A, et al. Evaluating YouTube as a Source of Patient Information for Functional Endoscopic Sinus Surgery. Ear, Nose Throat J 2020; 1–6.
26. 26. Strychowsky JE, Nayan S, Farrokhyar F, et al. YouTube: A good source of information on pediatric tonsillectomy? Int J Pediatr Otorhinolaryngol 2013; 77: 972–975.