Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
J Surg Educ. 2021 Jan-Feb;78(1):214-231. doi: 10.1016/j.jsurg.2020.06.019. Epub 2020 Jul 6.
YouTube has become the preferred resource for trainees in otolaryngology to prepare for surgery. This study aimed to compare the evaluation by 2 attending physicians and 2 resident physicians of the quality of videos on YouTube on neck dissection, a key indicator case in head and neck surgery. The authors aimed to assess the quality and quantity of YouTube videos available for development of a virtual surgical educational curriculum for trainees in otolaryngology.
Using the YouTube search feature, the top 10 videos by relevance and view count were compiled using the following search terms: radical neck dissection, selective neck dissection, modified radical neck dissection, lateral neck dissection, levels I-III neck dissection, levels II-IV, left neck dissection, right neck dissection, cervical nodal dissection, and supraomohyoid neck dissection. A total of 37 videos on neck dissection were identified and analyzed using the LAP-VEGaS criteria as well as author-specific modified LAP-VEGaS criteria.
The mean comprehensive LAP-VEGaS score was 8.74 (SD 3.10). The majority of videos (24/37) were designated as medium quality; 10 of 37 videos were low quality and 3 of 37 videos were high quality. In the total group analysis, there was excellent inter-rater reliability between attending physicians (Cohen's kappa coefficient of 0.84) and good inter-rater reliability between resident physicians (Cohen's kappa coefficient of 0.58). There was no correlation between total view count, video age, or number of likes/dislikes and the overall LAP-VEGaS score. The presence of audio or written commentary had a moderate positive correlation with LAP-VEGaS score (adjusted R of 0.36). There was no statistically significant difference in video quality between videos posted by US and non-US based physicians (95% confidence interval -0.10 to 4.10; p = 0.06). However, videos made by an otolaryngology-trained physician had a LAP-VEGaS score that was 3.93 points higher (95% confidence interval 2.34-5.52; p < 0.001) than that of videos made by a nonotolaryngology-trained physician.
Online videos of neck dissection represent an increasingly ubiquitous and appropriate resource for trainees in learning otolaryngology key indicator cases. While free-to-access video repositories, such as YouTube, have become increasingly popular among trainees as a primary resource for learning and preparing for surgical cases, they lack consistent quality and as such, global efforts should be taken to improve the breadth and depth of educational video content in otolaryngology.
YouTube 已成为耳鼻喉科住院医师准备手术的首选资源。本研究旨在比较 2 名主治医生和 2 名住院医生对颈部解剖 YouTube 视频质量的评估,这是头颈部外科的一个关键指标病例。作者旨在评估耳鼻喉科住院医师虚拟手术教育课程发展可用的 YouTube 视频的质量和数量。
使用 YouTube 搜索功能,根据以下搜索词,通过相关性和观看次数编译了前 10 个视频:根治性颈部解剖、选择性颈部解剖、改良根治性颈部解剖、外侧颈部解剖、I-III 级颈部解剖、II-IV 级、左侧颈部解剖、右侧颈部解剖、颈部淋巴结解剖和 supraomohyoid 颈部解剖。共确定了 37 个关于颈部解剖的视频,并使用 LAP-VEGaS 标准以及作者特定的改良 LAP-VEGaS 标准进行了分析。
综合 LAP-VEGaS 评分的平均值为 8.74(SD 3.10)。大多数视频(24/37)被指定为中等质量;37 个视频中有 10 个质量较低,3 个质量较高。在总组分析中,主治医生之间的观察者间可靠性极好(Cohen 的kappa 系数为 0.84),住院医生之间的观察者间可靠性良好(Cohen 的kappa 系数为 0.58)。总观看次数、视频年龄或点赞/不喜欢次数与整体 LAP-VEGaS 评分之间均无相关性。音频或书面评论的存在与 LAP-VEGaS 评分呈中度正相关(调整 R 为 0.36)。由美国和非美国医生发布的视频质量之间没有统计学差异(95%置信区间 -0.10 至 4.10;p=0.06)。然而,由耳鼻喉科培训医生制作的视频的 LAP-VEGaS 评分比由非耳鼻喉科培训医生制作的视频高 3.93 分(95%置信区间 2.34-5.52;p<0.001)。
颈部解剖的在线视频代表了耳鼻喉科住院医师学习耳鼻喉科关键指标病例的一种日益普遍且合适的资源。虽然像 YouTube 这样的免费视频库已成为学员作为学习和准备手术病例的主要资源越来越受欢迎,但它们缺乏一致性,因此,应在全球范围内努力提高耳鼻喉科教育视频内容的广度和深度。