King Daniel, Davison Danielle, Benjenk Ivy, Heinz Eric, Vaziri Khashayar, Hawkins Katrina, Yamane David
University of Maryland, Prince Georges Hospital Center, Cheverly, MD, USA.
Department of Anesthesia and Critical Care, George Washington University, Washington, DC, USA.
J Intensive Care Med. 2022 Apr;37(4):528-534. doi: 10.1177/0885066621999979. Epub 2021 Mar 10.
Instructional videos of medical procedures can be a useful guide for learners, demonstrating proper and safe technique. Open publishing sites such as YouTube are readily accessible, however the content is not peer reviewed and quality of videos vary greatly. Our aim was to evaluate a learner's ability to interpret the quality of openly published content by comparing their rating of the most popular central line insertion videos on YouTube to expert evaluations.
YouTube search results for "central line placement" sorted by views or relevance compiled a list of the four most common videos. A fifth gold standard video, published by the , was included, however was not found in the top results. Eleven expert practitioners from varying medical specialties (Critical Care, Surgery, Anesthesia, & Emergency Medicine) evaluated the 5 videos, utilizing a 22-item Likert scaled questionnaire emphasizing: preparation, sterility, anatomy, technique, & complications. Videos were compared as a composite average of the individual items on the survey. The highest, lowest, and 3rd ranked videos were evaluated by 45 residents ("learners") in varying specialties (Internal Medicine, Emergency Medicine, Surgery, Anesthesia) and post graduate year (PGY). Learners assessed the videos using the same scale. A Welch T-test assessed statistical significance between the two groups. Subgroup analysis compared experts against different PGY and specialty cohorts.
The lowest scored video among the experts and learners was the most popular on YouTube, with 858,933 views at the time of inclusion. Though lowest in rank, this video was judged higher by learners than the experts (2.63/5 vs 2.18/5, = 0.0029). The 3rd ranked video by experts with 249,746 views on YouTube, was also rated higher by learners (3.77/5 vs 3.45/5, = 0.0084). The gold standard video by NEJM had 320,580 views and was rated highest by both the experts and learners (4.37/5 vs 4.28/5, = 0.518). Subgroup analysis showed similar results with learners rating the videos overall better than experts, this was particularly true in the PGY-1 subgroup.
The most popular central line insertion video was the worst rated by both experts and learners. Learners rated all the videos better than the expert. YouTube videos demonstrating medical procedures including central line insertion should come from peer reviewed sources if they are to be incorporated into educational curriculum.
医疗操作教学视频可为学习者提供有用的指导，展示正确且安全的技术。像YouTube这样的开放发布网站易于访问，然而其内容未经同行评审，视频质量差异很大。我们的目的是通过比较学习者对YouTube上最受欢迎的中心静脉置管视频的评分与专家评估结果，来评估学习者解读公开发布内容质量的能力。
YouTube上按观看次数或相关性排序的“中心静脉置管”搜索结果汇总了四个最常见的视频。还纳入了由[机构名称]发布的第五个金标准视频，但未在搜索结果顶部找到。来自不同医学专业（重症医学、外科、麻醉和急诊医学）的11名专家从业者使用一份22项李克特量表问卷对这5个视频进行评估，问卷重点关注：准备工作、无菌操作、解剖结构、技术和并发症。视频以调查问卷中各个项目的综合平均值进行比较。45名不同专业（内科、急诊医学、外科、麻醉）和研究生年级（PGY）的住院医师（“学习者”）对排名最高、最低和第三的视频进行了评估。学习者使用相同的量表对视频进行评估。采用韦尔奇t检验评估两组之间的统计学显著性。亚组分析比较了专家与不同PGY和专业队列。
专家和学习者评分最低的视频是YouTube上最受欢迎的，纳入时观看次数为858,933次。尽管排名最低，但该视频学习者的评分高于专家（2.63/5对2.18/5，P = 0.0029）。专家排名第三的视频在YouTube上有249,746次观看，学习者的评分也更高（3.77/5对3.45/5，P = 0.0084）。《新英格兰医学杂志》的金标准视频有320,580次观看，专家和学习者的评分均最高（4.37/5对4.28/5，P = 0.518）。亚组分析显示了类似的结果，学习者对视频的总体评分高于专家，在PGY - 1亚组中尤其如此。
最受欢迎的中心静脉置管视频在专家和学习者的评分中都是最差的。学习者对所有视频的评分都高于专家。如果要将展示包括中心静脉置管在内的医疗操作的YouTube视频纳入教育课程，其来源应经过同行评审。
