The Quality of Open-Access Video-Based Orthopaedic Instructional Content for the Shoulder Physical Exam is Inconsistent

A cross-sectional study on reliability and quality of YouTube® videos related to hallux valgus and evaluation of newly developed hallux valgus-specific survey tool

Objective

Previous studies have reported low quality and reliability on YouTube videos about various medical issues including videos related to hallux valgus (HV) treatment. Therefore, we aimed to evaluate the reliability and quality of YouTube videos on HV and develop a new HV-specific survey tool that physicians, surgeons, and the medical industry can use to create high-quality videos.

Methods

Videos viewed over 10,000 times were included in the study. We used the Journal of the American Medical Association (JAMA) benchmark criteria, global quality score (GQS), DISCERN tool, and new HV-specific survey criteria (HVSSC) developed by us to evaluate the quality, educational utility and reliability of the videos, the popularity of which was assessed using the Video Power Index (VPI) and view ratio (VR).

Results

Fifty-two videos were included in this study. Fifteen videos (28.8%) were posted by medical companies producing surgical implants and orthopedic products, 20 (38.5%) by nonsurgical physicians, and 16 (30.8%) by surgeons. The HVSSC indicated that the quality, educational value, and reliability of only 5 (9.6%) videos were adequate. Videos posted by physicians and surgeons tended to be more popular (p = 0.047 and 0.043). Although no correlation was detected among the DISCERN, JAMA, and GQS scores, or between the VR and VPI, we found correlations of the HVSSC score with the number of views and the VR (p = 0.374 and p = 0.006, respectively). A good correlation was detected among the DISCERN, GQS, and HVSSC classifications (rho = 0.770, 0.853, and 0.831, respectively, p = 0.001).

Conclusions

The reliability of HV-related videos on YouTube is low for professionals and patients. The HVSSC can be used to evaluate the quality, educational value, and reliability of videos.

Social Media and Its Use in Orthopaedic Surgery Resident Education and Training

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The use of social media by health-care professionals and medical educators has been increasing over the past decade.

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Online social networks, professional networks, blogs, microblogs, forums, podcasts, and video-sharing platforms can be used effectively to communicate and engage with, as well as learn from, other residents and attending physicians worldwide.

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Social media platforms and other web-based applications can serve as powerful educational tools to enhance orthopaedic resident learning, collaboration, teaching, and case discussion.

The Role of Electronic Learning in Orthopaedic Graduate Medical Training: A Consensus From Leaders in Orthopaedic Training Programs

The US orthopaedic graduate medical education system is based on long established methods in education, but academic leaders at orthopaedic institutions now have the ability to use electronic learning innovations. Hospital for Special Surgery gathered graduate medical education leaders from orthopaedic training programs around the country and an electronic learning expert to review current orthopaedic residency and fellowship program practices. This group came to consensus with the following points: (1) current training methods do not take full advantage of available technology/innovations, (2) trainees inappropriately use electronic resources in the absence of or in an underdeveloped formal electronic training program, (3) trainees learn at different rates and in different ways requiring individualized plans for optimal content engagement, and (4) formal electronic learning programs better use time dedicated to educating trainees than informal programs. Orthopaedic graduate medical training programs that adopt these points can establish an electronic learning program to complement their traditional education program by (1) guaranteeing online content is standardized and approved, (2) reducing time spent covering standard lecture material and increasing time spent reviewing cases, and (3) engaging students of all learning backgrounds with content in both asynchronous and synchronous formats.

Université de Montréal Objective and Structured Checklist for Assessment of Audiovisual Recordings of Surgeries/ techniques (UM-OSCAARS): a validation study

Background

Use of videos of surgical and medical techniques for educational purposes has grown over the last years. To our knowledge, there is no validated tool to specifically assess the quality of these types of videos. Our goal was to create an evaluation tool and study its intrarater and interrater reliability and its acceptability. We named our tool UM-OSCAARS (Université de Montréal Objective and Structured Checklist for Assessment of Audiovisual Recordings of Surgeries/techniques).

Methods

UM-OSCAARS is a grid containing 10 criteria, each of which is graded on an ordinal Likert-type scale of 1 to 5 points. We tested the grid with the help of 4 voluntary otolaryngology – head and neck surgery specialists who individually viewed 10 preselected videos. The evaluators graded each criterion for each video. To evaluate intrarater reliability, the evaluation took place in 2 different phases separated by 4 weeks. Interrater reliability was assessed by comparing the 4 top-ranked videos of each evaluator.

Results

There was almost-perfect agreement among the evaluators regarding the 4 videos that received the highest scores from the evaluators, demonstrating that the tool has excellent interrater reliability. There was excellent test–retest correlation, demonstrating the tool’s intrarater reliability.

Conclusion

The UM-OSCAARS has proven to be reliable and acceptable to use, but its validity needs to be more thoroughly assessed. We hope this tool will lead to an improvement in the quality of technical videos used for educational purposes.

The influence of online video learning aids on preparing postgraduate chiropractic students for an objective structured clinical examination

OBJECTIVE

To investigate the influence of providing online procedural videos to postgraduate chiropractic students preparing for an objective structured clinical examination (OSCE).

METHODS

Eighty-three postgraduate chiropractic students enrolled in a diagnostic unit during 2017 received supplemental video resources prior to their final OSCE. Ninety students enrolled in the 2016 offering of the unit acted as the control group. Two-sample t tests were used to compare OSCE results between groups and paired t tests were used for within-group comparisons. Regression analysis was used to examine the association of age, undergraduate grade point average, and gender with the final OSCE scores. Students were also surveyed regarding their perceptions of the video resources using a purpose-built questionnaire.

RESULTS

A paired t test comparing initial and final OSCE scores found a small but significant increase in scores for the 2017 (mean change 3.6 points; p = .001) but not the 2016 (mean change -1.1 scores; p = .09) cohort. The 2017 cohort had significantly more change than the 2016 cohort (mean difference 4.7 points; p < .001). Analysis of responses to the questionnaire highlighted overall positive feedback for the procedural videos.

CONCLUSION

Online procedural videos as learning resources had a small but positive effect on OSCE performance for a group of postgraduate chiropractic students. Students perceived the resource as being helpful for OSCE preparation.

YouTube as an information source for clubfoot: a quality analysis of video content

Idiopathic clubfoot is the most common congenital anomaly of the lower extremity. YouTube has emerged as an important source of health-related information for patients and families. Parents seek information about clubfoot on YouTube. However, the quality of these videos remains unknown. Therefore, we decided to evaluate the quality of YouTube videos about clubfoot. We searched YouTube for clubfoot videos using appropriate keywords. English language videos with more than 10 000 views were included. Three fellowship trained pediatric orthopedic surgeons independently assessed the videos and classified them into corporate, hospital, education and private. The quality of information was assessed using the Modified DISCERN and JAMA benchmark scores. The search yielded 12 060 videos of which 42 were analyzed. There were 9 (21%) videos from corporate organizations, 12 (29%) from hospitals, 3 (7%) from educational organizations and 18 (43%) by private individuals. The mean Modified DISCERN score was 2.1 ± 1.07 (range 0.3-4) and mean JAMA benchmark score was 0.9 ± 0.65 (range 0-2). Educational videos had highest mean Modified DISCERN score (3.1 ± 0.85) and private videos, the least (1.43 ± 1). This difference was statistically significant (P = 0.004). Hospital videos had highest mean JAMA benchmark score of 1.3 ± 0.6 as compared with private videos which had the least mean score of 0.5 ± 0.6. This difference was also statistically significant (P = 0.001). The results of our study indicate that the quality of information on idiopathic clubfoot on YouTube needs improvement. Videos from educational and hospital sources should be preferred over private sources.

A Modification of the Active Compression Test for the Shoulder Biceps-Labrum Complex

The active compression test (O'Brien Sign) is widely used by physicians to aid in the diagnosis of biceps-labrum complex disease. This maneuver has been particularly criticized in the literature, however, with regard to interobserver reliability. Criticisms may in fact stem from inaccurate and inconsistent practice of the examination maneuver, stemming from both patient- and physician-related errors. In this Technical Note, we introduce an easy modification to the O'Brien Sign that limits such errors and improves test uniformity.

Social media: physicians-to-physicians education and communication

PURPOSE OF REVIEW

Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians.

RECENT FINDINGS

Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.