Should online, free proctology videos be used for self-directed post-graduate learning? A proposed evaluation using a...

Exposure to proctology during post-graduate colorectal training is often variable. Videos of proctological procedures can benefit surgical trainees' self-directed learning. The aim of this study is to evaluate the quality of freely available online video material on proctological procedures using a modified colorectal video assessment framework.

PubMed and the YouTube™ platform were searched for the following terms related to proctological procedures for haemorrhoids, anal fissure and fistula. These were assessed (cross-sectional study) for quality using a modified video-assessment checklist that was validated by three colorectal surgeons who regularly perform proctology cases. The resulting 9-item evaluation tool was designed to capture the extent to which videos provide concise and structured information typically required for peer review.

A total of 98 surgical videos were assessed, comprising 65 from peer-reviewed. Journals and 35 from YouTube™ only. The median total score for peer-reviewed videos was 16.0 (interquartile range [IQR] 13.0-17.0) compared to 10 (IQR 8.0-12.0) for the non-peer-reviewed videos. This difference was statistically significant (Mann-Whitney U = 2024.0, p < 0.001). In particular, journal videos were significantly better at providing more contextual information about the case including presenting symptoms and outcomes.

As might be expected, the quality of YouTube™ videos from the perspective of proctology training was inferior to those released online by peer-reviewed journals. This provides further evidence for the validity of using modified checklists to assess the quality of training materials. Given the findings of this study, trainees should be encouraged to prioritise journal-related over other freely available material for self-directed learning.