Emergency Surgical Cricothyrotomy Videos Online: Reliability and Training Quality Evaluation

Emergency cricothyrotomy is a life-saving, high-stakes surgical airway procedure that, although rarely performed, must be executed rapidly and accurately when indicated. Online video-based educational resources are increasingly used to support training in such critical interventions; however, the instructional adequacy and procedural accuracy of these materials remain uncertain. We aimed to evaluate the educational value, reliability, and procedural competency of online videos related to cricothyrotomy and to investigate whether video-related characteristics are associated with content quality.

Videos meeting predefined inclusion criteria were evaluated using the Global Quality Scale, DISCERN, The Journal of the American Medical Association benchmark criteria, and the cricothyrotomy-specific Cricothyrotomy-Objective Structured Assessment of Technical Skills (C-OSATS) scoring system. Two emergency medicine specialists independently assessed all videos. Inter-rater agreement was examined using the intraclass correlation coefficient. Associations between quality scores and video popularity indicators were analyzed using correlation analysis. In addition, a multivariable logistic regression analysis was performed to identify factors independently associated with high-quality videos.

A total of 83 videos were included in the analysis. A substantial proportion of the videos were insufficient in terms of educational quality and reliability. Video duration showed a significant positive association with quality scores. C-OSATS demonstrated strong correlations with DISCERN and Global Quality Scale and a moderate correlation with The Journal of the American Medical Association criteria. Inter-rater reliability was high across all instruments. In multivariable analysis, video duration (odds ratio [OR]: 2.867, 95% confidence interval [CI]: 1.650-4.979, P < 0.001), number of likes (OR: 1.012, 95% CI: 1.001-1.022, P = 0.026), and uploader type (OR: 0.092, 95% CI: 0.015-0.558, P = 0.009) were independently associated with high-quality videos, whereas views, subscriber count, and total number of videos on a channel were not.

Many online videos intended to teach emergency cricothyrotomy do not provide adequate educational content to effectively support competency acquisition for this critical procedure. Procedure-specific assessment approaches such as C-OSATS may complement general quality tools and provide a more clinically meaningful evaluation of instructional materials. Content-related characteristics and source credibility appear to be more important than popularity metrics in determining educational quality.