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|NI FEATURE: THE EDITORIAL DEBATE III-- PROS AND CONS
|Year : 2019 | Volume
| Issue : 2 | Page : 402-403
Neurosurgery videos on online video sharing sites: The next best teacher?
Rajesh Chhabra, Sunil Kumar Gupta
Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
|Date of Web Publication||13-May-2019|
Dr. Rajesh Chhabra
Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chhabra R, Gupta SK. Neurosurgery videos on online video sharing sites: The next best teacher?. Neurol India 2019;67:402-3
“The students of the future will demand the learning support that is appropriate for their situation or context. Nothing more, nothing less. And they want it at the moment the need arises. Not sooner, not later. Mobile devices will be a key technology to providing that learning support.”
- Dr. Marcus Specht
We have read with great interest the article by P Krishna Kumar et al., (Neurosurgery videos on online video sharing sites: The next best teacher?). With the upsurge in the web platforms for educational purposes, and the easy availability of distribution and accessibility of videos, a critical evaluation of these means are needed for their purposeful usage.
Online educational activities like surgical videos, topic-specific lectures and online case discussions are becoming very useful educational tools to enhance surgical decision making and skills training, especially in developing countries like India. More so, it is convenient, flexible, and cost effective. It can be tailored to different needs, and is also unrestricted. Education in this era is expected to be more innovative and creative. A recent study showed a faster learning curve for spinal surgery for residents participating in a video-based training program; and, the learning plateau was achieved in half the time it would take with regular training, without the systematic use of videos. One of the main advantages of video sessions in neurosurgery is that one can watch the procedure repeatedly, learn, and execute subsequent application of the acquired knowledge effectively.
Nowadays, it is a lot easier to record surgeries and lectures due to technological advancements. With the availability of inbuilt high quality cameras in microscopes, endoscopes, digital cameras and smartphones, not only can one record surgeries very easily, but one can also share these videos with just one click, making it very convenient for routine usage. Simultaneously, challenges related to intellectual property rights (IPR), privacy, and ethical issues such as consent, respect for autonomy, photograph ownership and physician responsibility to uphold patient confidentiality, have been initiated. Due to open access of these sources of learning, there are no clear guidelines available at present regarding their uploading and usage. Many people are not sure what it means to have medical data shared between medical centres or between doctors in different clinics. Is this data safely shared? Individuals want their data to be secure, but they may also want their data available for many to use. Can we be sure that shared medical data is secure but that the data can easily be shared by appropriate individuals and institutions? It might be time to produce a detailed ethical code specifically for external data sharing.,
This century has been witness to the great and unanticipated transformation in the domain of communication modalities. Social media users are commonly termed in the literature as the 'millennials' and the 'net generation', as they have grown up with the advancements of digital technology and use it in their daily lives.,, They do not only access the internet for entertainment, but also use it as a platform for communication and networking.
In this era, merely reading about the technique in the papers is not enough, and the visualization of the surgery is definitely a fundamental upgrade. It helps viewers to learn basic surgical techniques and get motivated to reach beyond defined limits, while taking calculated risks, to enhance skills. It is the responsibility of the main neurosurgical departments in the country to make their surgeries available for viewership – to allow any surgeon in the world to watch, learn and give their opinion, as this will ultimately improve patient care. Recording, editing and archiving should be made an integral part of neurosurgical training.
However, it is challenging to record, edit, archive and share high quality relevant material to cover broader areas of content, rather than to provide repetitive information. The cost of the software and hardware, its maintenance and upgradation, and keeping up with the changes in technology are other major challenges, especially for those working in the rural settings. The videos quality is an important consideration to elevate these videos to the status that facilitates professional training. It is important to devise a tool for video evaluation to ensure a common standardization of the video quality and ensure an effective methodology for quality measurement. Video sessions may help in improving one's surgical skills but can prove be risky to start an altogether new procedure, thus keeping this modality at an inferior level to hands-on training. Thus, these sessions cannot serve as a replacement to a systematic and stepwise training due to the low levels of safety awareness inherent within the content. Non-availability of other information parameters such as the type of anaesthesia given, the post-operative complications that occurred, and their management, may lead to a false sense of security, as video editing masks the mistakes or complications and makes the viewers overconfident regarding the procedure being conducted. It is advisable that video sessions as tools for learning should be restricted to the classroom setting where teachers impose quality control, degree of selection and make it proactive as a supplementary learning material. One of the main disadvantages of online learning is that one cannot access the instructor directly if further guidance is required.
We must have a holistic understanding of the surgical procedure and should be well versed to handle complications. Video sessions are a shortcut to learning without imparting comprehensive knowledge and experience. Before attempting the same procedure by copying others, one should be very careful that one's background knowledge regarding the procedure is adequate. As online communications continue to evolve, it will be important to utilise this tool in patient-oriented communication and knowledge translation in neurosurgery. Educational institutions should come forward with better quality videos and provide a broader content coverage to achieve superior training at a minimal cost.
Various web platforms are now working as e-classrooms with their inherent limitations and opportunities. Web-based closed groups serve as good platforms for discussion about cases, operative approaches, and management issues. However, their distribution is very variable, as evidenced by the article, and their reach is still predominantly in the urban areas. One important limitation related to imparting of learning through web-based video tools is the absence of any academic monitoring of these videos. Some of the online videos are published without any peer review, which appeals to a larger audience for different purposes. The videos published that favour a specific surgical hardware (instrumentation, device, etc.) or software should be taken with a pinch of salt. Conflict of interest issues also arise related to the endorsement of techniques, equipment and learning tools exhibited in the videos that have been uploaded, for which the author is getting reimbursed. The important objection is the reliability of these videos, which becomes a concern for both the caregivers and patients who search the internet to get answers for their disease. There are specific scoring scales (e.g., DISCERN; http://www.discern.org.uk/discern_instrument.php) to grade a video before posting it on online platforms, which are utilised by various professional bodies for critical evaluation of its content.
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