Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos’ content and approach to visualization

Abstract

BackgroundDirect ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization.MethodsIn order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman’s correlation.ResultsWe screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8–14 key points) were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman’s ρ=0.53; P=0.029).ConclusionVideos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on YouTube fail to address this particular issue adequately. There is a need for high-quality videos that include relevant points, provide realistic visualization of the examiner’s view, and give particular emphasis on fundus examination.

A virtual COVID-19 ophthalmology rotation

“…For teaching direct ophthalmoscopy, Borgersen and colleagues systematically evaluated the effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization. 5 Their group provided the following suggestions for videos instructing in direct ophthalmoscopy: (1) illustrate the key themes and points essential for performing direct ophthalmoscopy; (2) consider how to illustrate the key concepts so that the learner sees what he/she should expect to see; (3) put emphasis on how to examine the fundus and interpret findings; (4) consider omitting irrelevant details, highlighting essential information, and presenting words and pictures in combination. 5 …”

“…An advantage of social media is the visual nature of ophthalmology, offering a unique platform for educational image sharing. Borgerson et al 5 Evaluated the effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization. Devitt et al 9 Evaluated an ophthalmology computer aided learning (CAL) program for medical students and found that students in the control group showed no improvement over the test period, whilst the students who had access to CAL significantly increased their knowledge base.…”

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“…This can range from high fidelity (e.g., mannequins) to low fidelity (e.g., mock cases in an empty patient room). 118 Technology can facilitate these simulations by using stored images or videos, as well as a number of simulation smartphone apps.…”

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“…Borgersen et al 20 described the possible use of YouTube video lessons along with traditional theoretical lessons, since different instructional videos have been widely used in the past to aid in the guidance of general physical examination and basic medical skills. Problems with this method included lack of sufficient video lessons, low-quality videos and absence of long-term comparison studies.…”