Can doctors learn surgical skills on YouTube and Facebook?

I am a self-taught bass guitarist in a church band, and, to be honest, it sometimes shows. I know I need to improve my skills, but time commitments make formal lessons difficult.  So two days ago I opened up YouTube and entered “bass guitar lessons” into the search box.

19,000 hits registered.  I selected a few that looked good on the top of the list.  After several hours of practice, my skills and repertoire have improved considerably.  I have found teachers I like, areas I need to focus on, and I haven’t even scratched the surface of what is freely available out there.

What if surgical skills could be taught like musical skills in this way?  I realize surgery is different in that surgeons are not practicing repetitive inconsequential activities, but the difference is that there is a wealth of experience and helpful advice that is simpler than learning a musical skill and which can be presented in video form, and that will make a great difference to other surgeons, even experienced ones.  I have learned amazing things from surgeons both far less and more experienced than I am, just by observing them at work.

Among the reasons I go to academic congresses is to learn from distinguished presenters how they approach surgical problems, and specifically to see what their methods are, and how they solve common surgical challenges.  But going to congresses is expensive and time-consuming.  I could get as much from looking at their video presentations online at my own convenience.  So I thought I should see whether the information is out there on YouTube and Facebook and how deep that knowledge base could be.

Where to begin?  For a trainee surgeon, the most basic skill is tying a decent knot.  The consequences of a poorly tied knot are considerable and life threatening.  So I YouTubed “suture technique and knot tying” – well over 7,500 hits.  Some of them are very good, but what I really wanted was to find the best ones, and there was no way to do that.  There is no apparent rating system other than the number of views, and even these are not presented in order.

This raised another issue. Medical progress, including better surgical techniques, is usually announced in medical journals or at congresses and supported by research of some sort. If either is flawed, the journal or congress will not accept the paper or presentation.  A peer review process is applied.  YouTube and Facebook uploads are not peer-reviewed selection processes.  There is a lot of rubbish that needs to be sifted through.  With this in mind I looked further.

“Scalpel technique” drew a blank, but “appendectomy” had 37 videos on YouTube.  Again, there was no way to select the best ones and I was disappointed in the few I did see.  I typed in “rhinoplasty surgical tips” and found nothing really useful.  I suspect most of these uploads were really intended by the uploader in a self promotional manner, and I’m sure it works.

I broadened my search, typing in “surgery.” 268,000 results, seemingly in random order in all areas of medicine, and again, no way could I see a rating system.

I gave up on YouTube and Facebook, and Googled “surgical videos.”  Yes, there are many sites out there showing surgical procedures of all kinds, but again, nothing I was looking for.

So, no, at present YouTube and Facebook are not good surgical training tools.  There is no peer-reviewed, organised, systematic, list of surgical skills and techniques to be passed on to surgeons all over the world. And that is a pity.

But there could be.  Here’s the idea. Teaching hospitals and medical schools could find sponsorship from big pharma and surgical companies within all disciplines to use their own experts to record short five minute video clips on skills and tips that are worth disseminating to the benefit of doctors and patients all over the world.  I can think of twenty areas at least within my field that I would love to see presented in this manner.  And I can’t think of a reason that sponsoring companies, including Google and Facebook, should not be proudly associated with initiatives like this.

This could be the coming together of medical education and social media aimed at the medical trainee. It may be ambitious, but what is certain is that, if anybody, Google and Facebook have the power, resources and clout to make it happen.

Martin Young is an otolaryngologist and founder and CEO of ConsentCare.

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  • http://www.medicallessons.net Elaine Schattner, MD

    No, they can’t: You can get added info or tips, or a helpful review, but doctors can’t learn how to do an invasive medical procedure by watching a video. Imagine if that’s how internists learned to do spinal taps or bone marrow biopsies.

    • http://www.consentcare.net Martin Young

      I agree. But the opportunities to improve existing skills are massive.

    • Steve Agular

      I agree with you that nothing can replace direct, hands-on experience. However, I do think that video can be used to introduce new procedures (either new to a whole specialty or to an individual doctor) or specific techniques, in addition to the uses you outline. In fact, there are several hospitals piloting programs involving head-mounted video cameras to stream video for educational purposes (one, in particular, that I am familiar with incorporates a secure online environment to store/display any telehealth videos as well as a peer-review element). I think you would have to agree that utilizing video to augment paper-based and hands-on learning is overall a good thing, no? (Full-disclosure: I am not a doctor)

  • rmyhers

    We did VHS videos in the 80′s of cataract surgery with a lens implant. At the time this was new and the numbers of ophthalmic surgeons who wanted to see and learn the techniques were many. All of the surgeons we asked to record their cases obliged and even spent the extra time later to voice over.
    We handed out hundreds of videos capturing some very talented work.
    Better to have this available than not.

  • http://myheartsisters.org Carolyn Thomas

    Good grief. As a heart attack survivor, I’d really like to believe that my cardiologists have not been honing their cardiothoracic surgical skills at home with their laptops.

    Surgery is “simpler than learning a musical instrument?” Really? I’ll have to mention that to my son who is a (face to face) guitar teacher!

    • http://www.consentcare.net Martin Young

      Carolyn, there are fundamentals that have to be taught and learned in surgery like in any other learned skill. But new techniques and approaches to problems can be very simple adaptations that are easier to learn than a musical skill. Musical skills require repetition and more intensive training than the ‘good ideas’ that I suggest can be disseminated by social media like YouTube. These can be as simple as putting a suture in a certain position, or holding an instrument in a certain way. Most surgeons would know what I mean.

      Look at this post I wrote some months ago for KevinMD
      http://www.kevinmd.com/blog/2010/07/tomorrows-surgeons-todays-video-gamers.html, and you should hope your cardiologists are spending time on their laptops!!

  • Olafur Palsson

    I think that is the end goal of Khan Academy, having every field in teaching videos. He has only made videos for math, and he’s done it for every single subject from 1+1=2 to advanced university math.

    http://www.khanacademy.org/

    If you’re only looking for surgical videos a site I use myself as a med student is http://www.websurg.com/

    Carolyn: We have to learn how to practice medicine somehow, I don’t see why videos are worse than books or lectures. Of course you’ll have to see the procedure first before you perform it, but often you can only see it once, and having videos would significantly improve the details in our memory.

  • http://skepticalscalpel.blogspot.com/ Skeptical Scalpel

    I was a general surgery residency program director for 24 years.

    I do not think that even the basics of surgery can be learned from watching videos. Once one is trained, one can learn tips or modifications of some procedures that way.

    There is no substitute for learning how to operate in the operating room.

    • http://www.consentcare.net Martin Young

      Yes, I agree with you. But your third sentence is the area of possibility I have tried to emphasize.

      I am sure you have a long list of useful hints to enhance surgical skills that could be committed to video. I have. Why not share them?

      As yet, social media is not set up to do this. But it could be.

  • Jack

    It’s not JUST about learning the surgery or procedures. It’s about how to handle “live” situation and potential complications that arise DURING the procedures.

  • Chris Porter MD

    I too was disappointed, looking for videos to show residents before we scrubbed cases together. (I’m an attending.) In contrast to the view of Skeptical Scalpel, I think there is tremendous value in video *early* in the career of surgeons. (We should ask them, no?) In this spirit, I’m curating appropriate surgery-related videos at http://onsurg.com (site under beta testing at present)

  • http://www.rmagency.com Beverly Murray

    As a consumer, I love this discussion. We need to be open to new thinking in all fields and most importantly, in the arena of healthcare. First, I agree that learning immersed in an actual setting is absolutely critical. Second, I anticipate that many physicians are not able to attend conferences to partake of the latest and greatest techniques. Leveraging the online community platform (peer-reviewed), it seems reasonable that “technique refinements” might be possible. And, it might also help physicians better allocate their professional development budgets by getting a “taste test” of a new procedure before they commit to travel. Again, from the patient perspective, thank you for all you do to take care of those you serve.