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 YouTube and Facebook uploads are not peer-reviewed selection processes.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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