LAUSR

Technical skills are the sine qua non for an aspiring surgical trainee. With the adoption of a competency-based curriculum, surgical trainees need to perform administrative tasks and acquire non-technical skills. Patient privacy and confidentiality matters and duty hour restrictions reduce opportunities to acquire technical skills. Trainees need to find alternative means to acquire these skills. Simulation and cadaveric workshops are good avenues with high-quality training but require resources. The World Wide Web is easily accessible, people-centered, and has gained wide popularity in this digital age. YouTube was founded in 2005 as a social platform and has since become a popular educational platform. A survey conducted by Rapp et al. demonstrated that YouTube is the most preferred source for surgical videos across medical students, surgical residents, and specialists [1]. YouTube allows for ‘‘own time, own pace, own space’’ learning and also allows viewers to comment on videos, post questions, and generate discussions. Viewership statistics, such as the number of likes, are also publicly visible. However, YouTube is primarily a social media platform with a commercial intent. Hence, uploaded content does not undergo a peer-review process, undermining its quality. Videos uploaded are mainly screened for copyright infringement but not for educational value and quality. Figure 1 summarizes the issues related to surgical YouTube videos. Reporting bias, conflict of interest, commercial intent, and heterogeneity in educational content are some of the common drawbacks. Furthermore, viewers may not be able to replicate the same procedure in their institutions due to a lack of technology and resources. Several studies have reported on the quality of YouTube videos for common surgical procedures like appendectomy, cholecystectomy, thyroid surgery, and bariatric surgery. Many authors reported poor video quality, inaccurate information, incomprehensible or lack of audio, and absence of background patient information [2]. Lee et al. reported 30.1% of YouTube videos had poor quality and inaccurate content for laparoscopic cholecystectomy, such as the use of electrocautery near the common bile duct and failure to demonstrate the critical view of safety [2]. Rigorous peer review of surgical videos with quality assessment is necessary to enhance their educational value. Quality indicators of surgical training videos such as the educational quality rating score (EQRS) and the total video quality score (TVQS) are surrogate measures of a surgical video’s quality [3]. Unfortunately, there is no standardized nor validated measure used in assessing the quality of YouTube videos on many surgical procedures such as hepatectomy, distal pancreatectomy, splenectomy, and nephrectomy. Viewer metrics, particularly number of likes, do not translate into good video quality; Frongia et al. reported that the likes to dislikes ratio do not predict the quality of YouTube videos for laparoscopic fundoplication [3]. The lack of a peer-review process and validated quality indicators create an unmet need to establish guidelines to ensure a minimum standard in surgical videos uploaded onto YouTube. The recent international multispecialty LAP-VEGaS (LAParoscopic surgery Video Educational & Kai Siang Chan [email protected]