YouTube as a neurosurgical training tool for the insertion of external ventricular drain

Objectives: YouTube is the largest open-access media website and an increasingly recognised resource in Medical Education, with much content related to Neurosurgery. External Ventricular Drain (EVD) insertion is frequently undertaken by neurosurgical trainees. Online and distant learning have gained popularity during this COVID-19 pandemic more than ever. We evaluated content on YouTube as to its use as an effective open-access learning resource for EVD insertion as a key neurosurgical procedure. Methods: A keyword search identified videos related to EVD insertion on 01/06/2020. Inclusion criteria was created to focus on content aimed at describing the technique of EVD insertion. An educational scoring system was devised related to the procedure of EVD insertion. Each video was scored on our educational score, JAMA Benchmark Criteria and Global Quality Score (GQS). They were subsequently categorised as effective or ineffective. Results: A total of 12/700 videos met inclusion criteria. Dates posted ranged from 01/07/2012 - 24/04/2019, with views range 359 - 166,388, and mean of 30,531 (SD 49,570). Four videos (33%) were considered an effective learning resource. The cohort had a mean educational score of 6.91 (SD 3.86), with median JAMA score and GQS 2/4 (SD 0.62) and 2/5 (SD 1.6) respectively. A strong correlation was found between viewership and score (R 0.85, p < 0.005) Conclusion: The majority of YouTube content on EVD insertion is an ineffective resource. Neurosurgeons and Institutions could harness YouTubes broad access by posting high-quality educational content. This is more important than ever with increasing emphasis on online training resources, YouTube included.