- Hersh W.
Screening and Eligibility
|Author||Context||Aim||Methodology & Sample||Outcomes & Key Findings|
|Davis et al. (2012) [||Florida, USA.||To evaluate chest tube insertion performance after viewing a 3-minute mobile learning module.||Observational intervention vs control study. 128 participants (44 residents, 42 medical students, 42 Army personnel). Pre-questionnaire. The intervention group viewed a learning module on Apple iPod Touch then assessed placing a chest tube on a task simulator against a skill checklist.||Across all groups, the intervention participants scored better on the skills checklist vs control (11.09±3.09 versus 7.17±3.56, p<0.001, Cohen’s D=1.16). Participants who had placed fewer than 10 chest tubes (9.7±3 vs 6.6±3.9, p<0.001) performed significantly better with the video.|
|Rowse et al. (2014) [|
|Minnesota, USA.||To assess the effect of a video on residents’ FNA skills.||Observational study of 32 residents-PGY-2,3,4.|
Evaluated performing the FNA procedure 1 week after viewing a video on a skills checklist to a maximum score of 24. The results were compared against residents who did not have access to the video.
|21 residents had access to the video. Scores were higher (mean=15.8, range: 10–24 [SD not reported]) than residents who had no access to the video (range: 4–18, mean=11.4 [SD not reported]).|
Half the residents who had access to the video did not view it and scored lower.
|Liu et al. (2014) [|
|California, USA.||To examine the effect of viewing a 70-second video on how to apply a topical anaesthetic cream to a mannequin for a procedure.||Pre/post-test study. 30 RNs who completed a questionnaire and performed a skill pre and post-watching a 70-second video on YouTube. Inaccurate skill application was considered anything less than 100% measured by a template.||Significant change in comfort post-video (27% vs 23%, p<0.01) and coverage area (25% vs 82% p<0.01).|
RNs who were inaccurate prior were more likely to be accurate after watching the video (18% vs71% p<0.01).
7% of nurses watched the video twice. All RNs felt that having more JITT videos for nursing procedures and tasks would be helpful.
|Phillips et al. (2016) [|
|Massachusetts, USA.||To study the effect of a stereotactic core breast biopsy procedure video to standardise and improve residency teaching.||Observational pre/post-test study of 30 residents PGY-2,3,4,5.|
Pre: knowledge test and an instructional video. The “closed book” test had 42 video and non-video content (20 control) questions. Post: After 1.5 weeks and without prior notice, residents sat the same test again.
|Video increased the score of the video-content questions compared with 0% on the control questions (30.7% vs 0% p<0.001).|
90% of residents believed that the video was helpful and just right in the level of difficulty and length.
|Kandler et al. (2016) [|
|To study if an exemplar video would result in greater adherence to an RSI standard protocol.||Pre and post study of 345 HCW staff (57% nurses, 43% medical practitioner) observations of the effect of an educational video on anaesthetic team RSI practice. 425 (202 pre and 223 post) anaesthesia procedures were observed.||480 views within the study period exceeded staff numbers by 39%. The odds for the failure of adherence to safety-critical tasks after the video was introduced were reduced, with the odds ratio of 0.34 (95% CI 0.27–0.42, p<0.001).|
Video reduced non-adherence rates in 3 categories - clinical performance, medication, and omission errors.
|Wang et al. (2016) [|
|California, USA.||To examine the effect of viewing a JITT video on residents’ skill at applying a volar splint.||Randomised control trial comparing the pre/post effect of a 3-minute video on a skill. 30 Paediatric residents completed a questionnaire and were taught and assessed the skill. Post: residents repeated the questionnaire, the intervention group watched the video, and both groups were reassessed.||Over 90% of participants had no experience with splinting. Despite this, over 60% obtained 100% on the initial assessment.|
During a reassessment, the JITT group had higher scores, which was statistically significant (2.86 vs 4.73; 95% CI: 1.00–3.00).
The JITT video group took longer to complete the procedure but had statistically improved splint success.
|Walsh et al. (2017) [|
|Washington, USA.||To describe the development of an EM 52 procedure video-based curricula.||Survey 36 EM residents who viewed videos and participated in the program 2 years after curriculum introduction.||75% RR and 85% found videos easily accessible and helpful. 80% found the role of the instructor helpful in skill mastery.|
Exposure to the video curricula led to increased competence and confidence.
|Yuminaga et al. (2017) [|
|New South Wales, Australia.||To provide an evaluation of the Seldinger technique for IDC insertion by NUT doctors and video media.||A prospective, multicentre observational study involving 115 patients and 57 doctors. This technique was either via bedside teaching by the urology registrar or video media.||93% of cases had successful IDC placement by a NUT doctor. 38% of the study cases were out of working hours, and using the video led to an 88% reduction in hospital transfers.|
No complications of IDC insertion by NUT doctors were reported following the use of video.
|Phillips et al. (2017) [|
|Massachusetts. USA.||To describe a follow-up study using a previously developed video from Phillips et al. (2016) involving four institutions.||The video was emailed to 45 radiology residents PGY 2,3,4,5, and 6 in four institutions in this follow-up study. The residents were then asked to complete an anonymous breast imaging knowledge survey.||Over 80% of respondents felt that the video helped their understanding of procedure planning or technique. 60% thought it aided patient safety, and 69% felt increased confidence.|
Resident feedback has led to suggestions for other videos.
|Poon et al. (2017) [|
|Ohio, USA.||This pilot study aimed to describe the otology/neurotology |
videos and obtain residents’ feedback on the videos.
|15 Residents (PGY 2–5) were recruited to view at least three surgical videos and complete a questionnaire about the video's usefulness, effect on self-efficacy, and feedback suggestions.||88% of residents watched an average of 3.8 videos. The videos were rated highly useful compared with existing resources such as textbooks. (8.0±0.3 vs 5.0/10; p=0.002). The rating of the videos on self-efficacy scores averaged 7.2±0.3/10 across all groups.|
Residents fed back suggestions for refining the video, such as adding extra clinical information and using subtitles.
|Jyot, A et al. (2018) [||Minnesota. The USA.||To describe how learners used an educational website as an adjunct to the surgical curriculum.||A retrospective review of surgical website 6 months post introduction used by 257 HCWs. Website access data was analysed (Piwik, Matthieu Aubry, New Zealand) visits, page views, actions, bounce rate, and duration of usage.||257 users accessed the website in 18 months, 33% general surgical residents and 67% other staff. The most popular time of the day was 8 to 9 PM with 6,358 views (13%), and Thursday was the most popular day with 17,907 views (37%).|
|Wolfensberger et al. (2019) [||Zurich,|
|To evaluate the educational impact and user satisfaction of an edutainment video.||Randomised control trial of 363 HCWs comparing three arms (1:1:1) viewing an edutainment video, reading an SOP, or a no-intervention group on knowledge of infection control practices. Participants were assessed at three time points: randomisation, one month and three months post.||The 3 groups consisted of approx. 65% nurses, 25% physicians and 10% other health care professionals. The video group had higher knowledge scores across all 3-time points. TP 1 and TP3, the video group had higher scores than SOP and the no-intervention group (TP1-85.4% vs 81.3% vs 79.6% p<0.001 and 0.001; TP3 86.3% vs 83% vs 82.7% p=0.036 and 0.048). The video group was most likely to recommend that other HCWs watch the video and had fewer dropouts.|
|Posner et al. (2020) [|
|Ottawa, Canada.||To create video resources for staff in the COVID-19 pandemic.||A descriptive study on videos for patient care processes in pandemic PPE. This study reported total YouTube views.||In 72 days, over 12,000 views of 19 clinical videos and nearly 10,000 views of 4 patient-centred videos.|
|Beam et al. (2020) [|
|Omaha, USA.||This study compared 2 N95 respirator training methods.||Randomised control trial with 62 HCWs on N95 donning and doffing pre and 3 months post:|
1. viewing a video on N95 donning and doffing alone versus
2. viewing a video on N95 donning and doffing plus viewing and rating a video of own performance donning and doffing N95 (reflective practice).
|48 HCW in the final analysis. Both groups' scores deteriorated over time, but the RP group was still significantly higher at the follow-up than they were at the pre-test [paired t (23)=6.12, p<0.001].|
|Bonz et al. (2021) [|
|Connecticut, USA||To compare the efficacy of a locally developed video of emergent SBT insertion compared to usual preparation.||Randomised control trial of 32 EM residents comparing JITT procedure by any media (control group) or the JITT locally made a video (intervention group) before SBT insertion on a task trainer.||Local video was associated with reaching a passing score (12.5% vs 62.5%: OR=11.7, 95% CI=9.9–13.5). The local video group was favoured when adjusting for PGY, with a significant difference in final checklist scores between the two groups (mean difference=12.8, 95% confidence interval [CI]=7.6–18.0).|
|Patel et al. (2021) [|
|Kent, UK.||To assess the effectiveness of using a lecture and a clinical skills video on how to manage nasal fractures.||Pre -the post-test study of 12 ENT trainees completed a questionnaire and were evaluated on confidence at three intervals:|
2. post a lecture
3. post-viewing an instructional video
|After both the lecture and video intervention, there was a statistically significant improvement in performing nasal fracture manipulation independently (1.25±1.96 vs 6.83±1.33 vs 8.58±0.79 p<0.01) Baseline vs Video Effect Size 1.41.|
|Herstein et al. (2022) [|
|Nebraska, USA.||This study compared 2 N95 respirator training methods.||Randomised control trial of 62 HCW on N95 donning and doffing pre and post:|
1. viewing a video on N95 donning and doffing alone versus
2. viewing a video on N95 donning and doffing viewing plus viewing and rating a video of own performance donning and doffing N95.
|Scores were significantly higher on the post-test for the reflective practice intervention (3.4 to 4.9 vs 3.9 to 8.2 p<0.05).|
Years of experience and frequency of N95 respirator use did not predict pre or post-scores.
Charting, Collating, and Summarising Studies
|Pattern||Advances||Gaps||Evidence for Practice||Research Recommendations|
|1||Video content and purpose||Emerging evidence of the acceptability and effectiveness of video as a clinical skill instructional tool.|
Video use can assist staff in rare procedures and give them a clinical advantage.
Video is helpful for socially distanced instruction.
|Need for a framework to determine video's place in the workplace learning structure.|
Lack of research on the outcomes of video use in patient care.
|Support to develop clinical skills and rare procedure video libraries.|
Video procedures are an alternative resource when face-to-face instruction is not possible.
Video can raise the capabilities of both experienced staff and those in training.
|Developing a framework or taxonomy for instructional video development and use.|
Developing research to examine health professionals’ critical thinking and patient safety using video procedures.
|2||Target audience||Video use spreads beyond its intended target audience - suggesting it is acceptable to health care staff.||Limited research from nursing and allied health professionals.||Developing collaboration – between hospitals and health disciplines to reduce costs and increase access to procedure videos.||Expanding research on the longer-term results of video use.|
Research to identify opportunities for video to support nursing, allied health professions and other health care professionals.
|3||Curated vs original ‘homegrown’ video content||Health care professional-led video development is feasible.||Limited evidence on key features of clinical procedure videos.||Institutions can use existing research processes to create robust development and review methods for shared video resources.||Setting standards for health professionals’ video.|
|4||Video development||76% of investigators created their videos.||Limited reporting about steps in developing videos and patient consent processes.|
Need more evidence on factors that should influence video length.
|Improving staff capabilities in video development.|
Collaboration to increase access to content experts.
Organisational endorsement processes for video development should be developed based on alignment with best practices and peer review.
|Developing research into point-of-care health care videos, e.g., determining the optimal features.|
|5||Hosting site -internal websites vs YouTube||Health care organisations are supporting video development and use.|
Health care organisations support open internet access to approved websites.
|Hosting health care videos on YouTube may create privacy concerns, which health care staff will need guidance to navigate.||The use of YouTube increases the reach of video compared to internal websites.|
YouTube allows sharing of health care videos across organisations.
Organisational endorsement processes for video hosting need to be developed based on alignment with best practices and peer review.
|Research to investigate barriers and facilitators to video use.|
Development of privacy and consent guidance surrounding clinical procedure videos hosted on public platforms.
Key Themes and Patterns
Video Content and Purpose
Agreed Model of Local Practice
Target Audience and Video Content
Curated Versus Original ‘Homegrown’ Video Content
Video Development Process
Hosting Site—Internal Websites Versus YouTube
Outcomes From Studies to Date
Yuminaga Y. IDC insertion with Seldinger technique. 2015. Available from: https://www.youtube.com/channel/UCOXawC480ITy99LI81nROyw/videos
Conflict of Interest
Appendices. Supplementary Data
- Supplementary File 1
- Supplementary File 2
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