Experience Level Influences Users’ Interactions With and Expectations For Online Surgical Videos: A Mixed-Methods Study

Purpose: Upper-extremity surgeons and trainees widely use online surgical videos, and the use of these videos can assist with procedural learning. The purpose of this study was to characterize online video use and understand the role videos play in the learning process of orthopedic residents and practicing surgeons. We hypothesized that the use of surgical videos and video content desired among orthopedic learners differs based on their experience level. Methods: Four focus groups were conducted to discuss online surgical videos and their role in the learning process of orthopedic learners. Participants were separated based on their experience level. Three reviewers qualitatively analyzed the transcripts of the focus groups using constant comparative methods to identify overarching themes and categories. Findings regarding the participants’ desires for video content and production quality were translated into a survey. The survey results were analyzed to assess their associations with experience level. Results: The focus group analysis helped identify 4 overarching themes that reflected users’ interactions with videos: prewatching experience, choosing a video, video use, and video design, with the users’ comments differing based on their experience level. The survey results showed that the median ideal length for a video was 10 minutes and that all users, regardless of their experience level, ranked showing the surgical procedure as the most important part of a video. Junior residents more frequently desired background information and a written outline of surgical steps, whereas more senior learners placed greater emphasis on advanced surgical decision-making and the use of particular implants/devices. Conclusions: Experience level influences users’ interactions with videos, including how they are chosen and used, and their expectations in terms of content and production. Clinical relevance: Video creators should specify their targeted audience's experience level and adjust content to meet users’ needs. Our results can provide video creators and hosts a checklist for appropriate content and production standards.