Quality of Red Reflex Teaching Videos on the Internet: Cross-Sectional Study (Preprint)
BACKGROUND The importance of red reflex testing as part of neonatal screening is recognised worldwide. The technique is ideally suited to online video-based instruction. The quality of online teaching material is however unknown OBJECTIVE We aim to objectively score the quality of red reflex demonstration videos in order to determine their pedagogical effectiveness and to assess the relationship between search engine ranking and quality. METHODS An internet search was performed on 12th February 2020 using keywords related to red reflex examination on search engine platforms YouTube, Google and DuckDuckGo. Video characteristics were recorded and popularity determined by calculating a Video Power Index (VPI) score. The videos were assessed by two medical students and two ophthalmologists using scoring systems: Red Reflex Specific (RRS), Understandability & Attractiveness (U&A), Reliability (JAMA), and Global Quality Score (GQS). A Total Quality Score (TQS) was created from RRS, U&A and JAMA scores as a measure of overall quality. Videos were categorised by source and in terms of usefulness. Correlations between audience interaction parameters and video quality alongside ranking position on the three search engines were investigated using Spearman’s rho. RESULTS Of the 625 videos screened, 14 were eligible for inclusion. Overall, videos had a mean TQS of 24.3/50 (range: 9 – 41) with six videos considered “educationally useful” based on the GQS. The main video source was physicians (43%), with videos uploaded by academics being of greatest overall quality (P = .023). There was a positive correlation between TQS and ranking position of videos using Google (rs= 0.569, P = .034) but not with other platforms. CONCLUSIONS The limited red reflex training videos currently available on the internet are generally poor and of variable quality. We recommend Google as a suitable platform to search for red reflex videos of better quality. These results may play a role in ensuring video teaching is performed optimally and highlight the need for improved access worldwide to videos of greater accuracy and reliability.