Does Popularity Predict Quality? An Analysis of YouTube Transesophageal Echocardiography Video Quality for Emergency Medicine Education

Emergency Medicine (EM) learners often use free open access education resources such as YouTube (YT) for learning, especially for novel ultrasound applications. Transesophageal echocardiography (TEE) has gained traction in EM due to its utility in cardiac arrest. However, the quality of YT education videos on TEE remains unknown. This study evaluates whether the popularity of YT videos on TEE correlates with their educational quality for EM learners.

A Google search of YT videos on TEE in EM yielded 146 videos, screened for relevance, resulting in 42 videos. Three experts rated videos for quality using the Journal of the American Medical Association (JAMA) criteria (credibility), Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resource (AIR) score (educational value), and Global Quality Score (GQS) (overall quality). Experts were blinded to video popularity (Video Power Index (VPI)). Interrater reliability was assessed using intraclass correlation coefficient (ICC). Spearman’s correlation assessed VPI and quality. Mann-Whitney U test compared video quality and video source.

ICC indicated excellent agreement: GQS 0.89 (95% CI, 0.81 – 0.94; p<0.001), JAMA 0.91 (95% CI, 0.84 – 0.95, p<0.001) and AIR 0.92 (95% CI, 0.87 – 0.96; p<0.001). There was no significant correlation between VPI and quality for any metric: GQS (ρ = −0.09, p = 0.62), AIR score (ρ = −0.14, p = 0.40), or JAMA score (ρ = −0.19, p = 0.27). Video source was not associated with a statistically significant difference in GQS scores (U = 158.0, Z = –1.48, p = 0.138). However, academic/university-affiliated videos had significantly higher quality scores in JAMA (U = 137.5, Z = –2.01, p = 0.044) and AIR (U = 136.0, Z = –2.04, p = 0.042).

VPI does not predict quality for TEE EM education content. Academic/university-affiliated videos demonstrated higher credibility and educational value on JAMA and AIR scores, though GQS did not differ by source. Video source may serve as a useful guide for EM learners to quickly identify high-quality TEE educational videos.