An Analysis of the Educational Quality of YouTube Videos on Transesophageal Echocardiography for Emergency Medicine: Does Popularity Predict Quality?

Objective: Emergency medicine (EM) learners frequently use Free Open-Access Medical Education (FOAMED) resources, such as YouTube, to learn transesophageal echocardiography (TEE).As TEE becomes more widely used in EM, particularly during cardiac arrest, learners may rely on video popularity as a marker of educational quality.This study evaluated whether popularity correlates with educational value.Materials and methods: A YouTube search identified 176 TEE videos, and 42 met the inclusion criteria.Popularity was measured using the Video Power Index (VPI).Three blinded experts independently evaluated videos using the Journal of the American Medical Association (JAMA) criteria, the Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) score, and the Global Quality Score (GQS).Interrater reliability was assessed using intraclass correlation coefficients (ICCs).Spearman's rank correlation analysis examined associations between VPI and quality metrics, while Mann-Whitney U tests compared quality scores by video source.Results: Interrater reliability was excellent for GQS (ICC 0.89), JAMA (ICC 0.91), and AIR (ICC 0.92) (all p < 0.001).No significant correlation was found between VPI and GQS (ρ = -0.09,p = 0.62), AIR (ρ = -0.14, p = 0.40), or JAMA (ρ = -0.19,p = 0.27).Academic/university-affiliated videos had significantly higher JAMA (p = 0.044) and AIR (p = 0.042) scores than non-academic videos.No significant difference was observed in GQS by source.Conclusions: Video popularity does not predict educational quality for TEE content on YouTube.Academic/university-affiliated videos demonstrate higher credibility and educational value and may help EM learners identify high-quality TEE educational resources.