In its first year, Anesthesia Illustrated, an open-source repository of anesthesia video lectures, attracted users from more than 150 countries who downloaded videos 94,213 times, according to an assessment presented at the 2013 Society for Technology in Anesthesia meeting.
“This is one of our important and exciting projects,” said Larry Chu, MD, director of the Stanford University Anesthesia Informatics and Media Lab, in Stanford, Calif., which created and funds Anesthesia Illustrated.
The website—www.anesthesiaillustrated.com—includes recordings of every lecture given during an entire three-year anesthesia residency at Stanford University, originally meant to aid Stanford residents. Dr. Chu and his colleagues decided to open the lectures to the global community without cost.
“We want to remove the silos that limit the spread of knowledge between institutions, between societies and between individuals,” he told Anesthesiology News.
The video collection has expanded to include lectures from the 2012 Sol Shnider meeting of the Society for Obstetric Anesthesia and Perinatology, and from faculty members at many other institutions, including the University of Colorado, Harvard University, Washington University in St. Louis, and the University of California, San Francisco.
“It’s a fantastic project, it’s a great opportunity for learning,” said Doug McKendrick, MBChB, FFA, consultant anesthetist at Dr Gray’s Hospital in Elgin in the far north of Scotland.
The Association of Anaesthetists of Great Britain & Ireland has a similar website, the AAGBI Video Platform (videoplatform.aagbi.org) that includes conference videos with slides, a project in which Dr. McKendrick is involved.
“At the moment [the site] is open to visitors, but it will soon be restricted to members only. Whilst this is necessary to retain membership of the association, it will hamper global access to some valuable information. I hope that in the future organizations are able to share educational material in an open-data arrangement for global benefit,” Dr. McKendrick said.
Anesthesia Illustrated will enter a web space with earlier pioneers of open-source web-based information portals like OpenAnesthesia.org, a project of the International Anesthesia Research Society.
“I don’t view them as a competitor; I view them as complementary,” Dr. Chu said.
OpenAnesthesia is a wiki that allows users to add content that then is curated by the crowd. In contrast, Anesthesia Illustrated is curated by Dr. Chu and only takes contributions from partnering academic anesthesia departments.
Another distinction: OpenAnesthesia is text-based, whereas Anesthesia Illustrated is more visual.
“The key word of our website is ‘illustrated,’” Dr. Chu said. “We are a visual website. We focus on multimedia, interactive online content versus just text.”
The last distinction is that Anesthesia Illustrated crowd-sources feedback on their medical checklists, but not the actual lists.
“We try to leverage the wisdom of the masses by having them give us comments on our work,” Dr. Chu said. “It doesn’t actually allow people to go in and add content like a wiki.”
Traditional peer review “obviously has its benefits, but tends to be quite a slow process,” Dr. McKendrick said. He and his colleagues are looking at using opinion ratings, common in consumer websites, provided by anesthetists to evaluate the educational worth. However, in an open website, crowd-sourced peer review also may come from nonexperts, which might be a potential concern.
Dr. McKendrick suggested that in the future, websites like Anesthesia Illustrated, Video Platform and OpenAnesthesia could be connected using cataloged metadata working in the background to focus searches in a similar fashion to Google algorithms. This is some of the work currently being considered by the new discipline of Health Web Science.
“A search engine in the background could guide users to all of the best—by peer-reviewed ranking—sources of information from multiple websites around the world. This could be invaluable for learning processes in residency programs, and for [components of continuing education] such as revalidation,” Dr. McKendrick said.
Moving to MOOC
Plans to expand the website include developing a massive open online course, or MOOC, platform similar to Coursera. The crowd sourcing is expected to increase as the website unrolls its MOOC section.
“We can have an anesthesia resident or faculty member at Stanford take a course alongside someone from Yale or Johns Hopkins, or Cambodia or Vietnam or Africa,” Dr. Chu said. “They can all take a course together, learn together and benefit from the learning interactions that they all provide.”
The online videos could upend the traditional classroom model to one in which students watch online lectures before in-person educational sessions that include small group discussion as well as interactive simulations.
“Instead of having the residents come to a lecture hall turning the lights off and watching PowerPoint slides for an hour, flipping the classroom model says: Let’s have them do some homework beforehand,” Dr. Chu said.
He also imagines residents using the videos for just-in-time procedural task learning. “A resident can review a procedure by video before they then perform it themselves,” he said.
The Anesthesia Informatics and Media Lab is planning to launch free medical checklists that have been shown in medical emergencies to improve adherence to treatment protocols and improve the time it takes for doctors to intervene.
“We put crowd-sourcing tools on Anesthesia Illustrated that allow any anesthesiologist to go on our website, look at our checklist, and make suggestions for improvement or make comments,” Dr. Chu said. “In a sense, it is more crowd-sourcing the wisdom of the masses to help them through a very important patient safety initiative.”