Conteúdo académico e profissional para o mundo em desenvolvimento

How a video journal helps medical students and surgeons during the coronavirus pandemic

When most people picture a peer-reviewed academic journal, they envision text on paper. However, if your goal is to share insights on complex surgical procedures, that’s probably not the best way to do it. The Journal of Medical Insight (JOMI), gives a whole new meaning to the term ‘journal’ by providing video articles covering surgical procedures step by step. With success: in recent years, the journal’s usage has soared. Especially in the current pandemic, the journal offers added value to medical students and surgeons worldwide.

Warning: the content of the journal (which you can find via the links on this page) is not suitable for sensitive viewers, as they contain surgical procedures from up close.

Virtual shadowing

“Medical students shadow surgeons to learn during their clerkships,” explains JOMI’s CEO Nikita Bernstein over a Skype call from his home office in the Boston area. “Our goal is to offer a front-row seat for residents, medical students, surgical technologists, other surgeons, and operating room staff to follow specific procedures step by step.”

Since 2013, JOMI has published over 180 articles covering surgeries from incision to closure. Each video is a complex production: several cameras record to show multiple angles, and the surgeon narrates what is happening so it’s easy to follow along. “There are resources that offer videos that are either short, have low quality of production, or are not peer-reviewed. It’s very difficult to do all three.” explains Nikita. “JOMI is the only resource that offers peer-reviewed, deep-dive, expert-led masterclasses. Such virtual shadowing experiences bring the expertise of surgeons worldwide to anyone who could benefit from it.”

Coronavirus

During the coronavirus pandemic, JOMI has seen its value amplified. “For safety reasons, medical students are not allowed in operating rooms during this crisis. However, shadowing cases is essential for their education. Our growing readership shows that JOMI can fill that gap. Overnight we went from being a nice-to-have to a must-have alternative to in-person shadowing experiences.” 

Additionally, the crisis puts extra stress on hospitals in unexpected ways. “Smaller hospitals may not  be able to transfer patients to larger hospitals that are treating COVID-19 patients, so these surgeons are now confronted with more advanced procedures they would not ordinarily perform.” Especially for trauma operations, having a detailed walkthrough of a procedure can then be of vital importance to the doctors – and the patient undergoing it. 

JOMI is also an essential resource for hospitals in low- and middle-income countries that might not have the budget to spend on high-end materials or shadowing trips. “We have been part of Research4Life since 2015. While we are a for-profit organization, our end goal is to improve the quality of care for people around the world.”

Room for the unexpected

JOMI covers basic and advanced procedures in General Surgery, Otolaryngology, and Orthopedics. And since the surgery is real, sometimes unexpected things happen. “Some of the best learning moments are when the unexpected happens.  The viewer can see not only the proper way, but also how to address complications and  how to deal with the unexpected.” Check the full list of cases.

While many of the published cases were performed in Boston, where JOMI is located, the content is international.  The hospitals where cases were performed include Massachusetts General Hospital, Brigham and Women’s Hospital, Boston Medical Center, Newton-Wellesley, Mount Sinai, Yale New Haven Hospital, Rothman Institute, UChicago Medicine, Duke Medical Center, Huntington Memorial, Cancer Institute Hospital (in Tokyo), Charité (Berlin), and others. Cases also include those performed by the World Surgical Foundation missions at hospitals in rural Philippines and Honduras.

Around the world

“One of the problems that JOMI solves is exposure to a variety of cases that are, otherwise, difficult to gain exposure to.” Nikita explains. “Some examples:

• Flying to Massachusetts General Hospital to shadow Dr. Lillemoe is not easy under normal circumstances. With JOMI, Dr. Lillemoe walks you through the complicated Whipple procedure.
  
• A trauma surgeon never knows what may come through the door.  JOMI allows you to drop into Brigham and Women’s Hospital to see Dr. Weaver work on orthopedic trauma or UChicago Medicine to see gunshot wounds and general trauma. 
  
• Yet another example is an open cholecystectomy or gallbladder removal. Cholecystectomies are generally performed with a larascope, an instrument used to look at the abdominal organs. With JOMI, Dr. Rovito walks viewers through an open case to prepare them for a conversion during a surgical mission in Honduras.

“It is important that we film in different parts of the world and create windows into how surgery is done everywhere for everyone,” Nikita concludes. The journal is continually expanding the collection of available cases.