Abstract
BACKGROUND
The incorporation of video-based resources into medical education has become common practice in many middle- and high-income countries. This study aimed to assess the knowledge, usage, and receptivity of video-based learning among medical students in a resource-limited setting in Nigeria.
METHODS
A mixed-method approach was utilized, involving both quantitative and qualitative data collection among fourth, fifth, and sixth-year medical students. Sampling was conducted via simple random selection, and data were collected using questionnaires and focus group discussions. Quantitative data were analyzed using SPSS version 21 for descriptive statistics, while thematic coding was applied to qualitative data using NVivo.
RESULTS
A majority (79%) were aware of video-based learning, with YouTube being the most used platform. However, barriers such as high data cost (79.7%) and poor internet connectivity (77.2%) limited utilization. Qualitative analysis highlighted the value of flexible, engaging content in learning and restructuring of existing curriculum to maximize the benefits of videos but raised concerns about standardization, patient privacy, and infrastructure.
CONCLUSION
Although students recognize the effectiveness of video-based learning, its integration into medical curricula requires addressing barriers such as internet access and content quality. Institutional support is critical for maximizing its potential.
Keywords
Introduction
The use of video-based learning is increasingly prevalent in educational settings, effectively addressing practical limitations and expanding possibilities within digital environments. Videos can be seamlessly incorporated into online learning management systems and integrated with various educational tools, 1 which positively influences student satisfaction and academic outcomes. This enhancement is primarily attributed to the ability of video content to promote more active and engaged learning experiences. 2
The use of audiovisual tools in education has historical roots, dating back to World War II when filmstrips were used for military training. These resources enhance learning by engaging students and increasing motivation. With the rise of digital technology and mobile devices, videos have become integral to students’ lives, making their incorporation into educational settings, especially in surgical training, essential. 3 While video-based learning cannot entirely substitute for direct oversight by consultants in the workplace for surgical trainees, the integration of video-based learning with conventional educational approaches, referred to as blended learning, has demonstrated significant advantages and effectiveness. 4
Research suggests that effective learning necessitates both visual and auditory stimuli, especially in the context of technology-enhanced education, to facilitate cognitive processing. 5 This approach is particularly relevant as students today benefit from diverse media formats and visually engaging presentations, which enhance their learning experience and comprehension. 6 In various regions globally, initiatives have been established to create databases featuring video libraries that are readily accessible to medical students and surgical residents. A notable example is PASSIO education, which was designed to offer access to instructional videos on peripheral nerve surgery. 7 Additionally, a study conducted among dental students across five dental schools in the United States from 2019 to 2020 revealed that 95% of participants found YouTube videos on clinical procedures to be beneficial for their learning, while 89% expressed a desire for their dental institutions to upload tutorials to YouTube or other social media platforms. 8 This trend is not surprising, as many surgical techniques can be more effectively understood through these videos, which can be replayed multiple times for enhanced comprehension. Research indicates that a combination of multiple simultaneous techniques for information can significantly enhance comprehension and retention, making multimedia learning a powerful tool for education.5,9 Furthermore, studies conducted in developed countries have demonstrated a gradual and consistent acceptance of video-based learning in training curricula.10–13 However, there is a lack of research on the utilization of video-based surgical instruction in Nigeria. The level of receptiveness among instructors and students in a continuous training environment remains unknown, despite some evidence suggesting a certain degree of familiarity with online instructional tools.14,15 Therefore, the objective of this study is to assess the extent of medical students’ knowledge, usage, and receptivity toward video-based learning in surgery. By doing so, this research aims to provide insights into the informal practices in surgical education and pave the way for integrating video-based learning as a supplementary approach to the country's traditional mode of instruction and learning.
Methods and Materials
Study design
This was a mixed-methods study carried out over a period of two months from January 2024 to February 2024 using online administered questionnaires and focus group discussions (FGDs). The mixed-methods approach was selected to capture both numerical data and in-depth insights, which allowed for triangulation toward a holistic understanding of the factors influencing video-based learning in surgical education. The reporting of this study follows the Good Reporting of A Mixed Methods Study used to assess the quality of reporting in mixed-methods research. The completed checklist is provided as Supplemental Material. 16
Study setting and population
The study population consisted of fourth-, fifth-, and sixth-year undergraduate medical students in the clinical arm of Ambrose Alli University, Ekpoma, Edo State, Nigeria, totaling 327 students.
Sampling and sample size
Quantitative sampling
The sample size was estimated using Cochran's formula for cross-sectional surveys. 17 Parameters included the 93% of residents who used video-based education resources to prepare for operation from a previous study conducted in United States, 18 as no similar study has been conducted in Nigeria to the best of our knowledge. While this study's context may differ, its parameters were deemed sufficiently comparable. A 5% margin of error and 10% attrition rate were applied, resulting in a calculated sample size of 100. A simple random sampling technique was used to ensure an unbiased representation of students across the study years.
Qualitative sampling
Participants were purposively selected based on prior exposure to video-based learning. Focus group discussions were moderated by a trained facilitator and guided by a semistructured protocol to ensure consistency; these discussions were organized into two groups, one comprising six participants and the other consisting of five.
Researcher characteristics and reflexivity
The research team comprised physicians and public health researchers with expertise in qualitative and quantitative methodologies. The lead interviewer, AD is a male and physician, with experience in qualitative research. There were no preexisting relationships with the study participants, and nonparticipation was not tracked.
Data collection methods
Quantitative data collection
Data were collected using a Google Form containing a structured questionnaire. Pretesting was done with 10 participants to refine its content and ensure clarity. The online Google form comprised questions that have been modified and adapted from previous study examining students’ perceptions toward video-based and video-assisted learning scenarios in journalism and communication courses, with a Cronbach alpha of 0.933, indicating high reliability. 19 Pretesting was conducted with 10 participants to refine the content and ensure clarity. Invitations to participate were distributed via email and WhatsApp, including unique links to the survey.
Qualitative data collection
Focus group discussions were used to gather qualitative data. Discussions were conducted via Telegram, chosen for its video conferencing capabilities, which fostered a relaxed atmosphere. WhatsApp and Telegram were also used for participant recruitment and organization. Two FGDs were done, with group 1 containing six participants and group 2 having five participants. A semistructured interview protocol guided the discussions. The study adopted a phenomenological approach to understand the lived experiences of medical students regarding video-based learning. This orientation was chosen to explore participants’ perceptions of video-based learning, current usage patterns, perceived benefits and challenges, and attitudes toward its integration into the curriculum. Each discussion lasted an average of 60 to 75 min, facilitated by a physician and trained moderator. Audio recordings of the discussions were transcribed verbatim for analysis, and data saturation was achieved during analysis, ensuring comprehensive qualitative insights and sufficient coverage of the study themes.
Statistical analysis
Quantitative data were analyzed using IBM SPSS Statistics Version 21. Continuous variables such as age were described using means and standard deviations, while categorical variables such as sex, level of study, and marital status were presented using frequencies and proportions. The statistical level of significance was set at P < .05 and 95% confidence interval.
For the qualitative data, a thematic analysis was conducted to assess the medical students’ perceptions regarding video-based learning, following the framework outlined by Braun and Clarke, supported by NVivo 12 software for coding. 20
Ethical consideration
Ethical approval for the study was obtained from Irrua Specialist Teaching Hospital Health Research Ethics Committee (Protocol no: ISTH/HREC/20232012/522). Informed consent was obtained from all participants prior to data collection. Separate informed consent was obtained for participation in the focus groups and for audio recordings. Confidentiality was ensured through the anonymity of transcripts and secures storage of audio recordings on password-protected devices accessible only to the research team. They were also explicitly informed that their responses would have no effect on their academic standing or performance, ensuring stress-free and unbiased participation.
Results
A hundred completed questionnaires were analyzed for this study. The results are as shown below.
From Table 1, the majority were in the 25 to 33 age group (55, 55.0%), and the gender distribution was almost equal, with 52 (52.0%) female and 48 (48.0%) male students. Most students were in their fourth year (62, 62.0%), followed by sixth-year students (25, 25.0%) and fifth-year students (13, 13.0%). Nearly all participants were single (99, 99.0%).
Sociodemographic characteristics of respondents.
From Table 2, of the 100 students, 79 (79.0%) had heard of video-based surgical learning. Among them, the primary source of information on surgical procedures was video-based resources (65, 82.3%), followed by textbooks (43, 54.4%) and lectures (38, 48.1%). A majority, 64 (81.0%), knew platforms where video-based learning resources could be accessed. Most participants accessed these videos through educational apps (77, 97.5%) and online platforms like YouTube (76, 96.2%), with fewer using institutional libraries (12, 15.2%) or peer-reviewed journals (1, 1.3%).
Assessment of knowledge of video-based learning among medical students in surgery.
Multiple responses,
From Table 3, among the 79 respondents, 77 (97.5%) believed that video-based learning should be incorporated into medical training as a learning tool. Additionally, 75 (94.9%) felt that the teaching hospital should actively promote the use of video-based resources among students in surgery. All respondents (79, 100.0%) expressed a willingness to encourage others to utilize videos for learning in surgical areas.
Assessment of receptiveness of video-based learning among medical students in surgery.
From Table 4, among the 79 respondents, 4 (5.1%) used video-based resources daily, 28 (35.4%) weekly, and 34 (43.0%) rarely, with most accessing videos primarily at home (68, 86.0%). The majority preferred videos of 10 min or less (54, 68.4%). Most students found video-based learning effective (78, 98.7%) and helpful, with 71 (89.9%) believing it enhanced their retention of information. Additionally, 78 (98.7%) expressed a willingness to use video-based learning more if integrated into the curriculum, although only 9 (11.4%) reported that it was routinely utilized in lectures.
Assessment of level of utilization of video-based learning among medical students in surgery.
From Table 5, among the 79 respondents, the primary benefits of video-based surgical learning included better understanding (72, 91.1%) and improved knowledge (54, 68.4%). Other noted benefits were improved performance in class (43, 54.4%), saving time when studying (42, 53.2%), and helping to catch up on missed lectures (26, 32.9%). Key hindrances to utilizing video-based learning were high data costs (63, 79.7%) and poor internet connectivity (61, 77.2%). Other challenges included the length of available videos (29, 36.7%) and poor quality (19, 24.1%). Disadvantages of using video-based learning included susceptibility to online distractions (63, 79.7%) and watching unrelated videos (55, 69.6%). Additionally, varied video quality (27, 34.2%) and overreliance on edited procedures (39, 49.4%) were significant concerns.
Factors relating to the use of video-based learning among medical students in surgery.
Multiple responses.
Table 6 presents the qualitative data analysis results, organized into three columns: themes, codes, and verbatim statements. Themes represent the overarching categories identified during the analysis, summarizing key areas of focus from the discussions. Codes are subcategories within each theme that capture specific ideas or concepts shared by participants. Verbatim statements are direct quotes from participants, used to illustrate the themes and codes and provide insight into their perspectives on video-based learning in surgical education. It is worth mentioning that across both FGDs, a few participants were more vocal, providing in-depth perspectives and shaping the discussions. For instance, Participants 1A, 1B, and 2A frequently engaged with the moderator, offering detailed responses and reflecting on their experiences with video-based learning. Other participants, such as 1D, 1E, and 1C, contributed periodically, often responding to cues from the moderator rather than initiating discussions. Some participants were less engaged, offering brief responses when directly addressed by the moderator. Participants 2D, 2E, and 2F had minimal contributions, mainly affirming points raised by more active participants rather than presenting new insights. This pattern suggested a reliance on structured prompting rather than spontaneous peer-to-peer engagement. Notably, side discussions were limited due to the structured nature of the FGDs. When they did occur, they were brief and typically involved clarifying a point raised by another participant rather than independent exchanges between participants. Overall, the discussions were moderator-centered, with engagement patterns reflecting a structured yet varied level of participation among respondents.
Qualitative analysis of medical students’ perceptions and experiences with video-based learning in surgical education.
Discussion
The study reveals a strong foundation of knowledge about video-based surgical learning among medical students in the institution. Specifically, 79 (79.0%) of students had heard about video-based learning prior to the survey, indicating widespread awareness. Among those familiar with video-based surgical learning, 65 (82.3%) reported using video-based resources for information on surgical procedures, showing a clear preference for modern, accessible platforms. This reliance on video-based resources was notably higher than traditional sources such as textbooks (43, 54.4%) and lectures (38, 48.1%). Only 3 (3.8%) of students reported using journals, reflecting a shift toward more visually engaging learning methods. Moreover, fewer students accessed institutional video databases or peer-reviewed content (12, 15.2% and 1, 1.3%, respectively), suggesting a reliance on informal platforms like YouTube, which may raise concerns about content quality and accuracy. A study conducted in Iowa, United States, by Rapp et al 21 similarly found that 90% of medical students and residents used videos for online learning of surgical procedures, with 86% of them using YouTube, but only about 25% accessed peer-reviewed video resources. In terms of receptiveness, students overwhelmingly endorsed the inclusion of video-based learning in their curriculum. Of those aware of video-based surgical learning, 77 (97.5%) believed it should be formally incorporated into medical education, while 75 (94.9%) felt teaching hospitals should actively promote its use in surgery. This high level of support reflects a broader recognition of the benefits of video-based learning, such as improving understanding, offering flexible learning opportunities, and accommodating various learning speeds and styles. Moreover, 79 (100.0%) expressed willingness to encourage others to use videos for surgical learning. This mirrors findings from Selten et al, 22 where medical students in the Netherlands supported the use of standardized videos in surgical clerkships. Despite this enthusiasm, institutional support and infrastructure, as well as clear guidelines on video resource use, remain barriers to full integration into formal education.
When assessing the actual utilization of video-based learning, a clear gap between receptiveness and practice becomes apparent. Only 4 (5.1%) of students reported daily use of video-based resources, while 34 (43.0%) used them rarely, and 12 (15.2%) accessed them monthly. This discrepancy suggests that external factors like accessibility and institutional support significantly influence the use of video-based learning. The majority of students (68, 86.0%) accessed videos at home, with just 2 (2.5%) using them during lectures and 6 (7.6%) during clinical rotations, signaling an underutilization of video resources in formal educational settings. The significance of this finding is underscored by the limited support that institutions provide to students in terms of access to facilities for video-based learning, which results in a majority resorting to utilizing these resources at home instead at a greater cost. Additionally, 54 (68.4%) preferred shorter videos, under 10 min in length, aligning with findings from a study by Yee et al, 23 where shorter video content was favored for its focused, concise nature in surgical training. This is in agreement with a study carried out by Hassanien and Abou-Kamer, 24 which showed that the average length of medical education videos viewed by medical students was less than 20 min.
The barriers to video-based learning were significant. Among respondents, 63 (79.7%) cited the high cost of downloading or accessing videos, and 61 (77.2%) pointed to poor internet connectivity as a major challenge. These infrastructural limitations severely restrict students’ ability to regularly engage with video-based learning. Other obstacles included the length of available videos (29, 36.7%) and the poor quality of some content (24.1%). Additionally, 63 (79.7%) expressed concern over distractions from unrelated online content, a common issue with platforms like YouTube, which while widely used, pose challenges in maintaining focus and accessing relevant materials. A similar pattern was reported in Malaysia by Azlan et al, 25 where high data costs, poor internet connectivity, and online distractions limited the regular use of educational videos. The combination of these barriers and the lack of structured institutional resources hamper the full potential of video-based learning in this context. This study highlights the need for integrating video-based learning into medical education. Institutional support, such as subsidized internet access and curated video libraries, can address barriers such as high data costs and poor connectivity. Findings align with global trends, including high receptivity to video-based learning, as seen in studies from Malaysia and the Netherlands.21,23 The emphasis on standardization and infrastructure reflects universal challenges in video-based education.
Integrating video-based learning into the medical curriculum cannot be overemphasized, by providing students with institutional access to curated, high-quality video libraries and subsidized internet facilities. Formalizing its inclusion within the curriculum allows for the alignment of video resources with specific course objectives, structured learning schedules, and evaluation frameworks. Faculty training on effective use of video-based tools in teaching and the development of standardized instructional videos can further enhance the learning experience.
These findings underscore the global relevance of video-based learning and the urgent need for curriculum reforms, particularly in resource-limited settings. Institutional commitment to infrastructure development, standardization, and access can transform video-based learning from an informal supplement to a formalized, integral component of medical education. Future research should focus on strategies to overcome barriers, evaluate the impact of integrated video-based learning on academic outcomes, and explore innovative ways to incorporate this approach into clinical training.
Limitations of study
The study has several limitations that should be considered when interpreting the findings. First, it was conducted among medical students from a single institution, which may limit the generalizability of the results to other institutions or regions with different curricula, resources, and demographic characteristics. Additionally, while the sample size was sufficient for analysis, it was relatively small, particularly for the qualitative component, which may have restricted the diversity of perspectives captured during the FGDs. Another limitation is the reliance on self-reported data for both the quantitative and qualitative components, which introduces the potential for response bias. Participants might have overestimated or underestimated their knowledge, usage, or attitudes toward video-based learning. Furthermore, the use of online platforms, such as Google Forms, Telegram, and WhatsApp, for data collection, though convenient, may have excluded students with limited internet access or technological proficiency, potentially introducing selection bias.
This study's cross-sectional design provides only a snapshot of students’ perceptions and usage of video-based learning at a single point in time. A longitudinal study could offer deeper insights into how these perceptions and practices evolve over time. Moreover, while the study explored barriers such as data costs and poor internet connectivity, it did not delve deeply into institutional or faculty-level factors that might influence the integration of video-based learning into the curriculum. In the qualitative analysis, although efforts were made to achieve data saturation and reliability, some nuances of individual experiences might have been lost during the coding and thematic synthesis. The use of an adapted and pretested questionnaire, while helpful, involved a lack of fully validated measures specifically tailored to video-based learning in surgical education, which might have influenced the precision of the quantitative findings. Finally, focus group dynamics may have also affected the qualitative results. Certain participants might have dominated the discussions, limiting input from quieter individuals. Additionally, conducting the discussions virtually may have restricted the observation of nonverbal cues, which are typically captured in in-person FGDs.
Despite these limitations, the study provides valuable insights into the perceptions, usage, and barriers to video-based learning among medical students in a resource-limited setting. Future research should address these limitations by adopting a multisite, longitudinal approach with larger and more diverse samples, while also exploring institutional factors and validating measures tailored to video-based learning.
Conclusion
Most medical students are aware of the existence and benefits of video-based surgical learning, though they primarily rely on informal platforms like YouTube. This emphasizes the need for more structured, high-quality video resources within the formal educational system. The strong receptiveness to video-based learning suggests that students see it as a valuable tool for enhancing their surgical education. However, institutional support and formal integration into the curriculum are essential to realize its full potential. While students recognize the effectiveness of video-based learning, its actual utilization remains low due to infrastructural challenges such as high data costs and poor internet connectivity. Addressing these barriers is foundational to increasing the frequency of use and fully integrating video-based learning into their studies.
Supplemental Material
sj-docx-1-mde-10.1177_23821205251329676 - Supplemental material for Exploring the Knowledge and Utilization of Video-Based Surgical Learning Among Medical Students in a Teaching Hospital in Nigeria: A Mixed-Methods Study
Supplemental material, sj-docx-1-mde-10.1177_23821205251329676 for Exploring the Knowledge and Utilization of Video-Based Surgical Learning Among Medical Students in a Teaching Hospital in Nigeria: A Mixed-Methods Study by Asogun Daniel, Akhaine Jesu-Oboh Precious, Sulymon A. Saka, Vivian Oghobaghase, Ojeh-Oziegbe Oseyomon, Francis Ufuah and Adomi Solomon in Journal of Medical Education and Curricular Development
Supplemental Material
sj-docx-2-mde-10.1177_23821205251329676 - Supplemental material for Exploring the Knowledge and Utilization of Video-Based Surgical Learning Among Medical Students in a Teaching Hospital in Nigeria: A Mixed-Methods Study
Supplemental material, sj-docx-2-mde-10.1177_23821205251329676 for Exploring the Knowledge and Utilization of Video-Based Surgical Learning Among Medical Students in a Teaching Hospital in Nigeria: A Mixed-Methods Study by Asogun Daniel, Akhaine Jesu-Oboh Precious, Sulymon A. Saka, Vivian Oghobaghase, Ojeh-Oziegbe Oseyomon, Francis Ufuah and Adomi Solomon in Journal of Medical Education and Curricular Development
Footnotes
Author Contributions
AD conceived the study, wrote the first draft, and performed the quantitative statistical analysis. OO handled the qualitative data analysis. AJ and AP revised the first draft and made intellectual contributions. VO and FU prepared the tables and figure. SAS handled data curation, collection, edited, and thoroughly reviewed the revised manuscript. All authors reviewed the final manuscript.
Availability of Data and Material
The datasets utilized and analyzed during the study are available from the corresponding author upon reasonable request.
DECLARATION OF CONFLICTING INTERESTS
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
FUNDING
The authors received no financial support for the research, authorship, and/or publication of this article.
Consent for Participation
Written informed consent was sought from all participants before undertaking the study.
Ethics Approval and Consent to Participate
Ethics approval for the study was obtained from Irrua Specialist Teaching Hospital Health Research Ethics Committee (Protocol no: ISTH/HREC/20232012/522). The research was conducted in accordance with the declaration of Helsinki and other relevant guidelines. Informed consent was obtained from all participants prior to data collection.
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Supplemental Material
Supplemental material for this article is available online.
References
Supplementary Material
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