Assessing the Usefulness of Educational Videos on Endodontic Irrigation for Dental Students: A Pilot Study

Assessing the Usefulness of Educational Videos on Endodontic Irrigation for Dental Students: A Pilot Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing the Usefulness of Educational Videos on Endodontic Irrigation for Dental Students: A Pilot Study Jin Wey Kock, Shahmin Kar Sze Yeap, Naveen Chhabra, Philip Yuan-Ho Chien, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6241737/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Dec, 2025 Read the published version in BMC Medical Education → Version 1 posted 10 You are reading this latest preprint version Abstract Background This research aims to assess the usefulness of existing YouTube videos on endodontic irrigation, published between January 2013 and December 2022, as a learning resource for dental undergraduate students. Additionally, the study evaluates the educational value of these videos about factors such as video duration, authorship source, and view count. Methods YouTube searches for videos related to endodontic irrigation were conducted using search terms such as "irrigation protocol" and "endodontic irrigation." After screening, ninety-six videos were selected and assessed based on factors such as days since upload, video duration, number of views and likes, authorship source, and viewing rate. A set of six parameters was established to evaluate the educational value of the videos, with each element being assigned a score of 0 or 1. Statistical analyses were performed using the Kruskal-Wallis and Mann-Whitney tests, with a significant level of 5%. Results The videos received an average of 4,474.76 views, 38.67 likes, a 290.5% viewing rate, and a video length of 161.15 seconds. The mean usefulness score was 3.89, with the most discussed elements being demonstration, description, and equipment/apparatus. The majority of videos were from healthcare professionals (n = 73, 76.04%) or commercial sources (n = 22, 22.92%). Twenty-seven videos were classified as highly useful, sixty-one as moderately useful, and eight as low usefulness. Among the content usefulness categories, the highly useful videos had the shortest length (mean = 158.93s), while the moderately useful videos had the highest viewing rate. Videos uploaded by different authorship sources showed minimal statistical significance in content usefulness. Conclusions The usefulness of endodontic irrigation videos on YouTube has low educational value, and the available data to assess their effectiveness as a learning tool for undergraduate students is inconclusive. endodontics dental education root canal irrigants root canal therapy online learning Figures Figure 1 Figure 2 Figure 3 Introduction Endodontic irrigation is an essential component of root canal treatment (RCT) which removes noxious microorganisms that may cause intra-radicular and extra-radicular infection. Endodontic irrigation eradicates debris created during shaping of a root canal, lubricates the root canal, dissolves the organic and inorganic tissue, and removes the smear layer. 1 Irrigants can access areas beyond the reach of conventional instruments via chemical means. A previous study 2 emphasized the importance of irrigation as an adjunct to instrumentation techniques, as instrumentation alone left 35% or more of the canals' surface area unchanged, indicating that mechanical instrumentation has its limitations to access complex anatomy with multiple fins, isthmuses, ramification, and accessory canals. As such, the endodontic irrigation protocol is a critical part of RCT to ensure long-term success in the procedure. Preclinical endodontic education is integral to the dental curricula for undergraduate dental students and is traditionally delivered through lectures, demonstration of endodontic procedures, and simulated practical sessions supervised by endodontists. Endodontics is perceived as a challenging task for students to comprehend and as a result, dental educators have been exploring different avenues of education delivery at the preclinical phase to overcome the steep learning curve to help students establish a firm foundation of the discipline. 3 , 4 However, students excessively rely on popular search engines and social media despite the availability of library subscription databases and university-approved resources. 5 A possible reason for this could be attributed to the less user-friendly search tools for such databases which may be a barrier. 6 Dental education via YouTube has continued to grow in interest as a platform, particularly for dental education. Fu et al. 7 discovered that 96.7% of undergraduate dental students prefer YouTube for learning endodontics, a pattern growing more rampantly during the COVID-19 pandemic. When dental education transitioned online during the pandemic, a flow-on effect resulted in a steady increase of endodontic educational videos on YouTube and eventually weaved its way into the dental education system as a contemporary supplementary learning resource. However, the reliability of these YouTube videos remains questionable as the diverse range of authorship of the videos are unregulated. The suitability of the endodontic irrigation videos on YouTube for teaching and learning (T&L) purposes demands thorough scrutiny to ensure the videos are of merit: in other words, comprehensive and accurate evidence-based information that are suited to equip generations of undergraduate dental students to come. The present study aims to assess the educational value of endodontic irrigation as a learning resource for undergraduate students and the influence of different sources of authorship over the educational value of endodontic irrigation videos on YouTube. Methods The present study investigated YouTube educational videos regarding endodontic irrigation. Only videos related to irrigation in endodontics were analyzed. As such, other aspects of root canal disinfection, such as the mechanical shaping of a root canal, were beyond the scope of this study. The study was approved by the IMU Ethics and Research Committee (BDS I-01-2023(21)). The video selection was done by conducting a YouTube search on videos related to endodontic irrigation. The search was conducted with specific terms including [1] Irrigation protocol, [2] Endodontic irrigation, [3] Ultrasonic irrigation, [4] Sonic irrigation, [5] Machine-assisted irrigation, [6] Manual agitation. The search involved the use of a newly created YouTube account to store the included videos. In addition, the search was performed using the incognito function on Google Chrome with a) default settings, b) a clean cache, and c) an unlogged browser to prevent algorithmic learning from the search engine and browser history. The search was then sorted out by relevance; no other filters were applied. After compiling the videos with the specific keywords stated above, the videos were filtered with the following inclusion and exclusion criteria to obtain the final sample size (Table 1 ). Table 1 Inclusion and exclusion criteria of YouTube videos on endodontic irrigation Inclusion criteria Exclusion criteria 1. English-language videos. 2. Videos relevant to ‘endodontic irrigation’. 3. Videos with written or verbal explanations, including closed captions. 4. Videos with a demonstration of the technique. 5. Videos with a maximum duration of 10 minutes. 6. Videos uploaded between January 2013 to December 2022. 1. Non-English language videos (non-English videos with English subtitles were also excluded). 2. Videos irrelevant to ‘endodontic irrigation’. 3. Videos lacking written or verbal explanation. 4. Videos without demonstration of the technique. 5. Videos that exceeded 10 minutes in length. 6. Videos uploaded before January 2013 and after December 2022. 7. Duplicates of videos. Two observers were trained by an endodontist to evaluate the quality and content of the videos regarding irrigation methods. To analyze the content and assess the usefulness of the videos in providing information about endodontic irrigation, a scoring system based on six elements was established. This system was derived from the American Association of Endodontics (AAE) Treatment Standards and Haapasalo et al. 8 , 9 The elements consisted of the following: Definition Importance of irrigation Equipment/apparatus Description Irrigants Demonstration. Each element was scored as 0 or 1 with a maximum score of 6 for each video, based on its consistency in meeting the criteria for endodontic irrigation. The scoring was evaluated independently by two observers. Any differences in opinion were discussed between the observers to reach a unanimous agreement on the scoring. If necessary, a third observer was employed to resolve discrepancies. The data collected was entered into Microsoft Excel and then interpreted in terms of frequency and proportion. The data was coded, cleaned, and analyzed using IBM SPSS Statistics for Windows to apply various statistical methods. Inter-evaluator reliability was assessed using Cohen's Kappa statistics, while the Kruskal-Wallis test was used for statistical analyses. Overall, the videos were categorized as low [0–2], moderate [3–4], or high [5–6] usefulness. In addition to the scoring system, the included videos were thoroughly watched to gather information on the video duration, authorship source, and the number of views and likes. The data collected was then used to evaluate the educational value of the videos about their duration and viewer engagement. The viewing rate was calculated by considering both the number of views and likes, using the following formula: Viewing Rate = amount of views/number of days since upload x 100% The summary of the chronological flow of the methodology of this study is shown in Fig. 1 . Results Out of the 128 videos initially filtered, thirty were excluded due to being in a language other than English, irrelevant content, or the absence of written or verbal demonstration. Additionally, two videos became inaccessible during the data collection process and were therefore excluded from the analysis.The inter-rater evaluator reliability for the usefulness scoring was high (Kappa = 0.930). Among the elements, the most prevalent were “Demonstration” (98.96%), “Description” (87.50%), and “Equipment/Apparatus” (84.38%). The elements with less coverage included “Definition” (47.92%) and “Irrigants” (36.46%). The element “Importance of Irrigation” was the least prevalent, with an observation rate of only 34.38%, as shown in Table 2. The observation rate is displayed in Figure 2. The majority of videos achieved Demonstration (98.96%) while the Importance of Irrigation is the least achieved element (34.38%). Table 2: Content Usefulness of Endodontic Irrigation YouTube Videos: Observation Rate (N=96) Elements Observation Rate (%) N Definition 47.92 46 Importance of Irrigation 34.38 33 Equipment/Apparatus 84.38 81 Description 87.50 84 Irrigants 36.46 35 Demonstration 98.96 95 The mean usefulness score of the YouTube videos was 3.89 (range = 1–6), with a median score of 4. Only seven out of ninety-six videos scored the maximum score of 6, indicating that all elements were covered in detail." Descriptive statistics are shown in Table 3. The videos received a mean of 4,474.76 views (range = 19–48,032), with a mean duration of 161.15 seconds (range = 20–562). In terms of the number of likes, the videos received a mean of 38.67 likes (range = 0–303). The mean number of days since upload was 1,479.96 days (range = 103–3,858). In terms of viewing rate, the videos had a mean engagement rate of 290.5% (range = 1%–1,772%). Table 3 : Descriptive statistics of evaluated videos (N=96) Demographics Mean ± SD Median Q1-Q3 Min-Max Video length (in seconds) 161.15± 118.89 125 72-205 20-562 Days since upload 1479.96± 873.88 1468 855-1788 103-3858 Number of views 4474.76± 8335.24 1158 542-4200 19-48032 Number of likes 38.67± 59.22 16 7-34.5 0-303 Viewing rate (%) 290.5± 429.47 102.45 46.68-235.52 1-1772 Content usefulness score 3.89± 1.098 4 3-5 1-6 Abbreviations: Min, Minimum; Max, Maximum; SD, Standard Deviation. In terms of usefulness, less than one-third of the videos were determined to be high-usefulness videos (n = 27, 28.13%). The remainder of the videos were classified as moderate (n = 61, 63.54%) and low usefulness (n = 8, 8.33%). No significant statistical differences were observed across all video demographics (p > 0.05). It should be noted that high-usefulness videos had the shortest average length and were uploaded earlier compared to videos in the low and moderate-usefulness categories. High-usefulness videos also had the lowest number of views and viewing rate. Low-usefulness videos had the longest duration (mean = 172.38 seconds) and received the fewest likes (mean = 16.57). Moderate videos received the highest viewing rate (mean = 324.14%) and the highest number of likes (mean = 44.49). The results are displayed in Table 4. Table 4: Comparison of YouTube Demographics based on Usefulness Categories Demographics Low (n=8) Moderate (n=61) High (n=27) P-value a Mean ± SD Median Mean ± SD Median Mean ± SD Median Video length (in seconds) 172.38± 201.29 78 160.68± 107.39 132 158.93± 119.09 120 0.365 Days since upload 1429.75± 1129.17 1039.5 1429.44± 815.67 1337.5 1610.85± 943.82 1610 0.594 Number of views 5811± 10789.24 607 4799.61± 9087.72 1181 3332.89± 5410.29 1196 0.481 Number of likes 16.57± 20.31 6 44.49± 66.7 18 30.64± 42.68 13 0.522 Viewing rate (%) 282.77± 4.75 139.44 324.14± 4.75 102.52 215.55± 2.87 101.17 0.481 Abbreviation: SD, Standard Deviation. a Kruskal-Wallis and Mann-Whitney tests. For the sources of authorship, a large majority of the evaluated videos (77%) were uploaded by healthcare professionals, while the remainder were commercials and advertisements. Only one video was uploaded by an academic institution (Figure 3). Both sources remained in the moderate category for content usefulness, although videos uploaded by healthcare professionals received slightly higher scores. Videos posted by healthcare professionals also had longer durations and a higher number of views and likes. The data is summarized in Table 5. Table 5 : Comparison of Usefulness of Videos between Authorship Sources Healthcare Professionals (n = 73) Commercials (n = 22) P-Value Mean+ SD Median Mean+ SD Median Video length in seconds 220.4091 + 156.82828 173 146.0274 + 100.23555 123 0.06 Days since upload 1711.3636 + 888.56586 1599.5 1413.8082 + 864.29908 1283 0.119 Number of views 8027 + 10965.89378 1925.5 3495.9315 + 7239.64277 914 0.049 Number of likes 55.9+76.11826 17.5 34.5352 + 53.97561 16 0.264 Content usefulness score 4.0909 + 1.15095 4 3.8219 + 1.09725 4 0.00 Abbreviation: SD, Standard Deviation Discussion This study assessed the usefulness of endodontic irrigation YouTube videos uploaded as a learning resource for undergraduate dental students. After thorough scrutiny, most of the videos were in the moderate usefulness category, followed by high usefulness videos, and lastly low usefulness videos. As there is an apparent shift from professionals to users (such as laypeople) generating content over the years, the quality of the educational content uploaded is affected as not all videos meet high standards or are based on the school curriculum. 10 The surge of artificial intelligence (AI) videos circulating online has sparked contentious conversations about its benefits and challenges. 11 As of March 2024, YouTube creators are required to disclose any AI-generated videos to strengthen transparency with viewers. 12 As the sample size of the current study spanned from January 2013 to December 2022, synthetically generated videos in the sample size were not identified as they may not be as prevalent when compared to the present day. However, a study conducted by Leiker D 13 revealed that synthetically generated videos showed similar outcomes of learning to traditionally produced videos, suggesting that AI-generated videos are potentially a feasible learning resource for students. The videos in the sample size were contingent upon the inclusion criteria. The videos that were potentially synthetic in the sample size should be scrutinized like their traditionally produced counterpart as these videos were also highly unregulated on YouTube, regardless of its outset. The comprehensive search of videos regarding endodontic irrigation was conducted in August 2023, which was examined under the predefined criteria established based on AAE. Out of 128 videos, ninety-eight were suitable for analysis, with two videos being removed from the platform during the time of data collection. The sample size for endodontic irrigation videos is relatively larger than other topics within the discipline of endodontics. In similar study designs, Jamleh et al .14 conducted a study on the educational value of access cavities with a sample size of forty-two videos eligible in their inclusion criteria. Kiraz et al .15 conducted a study on YouTube as a source of information about rubber dams and had a sample of thirty-four videos. The abundance of videos may indicate a larger target audience, reinforcing the notion that students prefer using YouTube to obtain information on endodontic irrigation because of its user-friendly nature. The domain used to evaluate the videos were established based on information provided by the American Association of Endodontics (AAE) 8 regarding treatment standards and an article written by Haapasalo et al. 9 These criteria were also utilized in Jamleh et al’s study 14 on access cavity evaluation, where he also used an issue by the AAE 16 and the British Dental Journal 17 to create the evaluation system. This parameter is used to objectively assess the usefulness of the videos by determining the accuracy of the information they deliver based on the articles mentioned. Our inter-observer reliability is 98%, proving that the results and method are valid. Using this parameter, it is observed that most videos have achieved demonstration (98.97%) except for one video, in which both observers think the demonstration was poorly executed. The importance of irrigation is often not achieved by videos, although it is considered a foundation in endodontic irrigation. This could imply that there is a lack of emphasis on the importance and roles of irrigation in endodontics and that many students use YouTube to learn procedural techniques rather than abstract ideas since students often use YouTube primarily for visual learning. It could also suggest the lack of priority creators place on the context of endodontic irrigation, meaning that the YouTube creators are under the impression that their audience has the prior concept of the topic and dives into the topic instead of addressing the fundamentals. This creates a lack of contextualization for the learner and can hinder the learner’s ability to link these concepts to real-world scenarios. 18 With regard to the importance of irrigation, students may fail to comprehend clinical relevance if not explicitly conveyed in the context of the video. Videos of moderate usefulness exhibited the highest viewing rate compared to low and high-usefulness videos, which suggests that undergraduate students may have a lack of knowledge to identify better quality videos. This hypothesis is supported by the number of likes received by moderately rated videos, which is higher in comparison to poor and good videos. Ultimately, the student’s understanding of the topic may be affected as they do not consume high-quality educational content. Interestingly, the videos, on average, decreased in length as the quality increased, although there is a small difference between the moderate and high-usefulness videos. A study 19 published by Guo et al., suggests that the median engagement time for students reaches 100% when the video length is less than 6 minutes. In contrast, students’ engagement rate dropped as drastically as 50% when videos lengthened to nine to twelve minutes long, which was the rationale for selecting videos that did not exceed ten minutes. 18 Brame et al. 20 describes this as one of the key components of the cognitive load theory, whereby extraneous load decreases the effectiveness of an educational video. Thus, the shorter duration of the good videos may contribute to higher engagement time for students, which indirectly acts as another major supportive factor in the usefulness of the videos as an educational resource. Despite having a low number of likes and a lower viewing rate than moderate-useful videos, lower-usefulness videos were noted to have the highest mean number of views. Among these poor videos evaluated, it was found that the “definition”, “irrigants” and “importance of irrigation” were the elements least covered by the content creators. Possible reasons for this may be because students mostly focus on seeking knowledge about certain clinical skills and techniques to carry out a procedure e.g. demonstration of endodontic irrigation. With this, theoretical knowledge of the purpose of irrigation itself is often an overlooked aspect. As a result, content creators for these videos may show a tendency to focus solely on the demonstration aspect of endodontic irrigation, thus leading to a lack of comprehensiveness in covering this topic. The source of authorship had minimal significance to the content usefulness of the videos (p <0.05), as videos uploaded by both healthcare professionals and commercials showed moderate usefulness with a very slight difference in mean value and had the same median of 4. However, the descriptive statistics between the sources of authorship have a distinct difference. The videos by commercials are significantly shorter than healthcare professionals (p = 0.365). This was attributed to commercial videos tending to have higher production value, which shortened the video to be more concise. On the contrary, videos by healthcare professionals generally leaned into either a conversational format or uploading heavy videos on demonstration with the help of subtitles and captions, which can contribute to longer videos. Videos by healthcare professionals had a significantly higher viewing rate compared to commercial videos. An explanation could be that most commercial videos were tutorials of the irrigation system they were promoting, whilst videos by healthcare professionals were catered more around clinical skills, which could contribute to the higher viewing rate. This is supported by Schwab et al .21, who stated that learners perceive television (visual learning) as being more passive compared to print (textual medium), which inadvertently created superficial engagement and lower cognitive processing. Videos uploaded as commercials may prioritize more marketing value rather than critical educational substance, which could reduce the richness of content in favor of entertainment value, which reduces the educational effectiveness of the overall video, leading to lower performance in the viewing rate. A future consideration could be a sub-platform on YouTube dedicated solely to educational videos to distinguish the purpose of the videos posted. As both types of authors were only moderately useful, this indicates a need for collaboration between healthcare professionals and dental companies to enhance the quality of the videos produced on YouTube. The paucity of videos by academic institutions in this study (n=1) could be due to their copyright licenses, as academic institutions upload their learning materials into their e-learn portals, which are only accessible to students from their respective dental schools as part of their tuition. Limitation Across all YouTube demographics, there were no significant statistical differences (p>0.05). One of the possible causes for this was the sample size of the study. 22 While the actual data by Google was not disclosed, there is an estimated four billion videos uploaded on YouTube as of February 2024. This is a vast difference compared to the ninety-six videos obtained as the sample size in this study. 23 Moreover, this study utilized a 6-point scoring system that only covered 6 elements of the topic of endodontic irrigation. Each element is only given a score of either 0 or 1. As a result of the lack of detailed scoring criteria, there may be an inaccurate representation of the usefulness of the videos in this 6-point scoring system. This study is conducted retrospectively and not a controlled experiment. The videos evaluated can be removed or updated after the sample size is finalized, which can affect the results of the present study. YouTube is a dynamic platform that does not exclusively hold educational videos. As of 2021, YouTube has allowed users to hide the number of likes, which this study did not consider. Also, the results from this study can only be applied to videos in the English language. Videos uploaded in other languages were likely overlooked. It is worth noting that there is research suggesting that YouTube videos related to dentistry in other languages such as, Korean and Portuguese have been relatively useful, although there is still a lot of room for improvement. 24,25 During the sample size collection process, both researchers screened the videos individually to prevent observation bias. After compilation, the videos were cross-checked and any disagreements with the videos were discussed and confirmed by an endodontist. Additionally, this study may depict an inaccurate comparison of the video length in relation to the usefulness of the videos. As the length of the video is directly obtained from the duration displayed on the video, there may be non-educational content that is not accounted for. This study also does not account for the metrics whereby the videos may be sponsored or heavily advertised for the viewers. Lastly, there may be a discrepancy between the number of views displayed and the true viewing rate of the video. YouTube views are counted when a user clicks on the video and watches it for at least thirty seconds. Therefore, there is a possibility that the number of views is counted despite the user not watching the entire video. Conclusion At present, the educational value of endodontic irrigation YouTube videos as a learning resource for students remains average, deeming YouTube as an unsatisfactory platform for education. The information in the videos were incomprehensive, and the enrichment of students’ knowledge and perception of endodontic irrigation is questionable. There is a need for creators to improve the planning of the learning outcome of the video and the execution of the video with evidence-based information. Moreover, undergraduate students should be encouraged and trained to use more reliable platforms for information. Abbreviations J.W.K (Kock Jin Wey), S.K.Y( Shahmin Yeap Kar Sze ) , S.B(Shekhar Bhatia), N.C(Naveen Chhabra), and P.Y-H.C(Philip Yuan-Ho Chien) Declarations Ethics approval and consent to participate: This study was financially supported by the Institute of Research Development and Innovation, International Medical University, and was approved by the IMU Ethics and Research Committee, Project ID: (BDS I-01-2023(21)). Consent for publication: Not Applicable. Availability of data and materials: Data is provided within the manuscript. Competing Interests: The authors declare no competing interests. Funding: This study was financially supported by the Institute of Research Development and Innovation, International Medical University, and was approved by the IMU Ethics and Research Committee, Project ID: (BDS I-01-2023(21)). Authors' contributions: J.W.K, S.K.Y, S.B, N.C, and P.Y-H.C contributed to the conception, design, acquisition, analysis, interpretation, and drafting of the manuscript; J.W.K, S.K.Y, S.B, and P.Y-H.C contributed to the critical revision of the manuscript; J.W.K, S.K.Y contributed to the design, acquisition, and analysis of data. J.W.K, S.K.Y, S.B, N.C, and P.Y-H.C contributed to the conception, design, acquisition, analysis, interpretation, and drafting of the manuscript; J.W.K, S.K.Y, S.B, P.Y-H.C contributed to the critical revision of the manuscript; J.W.K, S.K.Y contributed to the design, acquisition, and analysis of data Acknowledgements: The authors would like to thank IMU University and the School of Dentistry for their support in this project. Conflict of interest: The authors declare no conflicts of interest. References Suresh Chandra B. Irrigants and Intracanal Medicaments. In: Gopikrishna V, editor. Grossman's endodontic practice. 14th ed. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6241737","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":457654784,"identity":"3ca17d10-1631-4ba8-a783-fa9ee8308ae8","order_by":0,"name":"Jin Wey Kock","email":"","orcid":"","institution":"International Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jin","middleName":"Wey","lastName":"Kock","suffix":""},{"id":457654785,"identity":"d2136bf1-f7c1-4e52-9ec9-af62c2b2751a","order_by":1,"name":"Shahmin Kar Sze Yeap","email":"","orcid":"","institution":"International Medical University","correspondingAuthor":false,"prefix":"","firstName":"Shahmin","middleName":"Kar Sze","lastName":"Yeap","suffix":""},{"id":457654786,"identity":"7621ed11-465b-480f-8f41-ce2888746e60","order_by":2,"name":"Naveen Chhabra","email":"","orcid":"","institution":"ITS Centre for Dental Studies and Research, Muradnagar, Ghaziabad, India","correspondingAuthor":false,"prefix":"","firstName":"Naveen","middleName":"","lastName":"Chhabra","suffix":""},{"id":457654787,"identity":"beef77a5-0dcf-4176-b375-1a69e046cca6","order_by":3,"name":"Philip Yuan-Ho Chien","email":"","orcid":"","institution":"University of Queensland","correspondingAuthor":false,"prefix":"","firstName":"Philip","middleName":"Yuan-Ho","lastName":"Chien","suffix":""},{"id":457654788,"identity":"e6c6d1fd-6cd5-4ad3-9a46-f9b41b1c65fd","order_by":4,"name":"Shekhar Bhatia","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYDACCQZmZhBtIAEkEhhsoIJEamFsSGBII1ULA8NhwlrkZzcfNi6oucdgLt38/MGDmvOJfQeYD97mYbBLbMChxeDOseTkGceKGSznHDNsSDh2O3HmAbZkax6GZNxaJHKMD/OwJTAY3EgAamG7nbjhAI+ZNA8DM04t8jPyPx/m+QfSkv6xIeHfOaAW/m9ALfU4tTDcyGFO5m0DackxbEhsOwCyhQ2o5TBuh91IMzbm7UvgsZyRUzgjsS/ZeOZhNmPLOQbHjXE7LPmxNM+3BDlzifQNH398s5PtO9788MabimpZnA6DAh4EExw1BgTUo4IDJKkeBaNgFIyCEQAAQCVZW2SQAtcAAAAASUVORK5CYII=","orcid":"","institution":"University of Queensland","correspondingAuthor":true,"prefix":"","firstName":"Shekhar","middleName":"","lastName":"Bhatia","suffix":""}],"badges":[],"createdAt":"2025-03-17 06:53:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6241737/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6241737/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-07647-0","type":"published","date":"2025-12-17T15:58:18+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":83032032,"identity":"d4eba475-17f9-4a4c-a212-0ef34e5bfc52","added_by":"auto","created_at":"2025-05-19 09:19:07","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":37210,"visible":true,"origin":"","legend":"\u003cp\u003eSummary of the methodology of this study\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6241737/v1/a861c3f6a71496a06de7570c.png"},{"id":83033434,"identity":"d4339194-4532-4ba0-bd83-41488e0d1dad","added_by":"auto","created_at":"2025-05-19 09:27:07","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":24559,"visible":true,"origin":"","legend":"\u003cp\u003eA visual representation of the scores assigned to each Element\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6241737/v1/3ad0317e72a21133cd48f712.png"},{"id":83032034,"identity":"5a4e9589-c70b-4f42-8bfa-f8de244a219a","added_by":"auto","created_at":"2025-05-19 09:19:07","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":21181,"visible":true,"origin":"","legend":"\u003cp\u003eSource of Authorship\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6241737/v1/ac22730192d4207701a66875.png"},{"id":98813998,"identity":"b7b77a57-e3af-48ee-9477-01fb187c4236","added_by":"auto","created_at":"2025-12-22 16:09:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":540833,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6241737/v1/45f1cd98-0ab1-479c-add4-b7202ba5f3be.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessing the Usefulness of Educational Videos on Endodontic Irrigation for Dental Students: A Pilot Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEndodontic irrigation is an essential component of root canal treatment (RCT) which removes noxious microorganisms that may cause intra-radicular and extra-radicular infection. Endodontic irrigation eradicates debris created during shaping of a root canal, lubricates the root canal, dissolves the organic and inorganic tissue, and removes the smear layer.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Irrigants can access areas beyond the reach of conventional instruments via chemical means. A previous study\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e emphasized the importance of irrigation as an adjunct to instrumentation techniques, as instrumentation alone left 35% or more of the canals' surface area unchanged, indicating that mechanical instrumentation has its limitations to access complex anatomy with multiple fins, isthmuses, ramification, and accessory canals. As such, the endodontic irrigation protocol is a critical part of RCT to ensure long-term success in the procedure.\u003c/p\u003e \u003cp\u003ePreclinical endodontic education is integral to the dental curricula for undergraduate dental students and is traditionally delivered through lectures, demonstration of endodontic procedures, and simulated practical sessions supervised by endodontists. Endodontics is perceived as a challenging task for students to comprehend and as a result, dental educators have been exploring different avenues of education delivery at the preclinical phase to overcome the steep learning curve to help students establish a firm foundation of the discipline.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e However, students excessively rely on popular search engines and social media despite the availability of library subscription databases and university-approved resources.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e A possible reason for this could be attributed to the less user-friendly search tools for such databases which may be a barrier.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDental education via YouTube has continued to grow in interest as a platform, particularly for dental education. Fu et al.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e discovered that 96.7% of undergraduate dental students prefer YouTube for learning endodontics, a pattern growing more rampantly during the COVID-19 pandemic. When dental education transitioned online during the pandemic, a flow-on effect resulted in a steady increase of endodontic educational videos on YouTube and eventually weaved its way into the dental education system as a contemporary supplementary learning resource. However, the reliability of these YouTube videos remains questionable as the diverse range of authorship of the videos are unregulated. The suitability of the endodontic irrigation videos on YouTube for teaching and learning (T\u0026amp;L) purposes demands thorough scrutiny to ensure the videos are of merit: in other words, comprehensive and accurate evidence-based information that are suited to equip generations of undergraduate dental students to come. The present study aims to assess the educational value of endodontic irrigation as a learning resource for undergraduate students and the influence of different sources of authorship over the educational value of endodontic irrigation videos on YouTube.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe present study investigated YouTube educational videos regarding endodontic irrigation. Only videos related to irrigation in endodontics were analyzed. As such, other aspects of root canal disinfection, such as the mechanical shaping of a root canal, were beyond the scope of this study. The study was approved by the IMU Ethics and Research Committee (BDS I-01-2023(21)).\u003c/p\u003e \u003cp\u003eThe video selection was done by conducting a YouTube search on videos related to endodontic irrigation. The search was conducted with specific terms including [1] Irrigation protocol, [2] Endodontic irrigation, [3] Ultrasonic irrigation, [4] Sonic irrigation, [5] Machine-assisted irrigation, [6] Manual agitation. The search involved the use of a newly created YouTube account to store the included videos. In addition, the search was performed using the incognito function on Google Chrome with a) default settings, b) a clean cache, and c) an unlogged browser to prevent algorithmic learning from the search engine and browser history. The search was then sorted out by relevance; no other filters were applied.\u003c/p\u003e \u003cp\u003eAfter compiling the videos with the specific keywords stated above, the videos were filtered with the following inclusion and exclusion criteria to obtain the final sample size (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInclusion and exclusion criteria of YouTube videos on endodontic irrigation\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInclusion criteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExclusion criteria\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. English-language videos.\u003c/p\u003e \u003cp\u003e2. Videos relevant to \u0026lsquo;endodontic irrigation\u0026rsquo;.\u003c/p\u003e \u003cp\u003e3. Videos with written or verbal explanations, including closed captions.\u003c/p\u003e \u003cp\u003e4. Videos with a demonstration of the technique.\u003c/p\u003e \u003cp\u003e5. Videos with a maximum duration of 10 minutes.\u003c/p\u003e \u003cp\u003e6. Videos uploaded between January 2013 to December 2022.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1. Non-English language videos (non-English videos with English subtitles were also excluded).\u003c/p\u003e \u003cp\u003e2. Videos irrelevant to \u0026lsquo;endodontic irrigation\u0026rsquo;.\u003c/p\u003e \u003cp\u003e3. Videos lacking written or verbal explanation.\u003c/p\u003e \u003cp\u003e4. Videos without demonstration of the technique.\u003c/p\u003e \u003cp\u003e5. Videos that exceeded 10 minutes in length.\u003c/p\u003e \u003cp\u003e6. Videos uploaded before January 2013 and after December 2022.\u003c/p\u003e \u003cp\u003e7. Duplicates of videos.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTwo observers were trained by an endodontist to evaluate the quality and content of the videos regarding irrigation methods. To analyze the content and assess the usefulness of the videos in providing information about endodontic irrigation, a scoring system based on six elements was established. This system was derived from the American Association of Endodontics (AAE) Treatment Standards and Haapasalo et al.\u003csup\u003e\u003cem\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/em\u003e\u003c/sup\u003e The elements consisted of the following:\u003c/p\u003e \u003cul\u003e\n \u003cli\u003eDefinition\u003c/li\u003e\n \u003cli\u003eImportance of irrigation\u003c/li\u003e\n \u003cli\u003eEquipment/apparatus\u003c/li\u003e\n \u003cli\u003eDescription\u003c/li\u003e\n \u003cli\u003eIrrigants\u003c/li\u003e\n \u003cli\u003eDemonstration.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\u003cp\u003eEach element was scored as 0 or 1 with a maximum score of 6 for each video, based on its consistency in meeting the criteria for endodontic irrigation. The scoring was evaluated independently by two observers. Any differences in opinion were discussed between the observers to reach a unanimous agreement on the scoring. If necessary, a third observer was employed to resolve discrepancies. The data collected was entered into Microsoft Excel and then interpreted in terms of frequency and proportion. The data was coded, cleaned, and analyzed using IBM SPSS Statistics for Windows to apply various statistical methods. Inter-evaluator reliability was assessed using Cohen's Kappa statistics, while the Kruskal-Wallis test was used for statistical analyses. Overall, the videos were categorized as low [0\u0026ndash;2], moderate [3\u0026ndash;4], or high [5\u0026ndash;6] usefulness. In addition to the scoring system, the included videos were thoroughly watched to gather information on the video duration, authorship source, and the number of views and likes. The data collected was then used to evaluate the educational value of the videos about their duration and viewer engagement. The viewing rate was calculated by considering both the number of views and likes, using the following formula: Viewing Rate\u0026thinsp;=\u0026thinsp;amount of views/number of days since upload x 100%\u003c/p\u003e \u003cp\u003eThe summary of the chronological flow of the methodology of this study is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of the 128 videos initially filtered, thirty were excluded due to being in a language other than English, irrelevant content, or the absence of written or verbal demonstration. Additionally, two videos became inaccessible during the data collection process and were therefore excluded from the analysis.The inter-rater evaluator reliability for the usefulness scoring was high (Kappa = 0.930). Among the elements, the most prevalent were \u0026ldquo;Demonstration\u0026rdquo; (98.96%), \u0026ldquo;Description\u0026rdquo; (87.50%), and \u0026ldquo;Equipment/Apparatus\u0026rdquo; (84.38%). The elements with less coverage included \u0026ldquo;Definition\u0026rdquo; (47.92%) and \u0026ldquo;Irrigants\u0026rdquo; (36.46%). The element \u0026ldquo;Importance of Irrigation\u0026rdquo; was the least prevalent, with an observation rate of only 34.38%, as shown in Table 2. The observation rate is displayed in Figure 2.\u0026nbsp;The majority of videos achieved Demonstration (98.96%) while the Importance of Irrigation is the least achieved element (34.38%).\u003c/p\u003e\n\u003cp\u003eTable 2: Content Usefulness of Endodontic Irrigation YouTube Videos: Observation Rate (N=96)\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"594\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eElements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eObservation Rate (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003eDefinition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e47.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003eImportance of Irrigation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e34.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003eEquipment/Apparatus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e84.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003eDescription\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e87.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003eIrrigants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e36.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34.8485%;\"\u003e\n \u003cp\u003eDemonstration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e98.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.8182%;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eThe mean usefulness score of the YouTube videos was 3.89 (range = 1\u0026ndash;6), with a median score of 4. Only seven out of ninety-six videos scored the maximum score of 6, indicating that all elements were covered in detail.\u0026quot;\u003c/p\u003e\n\u003cp\u003eDescriptive statistics are shown in Table 3. The videos received a mean of 4,474.76 views (range = 19\u0026ndash;48,032), with a mean duration of 161.15 seconds (range = 20\u0026ndash;562). In terms of the number of likes, the videos received a mean of 38.67 likes (range = 0\u0026ndash;303). The mean number of days since upload was 1,479.96 days (range = 103\u0026ndash;3,858). In terms of viewing rate, the videos had a mean engagement rate of 290.5% (range = 1%\u0026ndash;1,772%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e3\u003cstrong\u003e:\u003c/strong\u003e Descriptive statistics of evaluated videos (N=96)\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"583\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eDemographics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003eQ1-Q3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003eMin-Max\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eVideo length (in seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e161.15\u0026plusmn; 118.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003e72-205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e20-562\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eDays since upload\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e1479.96\u0026plusmn; 873.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003e1468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003e855-1788\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e103-3858\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eNumber of views\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e4474.76\u0026plusmn; 8335.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003e1158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003e542-4200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e19-48032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eNumber of likes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e38.67\u0026plusmn; 59.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003e7-34.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e0-303\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eViewing rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e290.5\u0026plusmn; 429.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003e102.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003e46.68-235.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e1-1772\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.47%;\"\u003e\n \u003cp\u003eContent usefulness score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e3.89\u0026plusmn; 1.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.554%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.211%;\"\u003e\n \u003cp\u003e3-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 19.3825%;\"\u003e\n \u003cp\u003e1-6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: Min, Minimum; Max, Maximum; SD, Standard Deviation.\u003c/p\u003e\n\u003cp\u003eIn terms of usefulness, less than one-third of the videos were determined to be high-usefulness videos (n = 27, 28.13%). The remainder of the videos were classified as moderate (n = 61, 63.54%) and low usefulness (n = 8, 8.33%). No significant statistical differences were observed across all video demographics (p \u0026gt; 0.05). It should be noted that high-usefulness videos had the shortest average length and were uploaded earlier compared to videos in the low and moderate-usefulness categories. High-usefulness videos also had the lowest number of views and viewing rate. Low-usefulness videos had the longest duration (mean = 172.38 seconds) and received the fewest likes (mean = 16.57). Moderate videos received the highest viewing rate (mean = 324.14%) and the highest number of likes (mean = 44.49).\u0026nbsp;The results are displayed in Table 4.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table 4:\u003c/strong\u003e Comparison of YouTube Demographics based on Usefulness Categories\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eDemographics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eLow (n=8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 139px;\"\u003e\n \u003cp\u003eModerate (n=61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eHigh (n=27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003eP-value\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eVideo length (in seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e172.38\u0026plusmn; 201.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e160.68\u0026plusmn; 107.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e158.93\u0026plusmn; 119.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eDays since upload\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1429.75\u0026plusmn; 1129.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e1039.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e1429.44\u0026plusmn; 815.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1337.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e1610.85\u0026plusmn; 943.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.594\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNumber of views\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e5811\u0026plusmn; 10789.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e607\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e4799.61\u0026plusmn; 9087.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e3332.89\u0026plusmn; 5410.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.481\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNumber of likes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e16.57\u0026plusmn; 20.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e44.49\u0026plusmn; 66.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e30.64\u0026plusmn; 42.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.522\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eViewing rate (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e282.77\u0026plusmn; 4.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e139.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e324.14\u0026plusmn; 4.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e102.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e215.55\u0026plusmn; 2.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e101.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.481\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviation: SD, Standard Deviation.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Kruskal-Wallis and Mann-Whitney tests.\u003c/p\u003e\n\u003cp\u003eFor the sources of authorship, a large majority of the evaluated videos (77%) were uploaded by healthcare professionals, while the remainder were commercials and advertisements. Only one video was uploaded by an academic institution (Figure 3). Both sources remained in the moderate category for content usefulness, although videos uploaded by healthcare professionals received slightly higher scores. Videos posted by healthcare professionals also had longer durations and a higher number of views and likes. The data is summarized in Table 5.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e: Comparison of Usefulness of Videos between Authorship Sources\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"616\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003eHealthcare Professionals (n = 73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 223px;\"\u003e\n \u003cp\u003eCommercials (n = 22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003eP-Value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 161px;\"\u003e\n \u003cp\u003eMean+ SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003eMean+ SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003eVideo length in seconds\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 161px;\"\u003e\n \u003cp\u003e220.4091 + 156.82828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\n \u003cp\u003e173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e146.0274 + 100.23555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003eDays since upload\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 161px;\"\u003e\n \u003cp\u003e1711.3636 + 888.56586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1599.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e1413.8082 + 864.29908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e1283\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNumber of views\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 161px;\"\u003e\n \u003cp\u003e8027 + 10965.89378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\n \u003cp\u003e1925.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e3495.9315 + 7239.64277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003eNumber of likes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 161px;\"\u003e\n \u003cp\u003e55.9+76.11826\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\n \u003cp\u003e17.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e34.5352 + 53.97561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.264\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 108px;\"\u003e\n \u003cp\u003eContent usefulness score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 161px;\"\u003e\n \u003cp\u003e4.0909 + 1.15095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 65px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 145px;\"\u003e\n \u003cp\u003e3.8219 + 1.09725\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 59px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviation: SD, Standard Deviation\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study assessed the usefulness of endodontic irrigation YouTube videos uploaded as a learning resource for undergraduate dental students. After thorough scrutiny, most of the videos were in the moderate usefulness category, followed by high usefulness videos, and lastly low usefulness videos. As there is an apparent shift from professionals to users (such as laypeople) generating content over the years, the quality of the educational content uploaded is affected as not all videos meet high standards or are based on the school curriculum.\u003csup\u003e10\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe surge of artificial intelligence (AI) videos circulating online has sparked contentious conversations about its benefits and challenges.\u003csup\u003e11\u003c/sup\u003e As of March 2024, YouTube creators are required to disclose any AI-generated videos to strengthen transparency with viewers.\u003csup\u003e12\u003c/sup\u003e As the sample size of the current study spanned from January 2013 to December 2022, synthetically generated videos in the sample size were not identified as they may not be as prevalent when compared to the present day. However, a study conducted by Leiker D\u003csup\u003e13\u003c/sup\u003e revealed that synthetically generated videos showed similar outcomes of learning to traditionally produced videos, suggesting that AI-generated videos are potentially a feasible learning resource for students. The videos in the sample size were contingent upon the inclusion criteria. The videos that were potentially synthetic in the sample size should be scrutinized like their traditionally produced counterpart as these videos were also highly unregulated on YouTube, regardless of its outset.\u003c/p\u003e\n\u003cp\u003eThe comprehensive search of videos regarding endodontic irrigation was conducted in August 2023, which was examined under the predefined criteria established based on AAE. Out of 128 videos, ninety-eight were suitable for analysis, with two videos being removed from the platform during the time of data collection. The sample size for endodontic irrigation videos is relatively larger than other topics within the discipline of endodontics. In similar study designs, Jamleh \u003cem\u003eet al\u003csup\u003e.14\u003c/sup\u003e\u0026nbsp;\u003c/em\u003econducted a study on the educational value of access cavities with a sample size of forty-two videos eligible in their inclusion criteria. Kiraz \u003cem\u003eet al\u003csup\u003e.15\u003c/sup\u003e\u003c/em\u003e conducted a study on YouTube as a source of information about rubber dams and had a sample of thirty-four videos. The abundance of videos may indicate a larger target audience, reinforcing the notion that students prefer using YouTube to obtain information on endodontic irrigation because of its user-friendly nature. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe domain used to evaluate the videos were established based on information provided by the American Association of Endodontics (AAE)\u003csup\u003e8\u003c/sup\u003e regarding treatment standards and an article written by Haapasalo et al.\u003csup\u003e9\u003c/sup\u003e These criteria were also utilized in Jamleh et al\u0026rsquo;s study\u003csup\u003e14\u003c/sup\u003e on access cavity evaluation, where he also used an issue by the AAE\u003csup\u003e16\u003c/sup\u003e and the British Dental Journal\u003csup\u003e17\u003c/sup\u003e to create the evaluation system. This parameter is used to objectively assess the usefulness of the videos by determining the accuracy of the information they deliver based on the articles mentioned. Our inter-observer reliability is 98%, proving that the results and method are valid. Using this parameter, it is observed that most videos have achieved demonstration (98.97%) except for one video, in which both observers think the demonstration was poorly executed. The importance of irrigation is often not achieved by videos, although it is considered a foundation in endodontic irrigation. This could imply that there is a lack of emphasis on the importance and roles of irrigation in endodontics and that many students use YouTube to learn procedural techniques rather than abstract ideas since students often use YouTube primarily for visual learning. It could also suggest the lack of priority creators place on the context of endodontic irrigation, meaning that the YouTube creators are under the impression that their audience has the prior concept of the topic and dives into the topic instead of addressing the fundamentals. This creates a lack of contextualization for the learner and can hinder the learner\u0026rsquo;s ability to link these concepts to real-world scenarios.\u003csup\u003e18\u003c/sup\u003e With regard to the importance of irrigation, students may fail to comprehend clinical relevance if not explicitly conveyed in the context of the video.\u003c/p\u003e\n\u003cp\u003eVideos of moderate usefulness exhibited the highest viewing rate compared to low and high-usefulness videos, which suggests that undergraduate students may have a lack of knowledge to identify better quality videos. This hypothesis is supported by the number of likes received by moderately rated videos, which is higher in comparison to poor and good videos. Ultimately, the student\u0026rsquo;s understanding of the topic may be affected as they do not consume high-quality educational content. Interestingly, the videos, on average, decreased in length as the quality increased, although there is a small difference between the moderate and high-usefulness videos. A study\u003csup\u003e19\u003c/sup\u003e published by Guo \u003cem\u003eet al.,\u003c/em\u003e suggests that the median engagement time for students reaches 100% when the video length is less than 6 minutes. In contrast, students\u0026rsquo; engagement rate dropped as drastically as 50% when videos lengthened to nine to twelve minutes long, which was the rationale for selecting videos that did not exceed ten minutes.\u003csup\u003e18\u003c/sup\u003e Brame \u003cem\u003eet al.\u003csup\u003e20\u003c/sup\u003e\u0026nbsp;\u003c/em\u003edescribes this as one of the key components of the cognitive load theory, whereby extraneous load decreases the effectiveness of an educational video. Thus, the shorter duration of the good videos may contribute to higher engagement time for students, which indirectly acts as another major supportive factor in the usefulness of the videos as an educational resource.\u003c/p\u003e\n\u003cp\u003eDespite having a low number of likes and a lower viewing rate than moderate-useful videos, lower-usefulness videos were noted to have the highest mean number of views. Among these poor videos evaluated, it was found that the \u0026ldquo;definition\u0026rdquo;, \u0026ldquo;irrigants\u0026rdquo; and \u0026ldquo;importance of irrigation\u0026rdquo; were the elements least covered by the content creators. Possible reasons for this may be because students mostly focus on seeking knowledge about certain clinical skills and techniques to carry out a procedure e.g. demonstration of endodontic irrigation. With this, theoretical knowledge of the purpose of irrigation itself is often an overlooked aspect. As a result, content creators for these videos may show a tendency to focus solely on the demonstration aspect of endodontic irrigation, thus leading to a lack of comprehensiveness in covering this topic.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; The source of authorship had minimal significance to the content usefulness of the videos (p \u0026lt;0.05), as videos uploaded by both healthcare professionals and commercials showed moderate usefulness with a very slight difference in mean value and had the same median of 4. However, the descriptive statistics between the sources of authorship have a distinct difference. The videos by commercials are significantly shorter than healthcare professionals (p = 0.365). This was attributed to commercial videos tending to have higher production value, which shortened the video to be more concise. On the contrary, videos by healthcare professionals generally leaned into either a conversational format or uploading heavy videos on demonstration with the help of subtitles and captions, which can contribute to longer videos. Videos by healthcare professionals had a significantly higher viewing rate compared to commercial videos. An explanation could be that most commercial videos were tutorials of the irrigation system they were promoting, whilst videos by healthcare professionals were catered more around clinical skills, which could contribute to the higher viewing rate. This is supported by Schwab \u003cem\u003eet al\u003csup\u003e.21,\u003c/sup\u003e\u003c/em\u003e who stated that learners perceive television (visual learning) as being more passive compared to print (textual medium), which inadvertently created superficial engagement and lower cognitive processing. Videos uploaded as commercials may prioritize more marketing value rather than critical educational substance, which could reduce the richness of content in favor of entertainment value, which reduces the educational effectiveness of the overall video, leading to lower performance in the viewing rate. A future consideration could be a sub-platform on YouTube dedicated solely to educational videos to distinguish the purpose of the videos posted. As both types of authors were only moderately useful, this indicates a need for collaboration between healthcare professionals and dental companies to enhance the quality of the videos produced on YouTube. The paucity of videos by academic institutions in this study (n=1) could be due to their copyright licenses, as academic institutions upload their learning materials into their e-learn portals, which are only accessible to students from their respective dental schools as part of their tuition.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitation \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAcross all YouTube demographics, there were no significant statistical differences (p\u0026gt;0.05). One of the possible causes for this was the sample size of the study.\u003csup\u003e22\u0026nbsp;\u003c/sup\u003eWhile the actual data by Google was not disclosed, there is an estimated four billion videos uploaded on YouTube as of February 2024. This is a vast difference compared to the ninety-six videos obtained as the sample size in this study.\u003csup\u003e23\u003c/sup\u003e Moreover, this study utilized a 6-point scoring system that only covered 6 elements of the topic of endodontic irrigation. Each element is only given a score of either 0 or 1. As a result of the lack of detailed scoring criteria, there may be an inaccurate representation of the usefulness of the videos in this 6-point scoring system. This study is conducted retrospectively and not a controlled experiment. The videos evaluated can be removed or updated after the sample size is finalized, which can affect the results of the present study. YouTube is a dynamic platform that does not exclusively hold educational videos. As of 2021, YouTube has allowed users to hide the number of likes, which this study did not consider. Also, the results from this study can only be applied to videos in the English language. Videos uploaded in other languages were likely overlooked. It is worth noting that there is research suggesting that YouTube videos related to dentistry in other languages such as, Korean and Portuguese have been relatively useful, although there is still a lot of room for improvement.\u003csup\u003e24,25\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eDuring the sample size collection process, both researchers screened the videos individually to prevent observation bias. After compilation, the videos were cross-checked and any disagreements with the videos were discussed and confirmed by an endodontist. \u0026nbsp;Additionally, this study may depict an inaccurate comparison of the video length in relation to the usefulness of the videos. As the length of the video is directly obtained from the duration displayed on the video, there may be non-educational content that is not accounted for. This study also does not account for the metrics whereby the videos may be sponsored or heavily advertised for the viewers. Lastly, there may be a discrepancy between the number of views displayed and the true viewing rate of the video. YouTube views are counted when a user clicks on the video and watches it for at least thirty seconds. Therefore, there is a possibility that the number of views is counted despite the user not watching the entire video.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAt present, the educational value of endodontic irrigation YouTube videos as a learning resource for students remains average, deeming YouTube as an unsatisfactory platform for education. The information in the videos were incomprehensive, and the enrichment of students\u0026rsquo; knowledge and perception of endodontic irrigation is questionable. There is a need for creators to improve the planning of the learning outcome of the video and the execution of the video with evidence-based information. Moreover, undergraduate students should be encouraged and trained to use more reliable platforms for information.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eJ.W.K (Kock Jin Wey), S.K.Y(\u0026nbsp;Shahmin Yeap Kar Sze\u003csup\u003e)\u003c/sup\u003e, S.B(Shekhar Bhatia), N.C(Naveen Chhabra), and P.Y-H.C(Philip Yuan-Ho Chien)\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: This study was financially supported by the Institute of Research Development and Innovation, International Medical University, and was approved by the IMU Ethics and Research Committee, Project ID: (BDS I-01-2023(21)).\u003c/p\u003e\n\u003cp\u003eConsent for publication: Not Applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials: Data is provided within the manuscript.\u003c/p\u003e\n\u003cp\u003eCompeting Interests: The authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding: This study was financially supported by the Institute of Research Development and Innovation, International Medical University, and was approved by the IMU Ethics and Research Committee, Project ID: (BDS I-01-2023(21)).\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions: J.W.K, S.K.Y, S.B, N.C, and P.Y-H.C contributed to the conception, design, acquisition, analysis, interpretation, and drafting of the manuscript; \u0026nbsp;J.W.K, S.K.Y, S.B, and P.Y-H.C contributed to the critical revision of the manuscript; \u0026nbsp;J.W.K, S.K.Y contributed to the design, acquisition, and analysis of data. J.W.K, S.K.Y, S.B, N.C, and P.Y-H.C contributed to the conception, design, acquisition, analysis, interpretation, and drafting of the manuscript; \u0026nbsp;J.W.K, S.K.Y, S.B, P.Y-H.C contributed to the critical revision of the manuscript; \u0026nbsp;J.W.K, S.K.Y contributed to the design, acquisition, and analysis of data\u003c/p\u003e\n\u003cp\u003eAcknowledgements: The authors would like to thank IMU University and the School of Dentistry for their support in this project.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConflict of interest: The authors declare no conflicts of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSuresh Chandra B. Irrigants and Intracanal Medicaments. In: Gopikrishna V, editor. Grossman\u0026apos;s endodontic practice. 14th ed. India: Wolters Kluwer Health; 2021. p. 298.\u003c/li\u003e\n\u003cli\u003ePeters OA, Sch\u0026ouml;nenberger K, Laib A. 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Available from: https://www.researchgate.net/publication/262393281_How_video_production_affects_student_engagement_An_empirical_study_of_MOOC_videos.\u003c/li\u003e\n\u003cli\u003eBrame CJ. Effective educational videos: principles and guidelines for maximizing student learning from video content. CBE Life Sci Educ. 2016;15:es6. DOI: 10.1187/cbe.16-03-0125.\u003c/li\u003e\n\u003cli\u003eSchwab F, Hennighausen C, Adler DC, Carolus A. Television is still \u0026quot;easy\u0026quot; and print is still \u0026quot;tough\u0026quot;? More than 30 years of research on the amount of invested mental effort. Front Psychol. 20183; 9:1098.\u003c/li\u003e\n\u003cli\u003eThiese MS, Ronna B, Ott U. P value interpretations and considerations. J Thorac Dis. 2016;8: E928-E931.\u003c/li\u003e\n\u003cli\u003eBroz M. How many videos are there on YouTube? Photutorial.com: 2024. Accessed 2 April 2024. Available from: https://photutorial.com/how-many-videos-on-youtube/\u003c/li\u003e\n\u003cli\u003eYoon HS, Lee YE, Kim SG. Evaluation of the quality of Korean dental educational YouTube videos as assessed by dental students. J Dent Educ. 2019; 83:1183-89.\u003c/li\u003e\n\u003cli\u003eLoureiro JM, Chaves VCV, Risso PA, et al. YouTube\u0026trade; as a source of tooth avulsion information: A video analysis study. Dent Traumatol. 2023; 39:616-24.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"endodontics, dental education, root canal irrigants, root canal therapy, online learning","lastPublishedDoi":"10.21203/rs.3.rs-6241737/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6241737/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis research aims to assess the usefulness of existing YouTube videos on endodontic irrigation, published between January 2013 and December 2022, as a learning resource for dental undergraduate students. Additionally, the study evaluates the educational value of these videos about factors such as video duration, authorship source, and view count.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eYouTube searches for videos related to endodontic irrigation were conducted using search terms such as \"irrigation protocol\" and \"endodontic irrigation.\" After screening, ninety-six videos were selected and assessed based on factors such as days since upload, video duration, number of views and likes, authorship source, and viewing rate. A set of six parameters was established to evaluate the educational value of the videos, with each element being assigned a score of 0 or 1. Statistical analyses were performed using the Kruskal-Wallis and Mann-Whitney tests, with a significant level of 5%.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe videos received an average of 4,474.76 views, 38.67 likes, a 290.5% viewing rate, and a video length of 161.15 seconds. The mean usefulness score was 3.89, with the most discussed elements being demonstration, description, and equipment/apparatus. The majority of videos were from healthcare professionals (n\u0026thinsp;=\u0026thinsp;73, 76.04%) or commercial sources (n\u0026thinsp;=\u0026thinsp;22, 22.92%). Twenty-seven videos were classified as highly useful, sixty-one as moderately useful, and eight as low usefulness. Among the content usefulness categories, the highly useful videos had the shortest length (mean\u0026thinsp;=\u0026thinsp;158.93s), while the moderately useful videos had the highest viewing rate. Videos uploaded by different authorship sources showed minimal statistical significance in content usefulness.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe usefulness of endodontic irrigation videos on YouTube has low educational value, and the available data to assess their effectiveness as a learning tool for undergraduate students is inconclusive.\u003c/p\u003e","manuscriptTitle":"Assessing the Usefulness of Educational Videos on Endodontic Irrigation for Dental Students: A Pilot Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-19 09:19:02","doi":"10.21203/rs.3.rs-6241737/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-05T15:21:25+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-28T13:59:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"2722743790317839170355828878990134946","date":"2025-05-28T12:30:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-28T08:36:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"184062595787187374123616287904675689708","date":"2025-05-15T16:33:38+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-15T07:27:45+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-14T07:03:30+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-28T15:28:30+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-28T12:43:57+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-04-28T12:42:52+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"25c776b5-8cf1-4842-8309-3c132b9f5b5d","owner":[],"postedDate":"May 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-22T16:02:47+00:00","versionOfRecord":{"articleIdentity":"rs-6241737","link":"https://doi.org/10.1186/s12909-025-07647-0","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-12-17 15:58:18","publishedOnDateReadable":"December 17th, 2025"},"versionCreatedAt":"2025-05-19 09:19:02","video":"","vorDoi":"10.1186/s12909-025-07647-0","vorDoiUrl":"https://doi.org/10.1186/s12909-025-07647-0","workflowStages":[]},"version":"v1","identity":"rs-6241737","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6241737","identity":"rs-6241737","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}