Ralph Clayman:Arthur, why and how did the idea of videourology begin?
Arthur Smith: In my mind, urology has many facets: the basic science of urology, indications, and contraindications of various treatments. Then there is the medical and the surgical management of patients. The first three are well covered in the AUA courses, but I don't think that the AUA does a particularly good job in teaching people the surgical craft of urology. I believe we all have to operate on patients — and we all want to do the best possible operation. The best way to achieve this is to watch the experts and learn from each other. That's how the idea of making videos and sharing videos with colleagues first came about.
RC:Arthur, you've been doing this for quite a bit of time, but those videos have not been widely available, if I'm not mistaken.
AS: It started off with a fellow named Dallas Pennington. Dallas Pennington did original tapes for Eaton Company about 30 years ago. And then he said: Why don't we put out a regular “broadcasting” office, putting out videotapes? And we produced videotapes for many, many years. We brought out four videotapes a year, and we had six programs in each videotape covering different topics of urology, hence the videos of techniques, and hard-to-do procedures. The basic principle that we had was that no video should be more than seven minutes. And the reason we chose seven minutes was that I can't concentrate for more than seven minutes!
RC:What stimulated you, though, to go from distributing videotapes quarterly, to bringing this out as an online videojournal, as part ofJournal of Endourology?
AS: What happened is that early on, Carlo Puppo said to me, “What about having a conference, a videourology conference?” So, we had the first World Conference in Videourology over 20 years ago. And we've had one virtually every year since then. The first one was attended by about 500 urologists, and everybody wanted to learn endourology, and all urological techniques. However, eventually we stopped bringing out the videotapes because everything was going onto a digital format. Then, we began distributing the videos on CDs twice a year with Journal of Endourology. So that was the next incarnation of videourology, really.
RC:So how do you think Videourology™ will actually improve physician education or patient outcomes, as opposed to the content provided in the Journal articles?
AS: I think that people need to observe the finer techniques of an operation. It's not enough just to describe it in a text format. You need to know exactly how to position the suture, how to position your hands. And I think you get all that additional information by watching the video carefully. And the more educated you are in the procedure, the more you learn from the video itself.
RC:Are these videotapes going to be done in a certain format so they maximize, if you will, their instructional abilities or capabilities? Or are they just going to be in whatever format people send it in?
AS: Well, I think that's something that Dr. Chandru Sundaram has worked on very diligently with the Publisher, and we have an excellent video submission and peer-review system in place. The videos are organized according to a very sophisticated taxonomy, so it will be easy to search for and find exactly what technique or procedure you need.
I think we'll have lots of video submissions. We'll have videos with experts doing the procedure and other videos where people show variations in techniques, because you can learn a slight variation from anybody who has done the procedure many, many times—they've developed some small nuance that can make the procedure that little bit easier for you the next time you do it. So I think we will all learn from one another.
RC:How important do you think that this new videojournal will be? What makes it different than other journals? How is this going to impact urology?
AS: I think it will have a tremendous impact. You can see a procedure whenever you want to see how to do it, and you can refresh your memory immediately. A physician can access that video at home, in the office, or in the operating room. Just before he or she scrubs for an operation, he or she can run through the technology again, to refresh his or her mind immediately before an operation. This will give the physician that much more confidence and knowledge when they are about to do a procedure, therefore the patient should get a better outcome.
RC:Will these videos, then, be peer reviewed? Will someone be responsible for assessing the quality and content of these videos?
AS: Absolutely. All of these videos will be approved by our editorial board and only the highest quality and most useful videos will be accepted — the same careful peer-review process as we have with all the articles in Journal of Endourology.
RC:This is a very unique plan – I've never seen urology videos actually subjected to true peer review in a journal. I think that's going to result in a very high quality of video accepted for publication. But what about videos that I've done in the past, or other people have done in the past, that are really great demonstrations of a particular technique but are not really archived anywhere, and are difficult, if not impossible, to find? Will the Journal have the ability to publish those videos also?
AS: Yes, a remarkable number of historical videos of groundbreaking procedures—some of them from 10–20 years ago—will be published in Videourology. As a matter of fact, at this moment in time, the editorial board is reviewing a lot of videotapes that we used for the original videocassette series and many of your tapes and my tapes are there, and if they are high enough quality, we can bring those archives back into circulation again.
You know, we all make videos. We all prepare talks and digital programs for presentation. It's a tragedy if you make a video and present it to a small audience, but the video is not available to anyone thereafter. Now, you can prepare a video, and if it meets the standards of the editorial board and our reviewers, then that presentation will be published online and will be widely accessible. And the video will link to related content in the flagship publication, Journal of Endourology. That will be wonderful.
RC:Will the printJournal of Endourologycome with CDs?
AS: No CDs. The print journal will continue, but the videos will all be online and officially published in Videourology.
RC:I'm very excited about this. I think it's a wonderful idea, tremendous progress, and I think it's emblematic overall of what you've done—by creatingVideourology, by being at the forefront and making videos available to as many people around the globe as possible.
AS: And the motto of endourology is always to be inclusive and to bring everybody in and get them involved.
