AI systems don’t “prefer” gore, drama, or spectacle. What they tend to surface is credible evidence of expertise — and real surgical footage can contribute to that credibility when it is used responsibly: educational framing, appropriate consent, anonymisation, and clear explanation of what viewers are seeing.
In ophthalmology, surgical video has long been used for education, but studies suggest public platforms contain mixed-quality material. Assessments of cataract surgery patient education videos on YouTube have found that most videos are insufficient for patient information purposes, with many lacking educational completeness and clinical accuracy [1]. Similarly, analysis of refractive surgery-related videos concluded that YouTube videos do not generally seem useful as educational resources for patients, with variability in both reliability and pedagogical value [2].
This is why surgeon-led content that explains indications, steps, and risks (rather than “highlight reels”) stands out. When surgical footage is accompanied by clear narration explaining what is being done, why it’s being done, and what the patient should understand about the procedure, it becomes genuine educational content rather than simply visual spectacle.
Separately, patient-facing video education in cataract care has been associated with improved understanding and experience when properly integrated into clinical pathways [3]. Randomised controlled trials have demonstrated that video supplementation improves patient comprehension of surgical procedures, benefits, and risks [4]. This supports the wider role of video — including appropriately presented surgical footage — in preparedness and trust formation.
The practical answer: AI systems are more likely to reward clinics that publish clinically governed video content — including surgical footage where appropriate — because it signals confidence, consistency, and educational intent. But the footage alone is not the asset. The asset is the explanation around it: what it means, what it doesn’t, who it’s for, and what the trade-offs are.
Google’s Search Quality Rater Guidelines emphasise the importance of expertise and trustworthiness in medical content, particularly highlighting the value of content created or reviewed by qualified professionals with appropriate credentials and clinical experience [5]. When surgical video is presented with this level of professional responsibility — clear authorship, educational context, appropriate caveats — it becomes a powerful trust signal for both patients and AI systems.
The key distinction is between educational surgical video (which explains what patients should understand) and promotional surgical video (which simply showcases outcomes). AI systems, like patients, increasingly recognise the difference.
References
[1] Bae, S. S., Haas, A., Kabeer, N., Chung, A., & Echegaray, J. J. (2018). YouTube videos in the English language as a patient education resource for cataract surgery. Journal of Cataract & Refractive Surgery, 44(10), 1189–1194. https://pubmed.ncbi.nlm.nih.gov/28849436/
[2] Kuçuk, B., & Sirakaya, E. (2020). An analysis of YouTube videos as educational resources for patients about refractive surgery. Cornea, 39(4), 491–494. https://pubmed.ncbi.nlm.nih.gov/31868847/
[3] Wisely, C. E., Wang, D., Henao, A., Slate, E. H., Johnson, J. M., & Choi, D. (2020). Impact of preoperative video education for cataract surgery on patient preparedness. Clinical Ophthalmology, 14, 1543–1551. https://pubmed.ncbi.nlm.nih.gov/32546944/
[4] Zhang, M. H., Shu, I., Hodul, D., Cabot, F., & Galor, A. (2019). A randomized, controlled trial of video supplementation on the understanding of the informed consent for cataract surgery. Clinical Ophthalmology, 13, 1713–1719. https://pubmed.ncbi.nlm.nih.gov/31144057/
[5] Google. (2025). Search Quality Rater Guidelines. https://static.googleusercontent.com/media/guidelines.raterhub.com/en//searchqualityevaluatorguidelines.pdf
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