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Ask a setup question
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01 Obsidian
Do I need Obsidian, or are my current notes enough?
Short answer
You need a place that stays plain text and never holds an identifier you might show a model. Obsidian is the assumption here. If you already have that, don't migrate for the aesthetic.
- If notes are trapped in someone else's database and you want to point an agent at files later, Obsidian is worth the afternoon.
- If your group is fluent in another tool and the notes are clean, keep it and steal the folder habits.
- Don't run both as permanent homes. Pick the teaching vault and stick to it.
Where should the vault live on my computer?
Short answer
On the machine where you write, in a folder you chose, not on a hospital shared drive and not inside a cloud folder until you have decided the vault is clean.
- Create the teaching vault locally first.
- Sync only after a week of notes you would project.
- Obsidian Sync is the least surprising sync. iCloud and Dropbox work until they don't, and they are still someone else's cloud.
- A second, unsynced vault stays on the hospital machine for anything not yet rewritten.
Which plugins should I install on day one?
Short answer
No community plugins. Turn on Templates, File recovery, Outline, Backlinks, and Canvas. Learn the quick switcher.
- Set the template folder to Templates.
- Leave Daily notes off unless you will really use them.
- Add Excalidraw later if you sketch. Add Dataview only when you have a question it can answer.
- An in-vault AI plugin can read notes you forgot to clean. Prefer a model outside the vault at the start.
How do I stop making a new Untitled note every day?
Short answer
Send every new note to 00 Inbox, and name it the way you would say it before you close the laptop.
- Settings → Files and links → new notes go to 00 Inbox.
- If you can't name it, it isn't a note yet. It is a line in an inbox capture.
- Twice a week, file or delete. An inbox that never empties is a second graveyard.
Can I use Obsidian on my phone between cases?
Short answer
Yes, for a sentence in the teaching-vault inbox. No, for photos of boards, badges, or screens.
- Sync only the teaching vault to the phone.
- Dictate a single sentence. Clean it later on a real screen.
- The graph on a phone is still not the system.
02 The vault
What folders should a surgeon's vault have?
Short answer
Inbox, practice, research, teaching, AI notes, admin, templates, assets, archive. Number the top level so the sort never depends on clever names.
- Paste the tree from the vault chapter and make the folders, empty.
- Technique notes are hubs. Cases and videos link to them.
- Don't add a new top-level folder because one note feels special. Put it in practice or archive it.
How do I keep patient information out of notes I might show an AI?
Short answer
Rewrite the lesson into a separate teaching vault with the chart closed. Don't copy the hospital note and delete the header.
- Hospital drafts stay on the hospital machine, unsynced.
- The teaching note starts from the template, phi set to none.
- No names, MRNs, dates of birth, faces, or rare story-plus-date combinations.
- If you wouldn't project it, it is not ready for a model.
What goes at the top of a teaching case?
Short answer
The decision, in one sentence, under four properties: type, procedure, status, and phi: none.
- Then what you can see, what you did, and what you would do differently.
- Link the clip and write what the clip does not show.
- Write it the day it happened, from memory.
How do I link a video to a procedure note?
Short answer
The technique note is the hub. The video note links to it, and the technique note links back.
- Use a wikilink with the plain-language title.
- Put Shows and Does not show on the video note so the link isn't just a filename.
- A canvas is optional: indication, setup, move, bailout. No legend.
How should I name files?
Short answer
Plain speech, procedure plus the job of the note. No initials, no case dates, no Untitled.
- Good: “Appendiceal ureteroplasty — bailout.”
- Bad: “Case 4-12 final FINAL.”
- Video files follow the same rule: procedure-maneuver-1080.mp4.
A colleague wants my system. What do I send?
Short answer
One chapter and an empty folder tree. Not your vault. Ask what they already know before you write the primer.
- Write it for that one reader. Don't name other recipients.
- If you include commands, start with cd to their vault. Don't assume the terminal is already there.
- Don't attach notes “so they can see the structure.”
What is a property, and do I need Dataview?
Short answer
A property is a field at the top of the note, like status or procedure. You don't need Dataview until those fields can answer a question you actually ask.
- Use type, procedure, status, and phi.
- Search and the quick switcher cover the first months.
- Add Dataview when you want a list such as every draft video for one procedure.
03 The AIs
Can I paste an operative note into Claude or ChatGPT?
Short answer
Not if it still identifies a patient. Rewrite the lesson with the chart closed, then paste that.
- A header you deleted is not enough if the story, date, and surgeon still point at one person.
- Cloud dictation is the same door.
- When the text cannot leave the machine, use a local model or don't use a model.
Which AI should I pay for?
Short answer
One writing model you will open when you are tired. Keep a second only as a check when the first is fluently wrong.
- Put the project brief in whichever one you pick.
- Don't collect four logins and call it a workflow.
- Brand names change. The rule about what may leave the building does not.
Claude, ChatGPT, Gemini, or Grok — which one for teaching?
Short answer
Use the saved writing project for talks and scripts, a long-context app for PDF piles, and a live model only as a temperature check.
- Attach papers, then open every one you might cite.
- Grok is a natural fit for a public argument or a labeled drawing. It is not a quotation source.
- A coding agent touches the teaching vault only.
How do I write a prompt that doesn't waste the evening?
Short answer
Lead with the result, name the reader, state what must not appear, then paste the source and ask it to flag gaps.
- “Cut this to 8 minutes for a fellow” beats “make this better.”
- Save the prompt as a note once it works.
- Ask what would make the paragraph wrong before you ask for polish.
The model cited a paper I can't find. Now what?
Short answer
Drop the citation. If the claim matters, you find the paper yourself. A model bibliography is not a reference list.
- Search the title and the authors separately. Invented papers often mix real names.
- Don't “ask it to double-check” and then trust the second version.
- Write a decision note when it happens so you remember the fluency, not just the embarrassment.
Should I run a local model?
Short answer
Yes when the text cannot leave the laptop and a weaker draft is still useful. No as a badge, and not on weekend one.
- Ollama is the usual door.
- Expect worse long-form writing than the model you pay for.
- A local model does not fix a note you then paste into a cloud chat.
How do I dictate into the vault?
Short answer
Speak a messy paragraph into 00 Inbox. Clean it later on a screen. Cloud dictation means the words have left the building.
- Phone dictation or a desktop dictation app both work if you respect that rule.
- Don't dictate names, numbers, or room chatter.
- The inbox is for sentences, not for finished teaching notes.
What is a project brief, and do I need one?
Short answer
Yes. It is the short rule sheet pasted at the top of a project so you are not re-teaching the model every night.
- Use the brief in the AI chapter.
- It says: stop if you see an identifier, don't invent papers, don't invent anatomy, write for one reader, flag gaps.
- An agent that edits files is optional and comes after this, pointed only at the teaching vault.
How do I keep a model from inventing anatomy?
Short answer
You name every structure in the source. The model may tighten sentences. It may not add a label you did not write.
- Arrows on a still are yours.
- If it inserts a plane or a vessel, delete it.
- Say so in the project brief, not only in one chat.
Can I use AI to draft a video script?
Short answer
Yes, from your outline, on a de-identified description of what the frame shows. You record it, and you disclose a synthetic voice.
- Present tense. Structure first, then the move.
- Leave a quiet beat so the picture lands before the sentence.
- Read it aloud. A stumble means rewrite, not another take.
04 Surgical video
What consent do I need before a clip goes on my website?
Short answer
Whatever your institution requires for a public file, which may be more than operative consent to record. If you don't know, it doesn't go up.
- Closed conference playback and a public URL are different.
- Unlisted is still a public file if the link escapes.
- This guide is not a clearance.
What resolution and format should I export for my site?
Short answer
MP4, H.264, 1920×1080, frame rate matched to the source, about 10 Mbps, AAC audio if you narrated.
- Don't use a mushy web preset. Suture disappears first.
- Filename: procedure-maneuver-1080.mp4. No initials, no case date.
- Poster frame is the anatomy, not a title card and not a face.
- Make the square social cut from the master, later.
Resolve, CapCut, Final Cut, or iMovie?
Short answer
DaVinci Resolve if you will do this more than twice. The editor you already know if a deadline is tonight. Not a cloud app with an identifiable file.
- The free version of Resolve is enough.
- Final Cut is correct if you already think in it.
- iMovie is enough for one clean internal clip.
- CapCut only if you are sure the project stays local and the file is already clean.
How do I get patient identifiers off a console recording?
Short answer
Crop them out, or re-export from the console without the banner. Don't paint over a name and call the file clean.
- Check the first and last three seconds.
- Delete the room audio completely.
- Check the filename, thumbnail, and webpage title too.
- A generated inpaint of a face does not fix the rest.
Should I narrate in the OR or after?
Short answer
After. Room audio has names in it, and you will talk differently once you can see what the frame actually shows.
- Script the video note first.
- Record close to the mic in a quiet room.
- A voice trained on you is fine if the page says the narration is synthesized.
- Put a transcript on the page for mute playback.
How long should a teaching clip be?
Short answer
As long as the decision. Usually 45–90 seconds for one maneuver on a site, or 3–6 minutes for a technique a fellow watches before the case.
- Speed the setup. Don't speed the critical suture.
- Chapter a long reconstruction. Don't upload the whole case as one file.
- One arrow, one freeze. No music under the move.
Can I put the video on YouTube and on my own site?
Short answer
Only if policy allows the file to exist off the hospital network at all. Your site still needs the words. The player is not the lesson.
- Unlisted is not the same as private once the link is forwarded.
- On your page: why it exists, what it shows, what it does not show, the decision, the transcript.
- Host the master yourself when you can. A platform re-compresses.
How do I make a still for the page that isn't just a title card?
Short answer
Export a frame of the field at the decision, as a JPG. The still should teach even if the video never plays.
- No face, no banner, no date stamp.
- If you need a title, put it in HTML on the page, not burned over the anatomy.
- One arrow in the editor is enough if the still is ambiguous. Then re-export the frame.
Is a cloned voice okay for narration?
Short answer
Your own voice, yes, disclosed on the page. Anyone else's, no. Don't let it imply you were speaking during the operation.
- Train it on recordings you made for that purpose.
- Write “Narration is synthesized” next to your name.
- If disclosure feels like a problem, record it yourself. It is a quiet room and one take.
The video looks mushy after I upload it. What was wrong?
Short answer
The export was probably a small web preset, or the host compressed an already-small file. Re-export around 10 Mbps and upload that master.
- H.264, 1080p, about 10 Mbps, frame rate unchanged.
- Don't upload a 2 Mbps file and hope the site fixes it.
- Platforms will crush it again. Start with detail to spare, especially on suture and planes.