Point of care ultrasound training needs for primary care physicians: Practice setting matters

Jalil, Rabiya; Warren, Robert; W.Y., Irene

doi:10.1080/2331186x.2019.1617826

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…Our sample was limited to residents and pediatricians currently working at or trained by one center in one state, limiting generalizability. Our low response rate at 20%, although comparable to other published surveys [ 23 , 26 , 51 ], may be a source of bias as it is possible that physicians and trainees with an interest or background in ultrasound may have been more likely to respond to a study about ultrasound, thus overestimating the demand for POCUS training and skewing our results. Indeed, in our barriers question, very few respondents (5%) endorsed a lack of interest in POCUS.…”

Section: Discussionsupporting

confidence: 59%

“…Fliers with a quick response (QR) code that linked to the survey were also distributed during resident teaching conferences and posted in both faculty and resident workrooms to which key or badge access was required. The survey was created in Qualtrics (Qualtrics, Provo, UT) based on review of prior needs assessments designed for family medicine and internal medicine [ 21 , 22 , 26 , 28 ]. Specific pediatric POCUS applications were selected based on published reviews describing the scans most pertinent to pediatric POCUS [ 1 , 12 , 16 ] and based on input from 2 of the authors (AS, MLM), who are experts in pediatric POCUS.…”

Section: Methodsmentioning

confidence: 99%

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The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

et al. 2022

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Background Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal surveys of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings. Methods In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results Response rate was 20% (98/485). Compared to attendings (n = 73), residents (n = 25) endorsed more exposure to POCUS in medical school (32% vs 5%, p = 0.003) and residency (12% vs 5%, p = 0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Although the majority of respondents were not POCUS users, our results could guide future efforts to study the role of POCUS in general pediatrics and develop pediatric curricula.

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Section: Discussionsupporting

confidence: 59%

Section: Methodsmentioning

confidence: 99%

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

et al. 2022

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“… 21 Moreover, in a recent needs assessment, pelvic ultrasound was found to be the POCUS application GPs had most interest in learning. 22 …”

Section: Discussionmentioning

confidence: 99%

“…21 Moreover, in a recent needs assessment, pelvic ultrasound was found to be the POCUS application GPs had most interest in learning. 22 This study illustrates that POCUS is used to support the physical examinations of patients presenting with a very broad range of clinical conditions. There have been attempts to outline which POCUS examinations are best suited to general practice.…”

Section: Findings In Contextmentioning

confidence: 90%

Use and impact of point-of-care ultrasonography in general practice: a prospective observational study

et al. 2020

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ObjectivesTo describe how general practitioners (GPs) use point-of-care ultrasonography (POCUS) and how it influences the diagnostic process and treatment of patients.DesignProspective observational study using an online questionnaire before and after POCUS.SettingOffice-based general practice.ParticipantsTwenty GPs consecutively recruited all patients examined with POCUS in 1 month.Primary and secondary outcome measuresWe estimated the use of POCUS through the indication for use, the frequency of use, the time consumption, the extent of modification of the examination and the findings.The influence on the diagnostic process was estimated through change in the tentative diagnoses, change in confidence, the ability to produce ultrasound images and the relationship between confidence and organs scanned or tentative diagnoses.The influence of POCUS on patient treatment was estimated through change in plan for the patient, change in patient’s treatment and the relationship between such changes and certain findings.ResultsThe GPs included 574 patients in the study. POCUS was used in patient consultations with a median frequency of 8.6% (IQR: 4.9–12.6). Many different organs were scanned covering more than 100 different tentative diagnoses. The median time taken to perform POCUS was 5 min (IQR: 3–8). Across applications and GPs, POCUS entailed a change in diagnoses in 49.4% of patients; increased confidence in a diagnosis in 89.2% of patients; a change in the management plan for 50.9% of patients including an absolute reduction in intended referrals to secondary care from 49.2% to 25.6%; and a change in treatment for 26.5% of patients.ConclusionsThe clinical utilisation of POCUS was highly variable among the GPs included in this study in terms of the indication for performing POCUS, examined scanning modalities and frequency of use. Overall, using POCUS altered the GPs’ diagnostic process and clinical decision-making in nearly three out of four consultations.Trial registration numberNCT03375333.

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Knowledge, attitude, practices, and perceived barriers to using point-of-care ultrasound by Asian primary care physicians – a mixed method study

Ng,

Liu,

Wong

et al. 2024

BMC Health Serv Res

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Background Although research shows that point-of-care ultrasound is helpful in primary care, there is little research on point-of-care ultrasound use and the barriers to its use in Asia. This study estimated the prevalence of primary care physicians using point-of-care ultrasound in Hong Kong and assessed their perceived knowledge, attitude, practices, and barriers to using point-of-care ultrasound. Study design This was a mixed-method study: cross-sectional survey, followed by semi-structured interviews. Primary care physicians who were members of the Hong Kong College of Family Physicians and/or were clinical teachers affiliated with the Department of Family Medicine and Primary Care at the University of Hong Kong were invited to participate. Results A total of 330 and 14 completed the survey and interviews, respectively. The prevalence of respondents using point-of-care ultrasound was 22.5%. Perceived knowledge was fair (mean score: 1.9 out of 4; SD: 0.6). The attitudes were mostly positive (mean score: 3.0 out of 4; SD: 0.5). Majority stated that barriers to using point-of-care ultrasound were related to training (90.9%), the competence of point-of-care ultrasound skills (90.2%), and clinical support (89.5%). Qualitative data identified that most participants found point-of-care ultrasound useful; however, participants felt that its use was limited by their competence of point-of-care ultrasound and by factors related to their clinical practice. Conclusions Almost a quarter of respondents are using point-of-care ultrasound with a majority having positive attitudes. They lack confidence in their skills as knowledge is poor but simultaneously find training and clinic support limited.

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Point of care ultrasound training needs for primary care physicians: Practice setting matters

Cited by 3 publications

References 14 publications

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

Use and impact of point-of-care ultrasonography in general practice: a prospective observational study

Knowledge, attitude, practices, and perceived barriers to using point-of-care ultrasound by Asian primary care physicians – a mixed method study

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