Abstract
BackgroundPoint-of-care ultrasound (POCUS) is increasingly used in internal medicine, but a lack of trained faculty continues to limit the spread of POCUS education. Using a framework based on organizational change theories, this study sought to identify barriers and enablers for hospital-based practicing internists to learn and use POCUS in clinical practice.MethodsWe invited practicing internists at six North American institutions to participate in an electronic survey on their opinions regarding 39 barriers and enablers.ResultsOf the 342 participants invited, 170 participated (response rate 49.3%). The top barriers were lack of training (79%), lack of handheld ultrasound devices (78%), lack of direct supervision (65%), lack of time to perform POCUS during rounds (65%), and lack of quality assurance processes (53%). The majority of participants (55%) disagreed or strongly disagreed with the statement “My institution provides funding for POCUS training.” In general, participants’ attitudes towards POCUS were favourable, and future career opportunities and the potential for billing were not considered significant factors by our participants in the decision to learn or use POCUS.ConclusionsThis survey confirms the perceived importance of POCUS to practicing internists. To assist in closing faculty development gap, interventions should address training, supervision, quality assurance processes, availability of handheld devices, as well as dedicated time to perform POCUS during clinical care.
Highlights
Point-of-care ultrasound (POCUS) is increasingly used in internal medicine, but a lack of trained faculty continues to limit the spread of point-of-care ultrasound (POCUS) education
It follows that any intervention to achieve system-level behavioural change will require a comprehensive, evidence-based strategy to identify and resolve barriers to POCUS adoption
Six centres were chosen based on convenience, where site investigators indicated a reasonable likelihood of achieving an approximate target response rate of 40% or greater
Summary
Point-of-care ultrasound (POCUS) is increasingly used in internal medicine, but a lack of trained faculty continues to limit the spread of POCUS education. Using a framework based on organizational change theories, this study sought to identify barriers and enablers for hospital-based practicing internists to learn and use POCUS in clinical practice. The use of point-of-care ultrasound (POCUS) is increasing in internal medicine (IM), for the guidance of bedside procedures [1,2,3], and for bedside assessments of medical patients to answer focused clinical questions [4, 5]. Wong et al Ultrasound J (2020) 12:19 the key barriers to faculty adoption of POCUS [7, 11, 13,14,15,16,17,18]. Faculty adoption of POCUS requires significant behavioural change. It follows that any intervention to achieve system-level behavioural change will require a comprehensive, evidence-based strategy to identify and resolve barriers to POCUS adoption
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