Sarah K Kennedy, Frances M Russell, Loren Rood, Benjamin K Nti, Audrey Herbert, Matt Rutz, Daniel Brenner, Matthew Hays, Robinson M Ferre
Most EPs utilized POCUS for patient care after completing a training program. Despite improved confidence and knowledge, overall clinical use of POCUS was lower than expected. Competency-based POCUS training alone may be insufficient to drive sustained clinical adoption among practicing EPs. Further studies are needed to understand factors associated with increased physician POCUS integration.
OBJECTIVE: Point-of-care ultrasound (POCUS) is an important diagnostic and procedural tool in emergency medicine. Although guidelines exist for POCUS training and credentialing, little data exist describing clinical utilization by practicing emergency physicians (EPs) after completion of residency or faculty training programs. The objective of this study was to evaluate the impact of basic and advanced POCUS training programs on subsequent clinical POCUS utilization by EPs.
METHODS: This prospective observational cohort study included EPs who completed a basic and/or advanced POCUS training program developed internally according to established guidelines. Participants were followed for one year after training completion to assess clinical POCUS utilization, defined as the number of billed POCUS examinations. Associations between billed scan volume, perceived barriers, confidence, knowledge assessment scores, and objective structured clinical examination (OSCE) performance were evaluated using chi-square, Fisher's exact, and Kruskal-Wallis tests.
RESULTS: A total of 138 EPs participated in the training program; 63 (46%) completed the basic program, and 75 (54%) completed the advanced program. Thirty-six (26%) faculty completed both. During the year following training, EPs in the basic cohort billed 814 POCUS examinations (median: three scans per physician, range: 0-185), while EPs in the advanced cohort billed 1,550 examinations (median: 10 scans per physician, range: 0-284). Confidence and knowledge improved following both training programs. However, billed POCUS utilization remained low. In the advanced cohort, greater comfort with ultrasound machine use was associated with increased clinical utilization.
CONCLUSIONS: Most EPs utilized POCUS for patient care after completing a training program. Despite improved confidence and knowledge, overall clinical use of POCUS was lower than expected. Competency-based POCUS training alone may be insufficient to drive sustained clinical adoption among practicing EPs. Further studies are needed to understand factors associated with increased physician POCUS integration.