Table 4.
PEM Fellows’ and Attendings’ Ratings of Potential Barriers (Individual and Institutional) to Integration of POCUS Into Their Clinical Practice
| Potential Barrier | Rasch Logits | SE | Rank | SD (1) | D (2) | N (3) | A (4) | SA (5) |
|---|---|---|---|---|---|---|---|---|
| P‐2 I do not feel comfortable enough with my ultrasound skills to use this modality clinically | –0.91 | 0.13 | 1 | 3 (3.9) | 7 (9.1) | 8 (10.4) | 35 (45.5) | 24 (31.2) |
| P‐3 I do not have sufficient educational time to dedicate to learning pediatric emergency ultrasound | –0.65 | 0.12 | 2 | 1 (1.3) | 11 (14.3) | 15 (19.5) | 34 (44.2) | 16 (20.8) |
| I‐6 There is a lack of subspecialists/consultants who would use emergency ultrasound findings for medical decision making | –0.54 | 0.13 | 3 | 2 (3.1) | 12 (18.5) | 12 (18.5) | 20 (30.8) | 19 (29.2) |
| P‐5 I feel that using emergency ultrasound during my clinical shifts negatively impacts my efficiency and patient flow | –0.50 | 0.12 | 4 | 3 (3.9) | 10 (13.0) | 19 (24.7) | 32 (41.6) | 13 (16.9) |
| I‐4 There is not sufficient mentorship or emergency ultrasound trained faculty to use this modality effectively and safely | –0.40 | 0.13 | 5 | 4 (6.2) | 12 (18.5) | 7 (10.8) | 30 (46.2) | 12 (18.5) |
| I‐5 The use of pediatric emergency ultrasound is not a priority in my department | –0.40 | 0.13 | 5 | 2 (3.1) | 11 (16.9) | 15 (23.1) | 25 (38.5) | 12 (18.5) |
| I‐7 We encounter resistance to usage of emergency ultrasound from other departments at our site (e.g., surgery, radiology). | –0.20 | 0.12 | 7 | 5 (7.7) | 15 (23.1) | 14 (21.5) | 16 (24.6) | 15 (23.1) |
| I‐3 There is no structured curriculum to educate the physicians on how to use pediatric emergency ultrasound | –0.17 | 0.12 | 8 | 6 (9.2) | 12 (18.5) | 12 (18.5) | 27 (41.5) | 8 (12.3) |
| I‐2 There is a lack of funding to further emergency ultrasound pursuits and education | 0.28 | 0.12 | 9 | 12 (18.5) | 16 (24.6) | 14 (21.5) | 17 (26.2) | 6 (9.2) |
| P‐1 I do not ascribe significant value to using emergency ultrasound clinically in my patients | 0.68 | 0.12 | 10 | 20 (26.0) | 30 (39.0) | 13 (16.9) | 9 (11.7) | 5 (6.5) |
| P‐4 I do not work enough clinical shifts to effectively practice my emergency ultrasound skills | 0.72 | 0.12 | 11 | 16 (20.8) | 36 (46.8) | 14 (18.2) | 8 (10.4) | 3 (3.9) |
| I‐1 There is no functional ultrasound machine available for use | 2.10 | 0.19 | 12 | 42 (64.6) | 18 (27.7) | 3 (4.6) | 0 (0) | 2 (3.1) |
Data are based on respondent ratings (using Likert response sets) of barriers to the use of ultrasound in practice. Responses of agreement (strongly agree or agree) were considered more significant barriers than responses of disagreement (strongly disagree or disagree).
Barriers are listed from most (1) to least (12) significant.
Fit statistics were all within the acceptable range of –2.0 to +2.0.
A = agree; D = disagree; N = neutral; PEM = pediatric emergency medicine; POCUS = point‐of‐care ultrasound; SA = strongly agree; SD = strongly disagree; SE = standard error.