Use of point-of-care ultrasound in rural British Columbia: Scale, training, and barriers

Tracy Morton; Daniel J Kim; Tracey Deleeuw; Jason Curran; Paul Olszynski; Virginia W Robinson

doi:10.46747/cfp.7002109

Use of point-of-care ultrasound in rural British Columbia: Scale, training, and barriers

Can Fam Physician. 2024 Feb;70(2):109-116. doi: 10.46747/cfp.7002109.

Authors

Tracy Morton¹, Daniel J Kim², Tracey Deleeuw³, Jason Curran⁴, Paul Olszynski⁵, Virginia W Robinson⁶

Affiliations

¹ Family physician at the Haida Gwaii Health Centre in British Columbia and Clinical Assistant Professor in the Department of Family Practice at the University of British Columbia.
² Clinical Associate Professor and Director of the Point of Care Ultrasound Fellowship program in the Department of Emergency Medicine at the University of British Columbia in Vancouver and an emergency medicine physician at Vancouver General Hospital.
³ Project and Research Facilitator at the Rural Coordination Centre of British Columbia in Penticton.
⁴ Manager of Rural Research and Physician Engagement at the Rural Coordination Centre of British Columbia in Vancouver.
⁵ Associate Professor of Emergency Medicine and Director of both Simulation and Clinical Ultrasonography in the College of Medicine at the University of Saskatchewan in Saskatoon.
⁶ Medical Lead for the Rural Provincial POCUS project at the Rural Coordination Centre of British Columbia and a family physician at Elk Valley Hospital in Fernie, BC.

PMID: 38383018
DOI: 10.46747/cfp.7002109

Abstract

Objective: To determine the scale and scope of use of point-of-care ultrasound (POCUS) in rural British Columbia (BC).

Design: Online survey.

Setting: Rural BC.

Participants: Physicians practising in rural BC communities.

Main outcome measures: Practitioner demographic and practice characteristics, locations and frequency of POCUS use, POCUS education and training, and practitioner attitudes about and barriers to POCUS use.

Results: Two hundred twenty-seven surveys were completed in fall 2021, corresponding to a response rate of 11.9% of all rural practitioners in BC. A total of 52.1% of respondents worked in communities with less than 10,000 people, while 24.9% had practices with relatively large proportions of Indigenous patients (more than 20% of the practice population). Respondents reported ease of access to local POCUS devices, with use highest in emergency departments (87.2%) followed by ambulatory care clinic (54.7%) and inpatient (50.3%) settings. Use of POCUS influenced clinical decision making in half the occasions in which it was employed, including a range of diagnostic and procedural applications. Barriers to use included lack of training, limited time to perform POCUS scans, and absence of image review or consultative support. Needed support for POCUS identified by respondents included real-time image acquisition advice and funding for both device acquisition and training. Recommendations for including POCUS training in undergraduate and residency education were strongly supported.

Conclusion: Use of POCUS in BC is expanding in frequency, scope, and scale in practices serving rural areas and in rural communities with large Indigenous populations, with practitioners reporting important improvements in clinical care as a result. Future research could help improve systemic support for POCUS use, guide needed curriculum changes in medical school and postgraduate training, and be used to inform continuing professional development needs.

MeSH terms

British Columbia
Curriculum
Humans
Point-of-Care Systems*
Rural Population*
Surveys and Questionnaires
Ultrasonography / methods