The use of evaluation tool for ultrasound skills development and education to assess the extent of point-of-care ultrasound adoption in lebanese emergency departments

Abstract
Background: Previously acknowledged as "bedside ultrasound", point-of-care ultrasound (PoCUS) is gaining great recognition nowadays and more physicians are using it to effectively diagnose and adequately manage patients. To measure previous, present and potential adoption of PoCUS and barriers to its use in Canada, Woo et al established the questionnaire "Evaluation Tool for Ultrasound skills Development and Education" (ETUDE) in 2007. This questionnaire sorted respondents into innovators, early adopters, majority, and nonadopters. Objectives: In this article, we attempt to evaluate the prevalence of PoCUS and the barriers to its adoption in Lebanese EDs, using the ETUDE. Materials and Methods: The same questionnaire was again utilized in Lebanon to assess the extent of PoCUS adoption. Our target population is emergency physicians (EPs). To achieve a high response rate, hospitals all over Lebanon were contacted to obtain contact details of their EPs. Questionnaires with daily reminders were sent on daily basis. Results: The response rate was higher in our population (78.8%) compared to Woo et al's (36.4%), as the questionnaire was sent by email to each physician with subsequent daily reminders to fill it. In fact, out of the total number of the surveyed (85 physicians), respondents were 67, of which 76.1% were males and of a median age of 43. Using ETUDE, results came as nonadopters (47.8%), majority (28.3%), early adopters (16.4%), and innovators (7.5%). Respondents advocated using PoCUS currently and in the future in five main circumstances: focused assessment with sonography in trauma (FAST) (current 22.9%/future 62.9%), first-trimester pregnancy (current 17.1%/future 68.6%), suspected abdominal aortic aneurysm (current 5.7%/future 51.4%), basic cardiac indications (current 8.6%/future 57.1%), and central venous catheterization (current 22.9%/future 85.7%). Conclusion: This study is the first to tackle the extent of use and the hurdles to PoCUS adoption in Lebanese emergency medicine practice, using ETUDE. The findings from this study can be used in Lebanon to strengthen PoCUS use in the future.