Enhancing Musculoskeletal Care in Rural Clinics: Barriers and Best Practices for PoCUS Training
Introduction: Point of care ultrasound (PoCUS) is a portable diagnostic technology with broad applicability, no radiation, and is less expensive than alternative imaging methods. PoCUS is emerging as high utility technology to expand bedside physical exams for primary care clinicians. This technolo...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
University of Minnesota Libraries Publishing
2025-04-01
|
| Series: | Journal of Regional Medical Campuses |
| Subjects: | |
| Online Access: | https://pubs.lib.umn.edu/index.php/jrmc/article/view/6267 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Introduction: Point of care ultrasound (PoCUS) is a portable diagnostic technology with broad applicability, no radiation, and is less expensive than alternative imaging methods. PoCUS is emerging as high utility technology to expand bedside physical exams for primary care clinicians. This technology is even being incorporated into medical school clerkships, such as Family Medicine. Access to medical care in rural areas is an ongoing issue, especially for specialty care. By using PoCUS, rural providers may be able to screen for conditions more completely and determine if patients need to seek specialty care, such as orthopedic intervention, and would be equipped to enhance the medical student’s learning experience.
Objectives: This study aims to identify barriers to learning and using PoCUS for musculoskeletal evaluations among rural primary care clinicians. A secondary objective is to evaluate best practices for expanding PoCUS training in these settings.
Methods: The team identified six rural primary care clinicians at outpatient clinics around Indiana. Grant funding was used to equip these clinics with portable ultrasound probes with PoCUS-software-equipped iPads. Training consisted of approximately one hour of independent didactic material and two hours of in-person hands-on training with our investigators and students. Initial surveys were collected before and after the in-person training session. The third survey was collected approximately six months after the initial training session. Teleguided follow-up sessions were offered to the clinicians, as well.
Results: The initial survey before the in-person training session from the six clinicians found that the previous PoCUS experience of these clinicians varied greatly. This survey also showed unanimously that these clinicians make orthopedic diagnoses in their practice but do not feel comfortable using ultrasound in supporting these diagnoses, demonstrating the potential for PoCUS in their clinical practice. The second survey results showed that even after just two hours of training, 100% of participants reported increased comfort in using PoCUS for orthopedic diagnoses, with 80% feeling confident enough to teach the material to others. The third survey focused on barriers to incorporating PoCUS into the participant’s clinic. Various barriers were reported, such as limited opportunity, insufficient time and training, and low comfortability. Reoccurring themes from qualitative comments included a busy practice and personal schedule and software issues ranging from equipment connectivity and login problems.
Conclusions: Implementing PoCUS in rural clinics to evaluate orthopedic diagnoses was met with enthusiasm and has shown potential for streamlining evaluation at specialty clinics. Significant barriers to adopting this technology include finding adequate time for busy clinicians to learn and practice using the equipment and scheduling live, ongoing training.
|
|---|---|
| ISSN: | 2576-5558 |