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Point-of-care ultrasonography adoption in Canada: using diffusion theory and the Evaluation Tool for Ultrasound skills Development and Education (ETUDE)

Published online by Cambridge University Press:  04 March 2015

Michael Y. Woo ,
Jason R. Frank  and
A. Curtis Lee
Michael Y. Woo*
Affiliation:
Department of Emergency Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON
Jason R. Frank
Affiliation:
Department of Emergency Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, ON
A. Curtis Lee
Affiliation:
School of Medicine and Public Health, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
*
Department of Emergency Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, ON K1Y 4E9; [email protected]

Abstract

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Objective:

Point-of-care ultrasonography (PoCUS) first appeared in the 1980s in North America, but the extent of the diffusion of its adoption is unknown. We characterized early PoCUS adoption by emergency physicians in Canada and its barriers to use using Rogers' diffusion of innovations theory.

Methods:

We developed a questionnaire based on a pilot study and literature review to assess past, current, and potential use of PoCUS and potential barriers to adoption. A Dillman technique for electronic surveys was used for dissemination. Using Rogers' diffusion of innovations theory, we developed and validated the Evaluation Tool for Ultrasound skills Development and Education (ETUDE). ETUDE scores allowed categorization of respondents into innovators, early adopters, majority, and nonadopters. Descriptive statistics, correlations, and x2 statistics were used to analyze the data.

Results:

The 296 respondents (36.4% of 814 surveyed) had a median age of 40 and were 72.5% male. Adoption scores using ETUDE revealed nonadopters (18.8%), majority (28.7%), early adopters (34.5%), and innovators (18.0%). Respondents endorsed “always” using PoCUS currently and in the future for focused assessment with sonography in trauma (FAST) (current 41.8%/future 88.4%), first trimester pregnancy (current 23.3%/future 73.7%), suspected abdominal aortic aneurysm (current 32.7%/future 92.6%), basic cardiac indications (current 30.7%/future 87.5%), and central venous catheterization (current 17.0%/future 80.3%). Several barriers to PoCUS were identified for part-time emergency physicians and those working in inner-city/urban/suburban settings.

Conclusion:

This is the first study to determine the state of adoption and barriers to the introduction of PoCUS in Canadian emergency medicine practice. The novel validated ETUDE instrument should be used to evaluate the uptake of PoCUS over time.

Keywords

emergency medicinepoint-of-care ultrasonographysurvey
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 16 , Issue 5 , September 2014 , pp. 345 - 351
Copyright
Copyright © Canadian Association of Emergency Physicians 2014

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