Assessing the Competence of Junior Doctors in performing Point-of-Care Ultrasound Scan and identifying the barriers in training

Parth K. Patel^1,2, Sahiba Maniar³, Samuel Mpinganjira^4,5, Efua Yaaba Gyan-Tawiah⁶, Ikshwaki Kaushik⁷, Alistair Mukondiwa⁸, Phil Chigiya⁹, Arsene Koumbem¹⁰, Arsene Muhumuza¹¹, Asmau Musa Lawali¹², Dalal Alane¹³, Heaven Yeshaneh¹⁴, Lina Rajwani¹⁵, Mehr Muhammad Adeel Riaz¹⁶, Phelile Mwape-Zindaba¹⁷, Rohma Ahmed18, Romeo Drabile¹⁹, Sarah Maitho²⁰, Senuri Perera²¹, Soukayna Baladi²², William Ssenkendu²³, Yaswa Djanwet²⁴

Abstract
Introduction
Point-of-care ultrasound (POCUS) has lately become an integral tool in healthcare due to its enhanced turnaround time and outstanding accuracy. Through development of improved quality handheld ultrasound devices, numerous countries have progressed to using POCUS as an adjunct to clinical examination. Effective use depends on the user’s abilities, and junior doctors often portray inadequate ultrasound scan competence. We investigated the status quo to further understand the deficiencies in contrast to gold standard radiological care in emergency settings across LMICs.
Methods
A validated questionnaire was distributed to junior doctors working in clinical roles in 28 countries to determine the self-reported competence, perceptions regarding POCUS, and its applicability to their practice of medicine.
Results
A total of 407 junior doctors participated (males: 198, females: 209, aged 22-38 years). 63% participants had never heard of POCUS and less than 15% participants received ultrasound training in medical school or internship. The greatest self-reported competence was in positioning the patient (65%) in contrast to visualizing the target area being the least competent (16%). Knowledge and competence of use of POCUS remained generally low in the participants. The greatest applicability-competence gap was for the assessment of abscess/cellulitis (41% see it regularly, but only 30% are competent in diagnosing using POCUS). 97% of the 407 participants believed that POCUS is an essential skill for their medical practice.
Conclusion
Despite the strong applicability and demand for POCUS, significant challenges in competence exist. Respondents to our study strongly believed that medical students and junior doctors should undergo formal training. The greatest barrier to POCUS training however, remains the lack of resources (equipment, infrastructure).

Keywords: Radiology, LMICs, POCUS, Healthcare Technology, Global Health.