Barriers and facilitators to achieving competence in lung ultrasound: A survey of physiotherapists following a lung ultrasound training course |
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| Affiliation: | 1. Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia;2. Physiotherapy Department, Royal North Shore Hospital, St Leonards, Sydney, Sydney, Australia;3. Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia;4. Division of Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, Australia;5. Northern Clinical School, Faculty of Medicine, The University of Sydney, Sydney, Australia;6. ANZIC Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia;7. Department of Anaesthesia and Perioperative Medicine, Westmead Hospital, Division of Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, Australia;8. Nepean Clinical School, University of Sydney and Senior Staff Specialist, Nepean Hospital, Australia;9. Physiotherapy Department, St Vincent''s Hospital, Sydney, Australia;1. Centre for Quality and Patient Safety Research – Eastern Health Partnership, 2/5 Arnold St, Box Hill, Victoria, 3128, Australia;2. Deakin University: School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria, 3220, Australia;3. Eastern Health, Arnold Street, Box Hill, Victoria, 3128, Australia;4. Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 5 Arnold St, Box Hill, Victoria, 3128, Australia;1. Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia;2. Department of Physiotherapy, Monash Health, Clayton, VIC, 3168, Australia;3. College of Health and Biomedicine, Victoria University, Footscray, VIC, 3011, Australia;4. Department of Intensive Care, Monash Health School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia;5. Department of Physiotherapy, Alfred Hospital, Melbourne, VIC, 3004, Australia;1. KU Leuven, Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium;2. Department of Intensive Care Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium;3. Rehabilitation Unit, Department of Physiotherapy, University Hospital Puerta de Hierrro Majadahonda, Madrid, Spain;4. KU Leuven, Division of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium;1. Austin Health, Melbourne, Australia;2. School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia;3. Melbourne Medical School, The University of Melbourne, Melbourne, Australia;4. CCRE Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;5. Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia;6. Melbourne Academic Centre for Health, Melbourne, Australia;7. General Surgery and Gastroenterology Clinical Institute, Epworth Healthcare, Melbourne, Australia;8. Department of Surgery, The University of Melbourne, Australia;9. Department of Intensive Care, The Royal Melbourne Hospital, Melbourne, Australia;1. The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3010, Australia;2. School of Nursing & Midwifery, Deakin University, Gheringhap Street, Geelong, VIC, 3220, Australia;3. Royal Adelaide Hospital, Adelaide, South Australia, Australia;4. North West Hospital & Health Service, Mt Isa, QLD, 4825, Australia;5. Centre for Quality & Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, Australia;1. The Royal Melbourne Hospital, 300 Grattan St, Parkville, Victoria 3050, Australia;2. Monash University, Wellington Road, Clayton, Victoria 3800, Australia;3. The University of Melbourne, 161 Barry St, Carlton, Victoria 3053, Australia |
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| Abstract: | Background and purposeLung ultrasound (LUS) is an emerging tool for acute respiratory physiotherapists. In Australia, there are a select few LUS training courses run for physiotherapists. Research to date has evaluated LUS training courses for physiotherapists in terms of knowledge and skill acquisition. The impact of LUS training on user competence and confidence and whether LUS is used in clinical practice has yet to be evaluated. This study therefore explored the impact of attending a physiotherapy LUS training course on acquisition of competence and confidence and the barriers and facilitators for physiotherapists in achieving competence in LUS.MethodsA quantitative survey containing 21 questions was distributed to 77 Australian physiotherapists.ResultsOf the invited physiotherapists, 39 (50%) completed the survey. Most participants were working in intensive care, in the public hospital setting. Binary logistic regression was performed and demonstrated no significant difference in the relationship between years of clinical experience and having confidence in performing or interpreting LUS images. There was also no statistical significance in the relationship between years of clinical experience and gaining competence and accreditation in LUS. Of the 39 responders, 20 physiotherapists had performed at least one LUS scan since completing training; however, most identified they never use LUS to inform clinical decision-making. Only one physiotherapist had gained accreditation through an ultrasound-governing body. The most frequently reported barriers to achieving competence were lack of clinical time to devote to training and lack of an LUS supervisor.ConclusionA majority of physiotherapists who participated in an LUS training course did not attain competence or accreditation, nor were they confident in performing LUS and interpreting images. Barriers exist that prevent intensive care physiotherapists from being able to use LUS in clinical practice. LUS is also not frequently used by acute respiratory physiotherapists to make clinical decisions. |
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| Keywords: | Physiotherapy Intensive care Lung ultrasound POCUS |
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