Barriers and enablers to point-of-care ultrasound use in emergency departments: a multicentre survey of practicing residents in Switzerland.

STUDY

Aims

Point-of-care ultrasound (POCUS) has become a key diagnostic modality in emergency departments, facilitating rapid clinical decision-making and improving patient care. Despite its benefits, POCUS adoption remains heterogeneous. Barriers reported in the literature include the absence of standardised certification pathways, limited access to training and insufficient equipment availability. This study aimed to explore barriers and enablers of successful implementation of POCUS in Swiss emergency departments.

Methods

We conducted a national, cross-sectional multicentre survey targeting medical residents from 15 category 1 emergency training centres in Switzerland. The survey included questions on POCUS usage, training, perceived barriers and facilitators. Data were analysed using descriptive statistical methods. The data collection period spanned from October 2023 to April 2024.

Results

A total of 165 residents participated in the survey (35.6% response rate). Of these, one-third (32%) had attended accredited POCUS training, while only 6% reported no prior ultrasound experience. Residents exhibited a positive attitude towards POCUS, with the majority recognising it as a valuable diagnostic tool and a core skill for trained emergency physicians. Key barriers to POCUS implementation in Swiss emergency departments included limited access to training, difficulties completing certification requirements and challenges in skill maintenance after initial training. Specific obstacles were unavailable courses, lack of supervision and time-consuming logbook completion. Unlike prior literature, this study did not identify doubtful attitudes towards POCUS utility, lack of a standardised national curriculum or resistance from other specialties as barriers.

Conclusions

Swiss emergency medicine residents strongly support POCUS and are motivated to pursue certification. A nationally standardised training curriculum may help address some of the barriers commonly described in the literature by providing a structural advantage. However, inconsistent local implementation, limited mentorship and restricted training access hinder full integration into practice. Bridging this gap requires stronger institutional support, better awareness of certification pathways and more hands-on opportunities to ensure residents can achieve and maintain POCUS competency, ultimately advancing the quality and efficiency of emergency care in Switzerland.