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波兰儿科实践中的床旁超声检查(POCUS):认知、能力及实施障碍——一项全国性横断面调查

Point-of-Care Ultrasound (POCUS) in Pediatric Practice in Poland: Perceptions, Competency, and Barriers to Implementation-A National Cross-Sectional Survey.

作者信息

Kiepuszewska Justyna, Gałązka-Sobotka Małgorzata

机构信息

Department of Pediatrics, Florian Ceynowa Specialist Hospital, ul. Dr Alojzego Jagalskiego 10, 84-200 Wejherowo, Poland.

Institute of Healthcare Management, Lazarski University, ul. Swieradowska 43, 02-662 Warsaw, Poland.

出版信息

Healthcare (Basel). 2025 Aug 5;13(15):1910. doi: 10.3390/healthcare13151910.

Abstract

Point-of-care ultrasound (POCUS) is gaining recognition as a valuable diagnostic tool in various fields of medicine, including pediatrics. Its application at the point of care enables real-time clinical decision-making, which is particularly advantageous in pediatric settings. Although global interest in POCUS is growing, many European countries-including Poland-still lack formal training programs for POCUS at both the undergraduate and postgraduate levels. Nevertheless, the number of pediatricians incorporating POCUS into their daily clinical practice in Poland is increasing. However, the extent of its use and perceived value among pediatricians remains largely unknown. This study aimed to evaluate the current level of POCUS utilization in pediatric care in Poland, focusing on pediatricians' self-assessed competencies, perceptions of its clinical utility, and key barriers to its implementation in daily practice. This cross-sectional study was conducted between July and August 2024 using an anonymous online survey distributed to pediatricians throughout Poland via national professional networks, with a response rate of 7.3%. Categorical variables were analyzed using the chi-square test of independence to assess the associations between key variables. Quantitative data were analyzed using descriptive statistics, and qualitative data from open-ended responses were subjected to a thematic analysis. A total of 210 pediatricians responded. Among them, 149 (71%) reported access to ultrasound equipment at their workplace, and 89 (42.4%) reported having participated in some form of POCUS training. Only 46 respondents (21.9%) reported frequently using POCUS in their clinical routine. The self-assessed POCUS competence was rated as low or very low by 136 respondents (64.8%). While POCUS was generally perceived as a helpful tool in facilitating and accelerating clinical decisions, the main barriers to implementation were a lack of formal training and limited institutional support. Although POCUS is perceived as clinically valuable by the surveyed pediatricians in Poland, its routine use remains limited due to training and systemic barriers. Future efforts should prioritize the development of a validated, competency-based training framework and the implementation of a larger, representative national study to guide the structured integration of POCUS into pediatric care.

摘要

床旁超声(POCUS)在包括儿科在内的各个医学领域正逐渐被认可为一种有价值的诊断工具。它在床旁的应用能够实现实时临床决策,这在儿科环境中尤为有利。尽管全球对POCUS的兴趣在增加,但包括波兰在内的许多欧洲国家在本科和研究生层面仍缺乏正式的POCUS培训项目。然而,在波兰,将POCUS纳入日常临床实践的儿科医生数量正在增加。然而,其使用程度以及儿科医生对其感知价值在很大程度上仍不为人所知。本研究旨在评估波兰儿科护理中POCUS的当前使用水平,重点关注儿科医生的自我评估能力、对其临床效用的看法以及在日常实践中实施的主要障碍。 这项横断面研究于2024年7月至8月进行,通过全国专业网络向波兰各地的儿科医生分发匿名在线调查问卷,回复率为7.3%。使用独立性卡方检验分析分类变量,以评估关键变量之间的关联。定量数据使用描述性统计进行分析,开放式回答的定性数据进行主题分析。 共有210名儿科医生回复。其中,149名(71%)报告在其工作场所可使用超声设备,89名(42.4%)报告参加过某种形式的POCUS培训。只有46名受访者(21.9%)报告在临床常规中经常使用POCUS。136名受访者(64.8%)将自我评估的POCUS能力评为低或非常低。虽然POCUS通常被视为有助于促进和加速临床决策的工具,但实施的主要障碍是缺乏正式培训和机构支持有限。 尽管波兰接受调查的儿科医生认为POCUS具有临床价值,但其常规使用由于培训和系统障碍仍然有限。未来的努力应优先制定经过验证的、基于能力的培训框架,并开展规模更大、具有代表性的全国性研究,以指导POCUS有组织地融入儿科护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/499c/12345954/bc79eff1ae17/healthcare-13-01910-g001.jpg

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