July 2025 Ultrasound Division Journal Club

Hello Wash U Pocus community!

Welcome to the new academic year! We hope all our new learners are settling in well and that your year is off to a great start.
The Ultrasound Division has been busy kicking things off, with Kelly and I (Courtney) starting as the new fellows and helping to welcome our incoming interns during bootcamp.

Below are two articles we discussed during our recent journal club and a few take home points for each. 

Eke OF, Shokoohi H, Serunjogi E, Liteplo A, Haberer JE, Jung OS. Barriers and facilitators to point-of-care ultrasound use in an academic emergency department by perceived usability. Am J Emerg Med. 2025 Feb;88:105-109. doi: 10.1016/j.ajem.2024.11.056. Epub 2024 Nov 23. PMID: 39612527.

This study used structured quantitative surveys to determine barriers and facilitators to the use of POCUS in an academic emergency department. Participants were divided into groups based on perceived ultrasound utility (high, medium, low) and training (resident, attending, APP). 29 interviews were analyzed divided based on perceived POCUS utility. The barriers identified included perceived insufficient bedtime time to conduct the POCUS study, the need for additional studies when POCUS was inconclusive, lack of confidence and/or training in POCUS use/applications/interpretations, and unfamiliarity with machines. Facilitators identified included POCUS aiding in clinical decision making, supervision for trainees, and machine availability/functionality/user friendly interface. The barriers were consistent across participants, with the lack of education being noted particularly by senior faculty, APPs and residents. This study was overall well performed especially in consideration of a survey study where participation can be limited and bimodal in response. As this was conducted in an academic institution, performing a similar study in a community/RVU based setting could help elucidate common trends or unique factors in that clinical setting. 



Skitch S, Vlahaki D, Healey A. Quantifying Clinically Meaningful Point-of-Care Ultrasound Interpretation Discrepancies Using an Emergency Department Quality Assurance Program. Cureus. 2023;15(7):e42721. Published 2023 Jul 31. doi:10.7759/cureus.42721

A 2023 study evaluating a Point-of-Care Ultrasound (POCUS) Quality Assurance (QA) program in a Canadian academic Emergency Department (ED) found remarkably low rates of interpretation discrepancies. Out of 2,668 POCUS examinations reviewed over a year, only 1.4% contained an interpretation discrepancy, and 0.5% of all scans had a clinically meaningful discrepancy, meaning an error that altered patient care. The study also revealed that scans performed by non-expert sonographers (no formal ultrasound training) were significantly more prone to discrepancies compared to those performed by experts (3.4% vs. 1.1%). No specific scan type showed a higher discrepancy rate. This rate is comparable to quoted radiology literature, with clinically significant plain radiograph discrepancies being 0.95%. These findings provide strong reassurance regarding the diagnostic accuracy of ED POCUS!

Courtney Smith, MD
​Clinical Ultrasound Fellow