'Closed loop' learning barriers hinder the use of bedside ultrasound by clinicians

Recent research highlights a critical issue in the adoption of point-of-care ultrasound (POCUS) technology in clinical practice. Despite the availability of training and the potential lifesaving benefits of bedside ultrasound, many healthcare professionals abandon its use shortly after training. A study published in Advances in Health Sciences Education reveals systemic barriers that create self-reinforcing cycles, preventing routine integration of POCUS into patient care.

Point-of-care ultrasound allows clinicians to perform rapid, bedside scans that can detect urgent clinical conditions such as heart failure, internal bleeding, or pulmonary fluid accumulation, enabling immediate intervention. Although thousands of UK doctors have received training, ongoing use in practice remains inconsistent.

The study, conducted by researchers from the University of Cambridge, the University of Exeter, and Royal Papworth Hospital, identifies six interconnected "vicious cycles" that impede POCUS adoption. These include a lack of expert support, workplace norms that discourage scanning, and early technical challenges that undermine confidence.

One significant cycle involves trainees' initial difficulties in obtaining high-quality scans, which fosters skepticism among experienced clinicians. This skepticism discourages further use and reduces opportunities for trainees to gain confidence. Another cycle revolves around limited access to expert feedback and protected learning time, which hampers skill development and the growth of a supportive expert community. Furthermore, cultural resistance within departments and concerns about stepping on senior colleagues' toes perpetuate the underuse of ultrasound.

To address these barriers, researchers recommend practical, scalable steps such as diversifying training exposure through shared image banks, leveraging natural teaching moments during ward rounds, and encouraging discussion of scan results in existing professional forums. These strategies aim to break the cycle of underutilization, leading to increased clinician confidence and better patient outcomes.

Lead author Professor Riika Hofmann emphasizes that addressing the ingrained cultural challenges is essential to maximize the lifesaving potential of POCUS. Dr. Nicola Jones from Royal Papworth Hospital highlights that overcoming these barriers could significantly improve the timely diagnosis and management of critically ill patients. This research underscores the importance of cultural change in the healthcare environment to fully leverage simple yet effective diagnostic tools like bedside ultrasound.

Source: https://medicalxpress.com/news/2025-06-loop-barriers-doctors-life-bedside.html