At Srinagarind Hospital's emergency department, Khon Kaen University, this study included 16 emergency-medicine residents and 60 emergency nurse practitioners who completed institutional POCUS training during 2024–2025, plus 2,097 electronically archived examinations over a standardized one-month observation per provider. Residents had higher mean competency scores. Both groups identified workload and time, limited equipment, and interpretive confidence as major barriers, while nurse practitioners reported greater concern about institutional support and medicolegal risk. Competency and provider type were associated with more recorded examinations, while patient volume was associated with fewer. The study did not assess image quality, diagnostic accuracy, treatment decisions, or patient outcomes.
Key findings
- Residents had a mean competency score of 86.3±5.7 versus 78.9±7.4 among nurse practitioners, p=0.002.
- Nurse practitioners rated insufficient institutional support higher, 3.88 versus 3.06, p=0.001, and medicolegal risk higher, 3.65 versus 2.94, p=0.004; residents rated structured feedback more favourably, p=0.012.
- After adjustment, each 10-point competency increase was associated with 3.97 more examinations per month, 95% CI 2.05–5.89; resident status with 9.64 more, 95% CI 2.78–16.50; and five additional patients per shift with 1.89 fewer, 95% CI -3.31 to -0.47.
Why this matters globally
Scaling POCUS requires more than one training course: criterion-based competency assessment, mentorship and feedback, equipment access, protected time, image archiving and quality assurance, and clear scope-of-practice and medicolegal support for nurses. These issues matter in resource-constrained hospitals internationally, but implementation studies must show that system changes improve appropriate, accurate scanning and patient care—not merely counts.
Thai researcher contribution
Five Thai authors from Khon Kaen University's Department of Emergency Medicine and Department of Adult Nursing used real-world Srinagarind Hospital data, collaborating with Lap Woon Cheung in Hong Kong. The work directly characterizes Thai conditions including high workload, equipment access, and uncertainty around nurse-performed POCUS scope and liability.
Limitations to consider
This was a retrospective study at one academic hospital, with only 16 residents versus 60 nurse practitioners. The two curricula differed in content, duration, and structure, so professional role cannot be separated from training, supervision, and clinical opportunity. The post-training survey is vulnerable to recall bias. Scan count was modelled with OLS despite being count data, and analyses lacked hours worked, shift assignment, acuity, and POCUS-eligible encounters. Motivation, scheduling, and supervision may confound results; one-month follow-up was short; and quality, accuracy, treatment timing, and patient outcomes were unmeasured.
Verify the original sources
Journal of Multidisciplinary HealthcareJournal of Multidisciplinary Healthcare↗DOI: 10.2147/jmdh.s649231