The primary indication of international imaging criteria in emergency ultrasound performed by emergency physicians: an internet-based study

Abstract

Aim Point-of-care ultrasound (POCUS) is indispensable in emergency medicine. However, baseline clinician knowledge of standardized international clinical criteria remains suboptimal. This study evaluated theoretical knowledge of international criteria for primary POCUS indications and clinical practice patterns among emergency physicians. Methods This cross-sectional survey assessed emergency medicine residents and specialists using a 25-item Google Forms questionnaire based on the American College of Emergency Physicians (ACEP) Compendium 2021. An expert panel validated the questions. Total knowledge scores (range: 0–15) were calculated dichotomously. Internal consistency was evaluated using the Kuder-Richardson 20 (KR-20) coefficient. Results Final analysis included 98 participants (62.2% male; 37.8% aged 25–29). The mean total knowledge score was 7.12±1.74 (median: 7.00). Proficiency was highest for pediatric appendicitis (90.8%) and lowest for gastrointestinal/bowel ultrasound (4.1%). The tool demonstrated low internal consistency (KR-20 = 0.112), reflecting domain heterogeneity. Total scores did not significantly differ across demographic characteristics or training backgrounds (all P > .05). Multivariable linear regression identified no independent predictors of overall knowledge. In item-level analyses, only the association between specialist experience and lung/pleural ultrasound proficiency survived strict Bonferroni corrections (adjusted P = .029), with younger specialists (≤10 years of experience) outperforming senior colleagues. Conclusion Significant knowledge gaps persist in specialized POCUS domains despite high proficiency in core modalities. Given the high heterogeneity of ultrasound applications, future efforts should move beyond generalized curricula toward standardized, domain-specific continuous education programs to ensure clinical competency.