title: Physician-performed chest ultrasound: progress and future directions.
abstract: BACKGROUND
  Pleural ultrasound guidance reduces complications of pleural procedures, and lung ultrasound can diagnose the cause of acute respiratory failure. Yet as recently as 5 years ago, many respiratory physicians lacked sufficient access, training and expertise to perform a chest ultrasound.
  
  
  OBJECTIVE
  This study examines whether progress has been achieved in chest ultrasound amongst respiratory physicians in Australia and New Zealand.
  
  
  METHODS
  We conducted a web-based chest ultrasound survey of adult respiratory physicians across Australia and New Zealand. We also surveyed advanced trainees.
  
  
  RESULTS
  The response rate was 38% among respiratory physicians. Between 2011 and 2016, access to bedside ultrasound increased from 53 to 90%. The proportion arranging ultrasound guidance for pleural aspiration rose from 66 to 95%. The proportion demonstrably competent in pleural ultrasound increased from 4 to 21%. In 2016, 67% of physicians and 80% of advanced trainees reported available workplace supervision for ultrasound training. Use of lung ultrasound to diagnose acute pulmonary oedema and consolidation improved from 2011 but remained low at 25 and 20% respectively.
  
  
  CONCLUSIONS
  These results establish pleural ultrasound guidance for pleural procedures as the standard of care in our region. However, lung ultrasound remains underutilised. Ultrasound training can and should be incorporated into specialist respiratory training.
authors.affiliation: Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.|Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia.
authors.forename: Eve J
authors.identifier: http://orcid.org/0000-0003-1482-7626
authors.initials: EJ
authors.lastname: Denton
authors.affiliation: Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia.
authors.forename: Liam M
authors.initials: LM
authors.lastname: Hannan
authors.affiliation: Department of Respiratory Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.|School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Hew
mesh_terms: D001315:Australia / Q000453:epidemiology; D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D010820:Physicians; D010995:Pleural Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D011030:Pneumothorax / Q000517:prevention & control*; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D059039:Standard of Care; D000069258:Thoracentesis / Q000295:instrumentation / Q000379:methods*; D013909:Thorax / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000592:standards; D018084:Ultrasonography, Interventional
keywords: competency; lung; pleura; training; ultrasound