Point-of-Care Ultrasound in Acute Care Did More Than Diagnose: It Reassured Patients, Reduced Burden, and Deepened Trust

Point-of-Care Ultrasound in Acute Care Did More Than Diagnose: It Reassured Patients, Reduced Burden, and Deepened Trust

Highlights

In this qualitative study of 18 adults receiving point-of-care ultrasound (PoCUS) in emergency department or inpatient general internal medicine settings, patients generally described PoCUS as a positive part of care rather than merely a diagnostic procedure.

Three themes emerged: PoCUS provided emotional reassurance and practical convenience; patient impressions of PoCUS were inseparable from their impressions of overall clinician behavior and care quality; and favorable experiences were grounded largely in trust in physicians rather than in technical understanding of ultrasound itself.

The findings suggest that the clinical value of PoCUS extends beyond diagnostic speed and bedside accessibility. How clinicians explain, perform, and contextualize PoCUS may meaningfully shape patient-centered care.

At the same time, the study underscores a critical boundary: patient trust should not substitute for clear communication about what PoCUS can and cannot answer in a given encounter.

Background

Point-of-care ultrasound has become a defining tool in modern acute care. Used at the bedside by treating clinicians, PoCUS can accelerate diagnostic clarification, guide procedures, and support dynamic reassessment without waiting for transport to radiology or formal sonography. Its uptake has been especially strong in emergency medicine, critical care, internal medicine, and hospital medicine, where time-sensitive decisions and unstable physiology often favor rapid, repeatable imaging.

Much of the literature on PoCUS has focused on diagnostic accuracy, procedural safety, workflow efficiency, and educational implementation. These are important domains. However, patient experience is increasingly recognized as a core quality dimension in healthcare, particularly in acute settings where anxiety, uncertainty, pain, and information asymmetry are common. Bedside technologies can influence not only what clinicians know, but also how patients interpret the care encounter.

Prior quantitative work has suggested that PoCUS is associated with higher patient satisfaction, especially in emergency settings. Yet satisfaction scores alone rarely explain why patients feel positively or negatively about a technology. Whether patients value speed, convenience, explanation, visual participation, perceived thoroughness, or simply clinician presence at the bedside remains less clear. This gap matters because implementation strategies often assume that PoCUS is inherently patient-centered, when in practice its patient-centeredness may depend on communication, context, and trust.

The study by Madrazo and colleagues addresses this gap directly by asking patients how they experienced PoCUS during real acute care encounters. Rather than treating PoCUS as a neutral diagnostic adjunct, the investigators explored how it shaped feelings of reassurance, perceptions of clinician attentiveness, and the broader meaning of care.

Study Design and Methods

Design

This was a qualitative study using semi-structured interviews and reflexive thematic analysis within a constructivist paradigm. That methodological choice is appropriate for exploring subjective experience, especially when the goal is not to quantify prevalence but to understand how patients make sense of a clinical intervention.

Setting and participants

The study was conducted at a tertiary care academic hospital in Ottawa, Canada. Participants were 18 adult patients who underwent PoCUS during either emergency department assessment or inpatient general internal medicine evaluation. Interviews were conducted at the bedside shortly after the PoCUS examination, which likely improved recall of the immediate experience while also anchoring responses in the emotional context of the encounter.

Data collection and analysis

Transcripts were coded inductively and analyzed using Braun and Clarke’s six-phase framework for reflexive thematic analysis. This is a widely used approach in qualitative health research and is particularly useful when investigators aim to generate themes grounded in participant narratives rather than forcing data into pre-specified categories.

The constructivist orientation is also noteworthy. It assumes that experiences are co-interpreted through context and interaction, not simply “captured” as objective facts. For a topic such as PoCUS, where patient impressions are deeply shaped by clinician communication and care environment, this framework is a conceptual strength.

Intervention and comparator

There was no comparator arm, as expected for this study design. The phenomenon of interest was the patient experience of PoCUS embedded within routine acute care.

Endpoints

The primary endpoint was thematic understanding of how patients experienced PoCUS and how it influenced their perception of care overall. No quantitative effect sizes, confidence intervals, or hypothesis tests were applicable.

Key Findings

1. PoCUS delivered reassurance as well as convenience

The first major theme was that PoCUS contributed both emotional and practical benefits. Patients described reassurance from seeing clinicians evaluate them in real time and, in some cases, receiving immediate feedback. In acute care, uncertainty can be as distressing as symptoms themselves. Bedside imaging appeared to reduce that uncertainty, even when the information communicated was provisional rather than definitive.

This reassurance likely stems from several mechanisms. First, PoCUS makes the diagnostic process more visible. Instead of waiting passively for transport, imaging, and delayed results, patients witness active assessment at the bedside. Second, the clinician who knows the patient’s symptoms is often the same clinician holding the probe, which may create a stronger sense of continuity and attentiveness. Third, immediate verbal explanation, however limited, can transform imaging from an opaque process into an interactive one.

The practical dimension was equally important. Patients appreciated avoiding transfer to separate diagnostic areas. For acutely ill individuals, transport can be uncomfortable, time-consuming, and disorienting. For hospitalized patients, it may interrupt monitoring or expose them to logistical delays. The bedside nature of PoCUS thus mattered not only because it was faster for the system, but because it was less burdensome for the person receiving care.

These findings are clinically relevant because convenience in acute care is not trivial. Reduced movement, less waiting, and visible bedside evaluation can directly affect patient comfort, perception of responsiveness, and willingness to engage in care.

2. Patients experienced PoCUS as part of holistic, patient-centered care

The second theme was that patient perceptions of PoCUS were tightly interwoven with their overall perceptions of care. Participants did not isolate the ultrasound device as a stand-alone technology. Instead, they experienced it as one element of a broader clinical relationship. If the physician was attentive, communicative, and respectful, PoCUS reinforced those impressions. In this sense, PoCUS functioned as a relational tool as much as a diagnostic one.

This is an important insight for clinicians and health systems. Technologies are often evaluated as if they carry intrinsic patient-centered value. The study suggests otherwise. The value patients assigned to PoCUS appeared to depend substantially on how it was introduced, explained, and integrated into the encounter. A bedside scan performed with little communication may not produce the same effect as one accompanied by clear explanation and shared visual interpretation.

In practical terms, PoCUS may signal thoroughness and presence. When clinicians remain at the bedside to examine, image, and discuss findings, patients may perceive a higher level of engagement. Particularly in acute care environments that can feel fragmented and rushed, this bedside attention may have outsized importance.

At the same time, the findings caution against attributing positive patient experience solely to the technology. What patients valued may have been the combination of bedside assessment, communication, and visible clinician investment. PoCUS was part of that package, not necessarily the whole story.

3. Trust compensated for limited technical understanding

The third theme may be the most clinically consequential: patients generally had little technical knowledge of PoCUS, yet still described positive experiences because they trusted their physicians. This trust operated despite uncertainty about what PoCUS could diagnose, how accurate it was, or how it differed from formal imaging.

On one level, this is unsurprising. Most patients do not need expert understanding of a diagnostic modality to benefit from it. Trust in clinician competence is foundational to medical care. But the finding has two sides. Trust can support comfort, acceptance, and therapeutic alliance. It can also mask misunderstanding if clinicians do not clarify the role and limits of PoCUS.

The authors therefore emphasize scope awareness. This matters because PoCUS is highly useful but not universally definitive. It is often focused, question-driven, and operator-dependent. If patients infer that a bedside scan is comprehensive or equivalent to all formal imaging, unmet expectations may follow. The positive halo generated by trust and bedside attention should not lead to overconfidence in what was actually assessed.

For clinicians, the implication is straightforward: explain what you are looking for, what the scan can reasonably show, and whether additional imaging or specialist interpretation may still be needed. Such communication preserves trust while aligning it with realistic expectations.

Clinical Interpretation

This study adds nuance to the expanding PoCUS literature by showing that patient-centered benefits are not merely downstream consequences of faster diagnosis. They are experienced in the moment through reassurance, reduced burden, and relational care. For emergency physicians and internists, this reframes PoCUS as a tool with communicative and experiential effects in addition to clinical ones.

Several practical lessons follow.

First, bedside explanation matters. Even brief language such as “I’m using ultrasound to look for fluid around the lungs” or “This helps me quickly assess your heart and volume status, but it may not replace other tests” can improve transparency.

Second, inviting the patient into the process may enhance reassurance. When appropriate, showing the screen and offering simple interpretation can convert a passive experience into a collaborative one. This does not require turning the encounter into a technical tutorial; it simply means making the purpose of the scan visible and understandable.

Third, clinicians should recognize the ethical weight of patient trust. Patients may assume more certainty than PoCUS actually provides. This is especially relevant in acute care, where focused scans are often performed under time pressure and before confirmatory testing. Clear framing protects against over-interpretation and helps patients understand why additional studies may still be necessary.

Fourth, implementation programs should consider patient communication as part of PoCUS competency. Training commonly emphasizes image acquisition, interpretation, and quality assurance. This study suggests that communication around indication, uncertainty, and next steps is also central to high-quality PoCUS practice.

Strengths and Limitations

Strengths

The study has several strengths. It addresses an underexplored but clinically meaningful question. Interviewing patients shortly after the PoCUS encounter likely enhanced the immediacy and accuracy of experiential recall. The use of reflexive thematic analysis was methodologically suitable for generating rich, inductive themes. The inclusion of both emergency department and inpatient general internal medicine patients broadens relevance across acute adult care settings.

Limitations

As with all qualitative research, the findings are not intended to estimate prevalence or establish causal effects. The sample was small, though appropriate for qualitative inquiry, and drawn from a single tertiary academic center in Ottawa. Patient experiences in community hospitals, nonacademic settings, lower-resource environments, or healthcare systems with different PoCUS maturity may differ.

Selection bias is possible. Patients willing and able to participate at the bedside may have been more likely to report positive experiences, and severely ill, cognitively impaired, or otherwise vulnerable patients may have been underrepresented. Interview timing shortly after the encounter is a strength for recall but may also favor immediate impressions over more reflective critiques.

Another limitation is contextual dependency. PoCUS was not experienced in isolation; it was embedded in clinician interactions. This is conceptually important, but it also makes it difficult to separate attitudes toward ultrasound from attitudes toward the physician and the broader care encounter. Still, one could argue that this is not a flaw but a realistic depiction of how patients actually experience bedside diagnostics.

How This Fits With Existing Literature

Earlier studies have suggested that PoCUS can improve patient satisfaction, especially in emergency medicine, likely through faster evaluation and more direct physician engagement. The present qualitative work extends that literature by identifying mechanisms behind those favorable impressions. Specifically, it points to reassurance, convenience, and trust as core explanatory domains.

It also aligns with broader literature on patient-centered care, which consistently shows that communication quality, shared understanding, and perceived clinician presence strongly shape healthcare experience. In that sense, PoCUS may be most effective from a patient-experience perspective when it strengthens—not replaces—human interaction.

For acute care leaders, this is a useful reminder that technology adoption should be evaluated not only in terms of throughput, accuracy, and cost, but also in terms of what patients feel it communicates about attention, competence, and compassion.

Implications for Practice and Policy

At the bedside, the immediate practice implication is to pair PoCUS with concise, honest communication. Explain the indication, describe what is being assessed, and clarify whether the scan is preliminary or definitive for the clinical question.

In training programs, competency frameworks may need to expand beyond technical image acquisition and interpretation to include patient-facing communication and expectation management. This is particularly relevant in internal medicine and emergency medicine, where PoCUS may be used in diagnostically uncertain situations and repeated over time.

At the institutional level, patient experience should be considered an outcome of PoCUS implementation. Quality programs often track credentialing, documentation, and image review; adding patient-centered metrics could provide a more complete picture of impact.

From a policy standpoint, the study supports the view that PoCUS is not only a diagnostic technology but also a care-delivery modality. Investments in training, governance, and quality assurance may therefore yield benefits beyond diagnostic efficiency, including improvements in the patient experience of acute care.

Conclusion

This study from Ottawa provides an important qualitative perspective on point-of-care ultrasound in acute care. Patients generally experienced PoCUS positively, not simply because it generated diagnostic information, but because it reassured them, reduced logistical burden, and conveyed attentive bedside care. Their impressions were closely tied to trust in clinicians, even when technical understanding of ultrasound was limited.

The central message is practical: PoCUS should be viewed as both a diagnostic instrument and a contributor to patient-centered care. Its benefits are maximized when clinicians pair bedside imaging with clear explanation, appropriate scope framing, and relational attentiveness. As PoCUS continues to expand across emergency and internal medicine practice, this human dimension deserves as much attention as probe selection and image interpretation.

Funding and Trial Registration

The abstract provided does not report a funding source. No ClinicalTrials.gov registration number is listed, which is typical for an interview-based qualitative study.

References

1. Madrazo L, Gaudreau-Simard M, Bowdridge J, Woo MY, Pageau P, Ruller S. Not Just a Diagnostic Tool: A Qualitative Study Exploring How Patients Experience Point-of-Care Ultrasound in Acute Care. Journal of General Internal Medicine. 2026-06-04. PMID: 42243432.

2. Moore CL, Copel JA. Point-of-care ultrasonography. New England Journal of Medicine. 2011;364(8):749-757.

3. Braaten KP, Dighe M, Dietrich CF, et al. Point-of-care ultrasound for clinicians. Ultrasound in Medicine and Biology. This broad literature supports bedside ultrasound as an extension of the physical examination and clinical decision-making, although patient-experience data remain comparatively limited.

4. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.

5. Atkinson P, Bowra J, Milne J, et al. International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC). CJEM. 2017;19(6):459-470.

6. Arntfield R, Millington SJ. Point of care cardiac ultrasound applications in the emergency department and intensive care unit: A review. Current Cardiology Reviews. 2012;8(2):98-108.

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