E9 DISCUSSIONS IN SURGERY • DISCUSSIONS EN CHIRURGIE Surgeon attitudes toward point of care ultrasound for biliary disease: a nationwide Canadian survey G allstone disease affects more than 20 million Americans yearly. 1 In Ontario, 260 elective cholecystectomies per 100 000 patients are performed each year. 2 Point of care ultrasound (PoCUS) has a growing role in the diagnosis of gallstone disease. 3 Results of PoCUS are similarly accurate compared with formal radiology-performed ultrasounds.

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... Emergency physicians who use biliary PoCUS improve emergency department (ED) throughput and reduce length of stay in the ED. 3 However, surgeons still depend on formal radiology-performed imaging for the management of biliary disease. 5 We surveyed surgeons about their opinions of biliary PoCUS. Our objectives were to quantify surgeon confidence in biliary PoCUS and elucidate possible barriers to use in order to improve surgeon utilization. Our apprOach A cross-sectional survey was emailed to general surgery program directors from the 14 primarily English-speaking academic programs in Canada. They were asked to distribute the survey to all general surgery residents, fellows and staff associated with their centre and to provide us with the number of survey recipients so we could determine the overall response rate. To explore the factors associated with confidence in biliary PoCUS, we dichotomized confidence by considering everyone who answered "slightly confident" to "extremely confident" as having some confidence with PoCUS and those who answered "unconfident" as being unconfident with PoCUS. All other variables were dichotomized as seen in Box 1. We also distilled 5 potential barriers to applying the results of biliary PoCUS in clinical practice: perceived poor test characteristics, user-dependent nature of the technology, poor documentation of results, lack of personal ability to replicate the test, and lack of detailed imaging findings. We analyzed the response data to model the relationships between the survey respondents'