POCUS Leaders Discussion: Building Confidence & Looking Ahead

At SONIC 2025 in Queenstown, POCUS champions came together in a facilitated discussion led by Dr Gabby King, for a forward-thinking discussion on two central questions:

1. How do we move clinicians from having the skills to having the confidence to use POCUS when it matters most?

   
   

2. What lies ahead for POCUS over the next five years?

   
   

What followed was a lively exchange of ideas that touched on generational shifts, departmental culture, the role of technology, and the future of clinical practice.

Building Confidence: From Skills to Clinical Impact

While many clinicians now possess the technical skills to use POCUS, translating that into confidence during high-stakes clinical situations remains a challenge.

Key Themes:

• Creating a supportive culture — Departments need to normalise ultrasound use, making it a core skill rather than an optional add-on. Removing the “path of least resistance” (where seniors do the scan instead of juniors) was seen as vital to embedding POCUS at every level.

• The role of mentorship — Champions and mentors with “infectious enthusiasm” can drive adoption, but they need infrastructure support, including PACS integration, archiving systems, and protected training time.

• Formalising supervision — Particularly in rural and resource-strained settings, structured supervision (through CLUS and SEED roles) and dedicated teaching time are essential to maintaining skills and confidence.

• Senior engagement — When senior clinicians are credentialed and confident, it removes friction for juniors and fosters shared expectations across the department.

• Quality assurance as confidence-building — Audit processes, case studies, and even “imperfect” uploads create opportunities for learning, reducing fear and building trust in one’s own skills.

• Cross-specialty collaboration — Confidence is undermined when scans aren’t valued. Departments need buy-in from multiple specialties so POCUS is trusted and used consistently.

The Next Five Years: Where POCUS is Headed

Looking ahead, the group shared a mix of optimism, pragmatism, and healthy cynicism about how POCUS will evolve over the next half-decade.

What We Can Expect:

• Handheld devices everywhere — Ultrasound will become as routine as using a stethoscope (if not replacing it). Nurses, nurse practitioners, and paramedics will increasingly use POCUS for IV access, nerve blocks, and more.

• Integration with hospital systems — Departments must advocate for POCUS images to flow seamlessly into PACS systems and electronic medical records. Middleware and cloud-based tools will be crucial.

• AI on the horizon — AI-driven quality assurance and assisted measurements will help boost confidence and streamline workflow. Image auditing will become essential.

• Expanding credentialing — To meet demand, a critical mass of credentialed clinicians will be required across specialties. Streamlined, standardised credentialing processes are needed now.

• Cultural and systemic change — True transformation will require collaboration across hospitals, states, and systems — not just isolated departmental change. Evidence-based efficiencies and standardised protocols will make POCUS part of routine clinical practice.

• Procedural revolution — More and more procedures (particularly nerve blocks) will be mandated as ultrasound-guided. Blind techniques will become a thing of the past.

Preparing Today for Tomorrow’s Practice

To prepare for this future, departments and health systems need to:

• Invest in archiving and IT systems that support image sharing and review.

• Establish dedicated POCUS leadership roles with protected time for training.

• Encourage seniors to upskill and model confident use for juniors.

• Build cross-specialty collaboration and shared protocols.

• Explore AI tools for audit, QA, and telehealth applications.

The discussion at SONIC 2025 underscored a clear message: POCUS is not just a skill, but a cultural and technological shift in how we deliver emergency and acute care. Confidence, collaboration, and infrastructure are the keys to unlocking its potential.

As one participant noted, “The stethoscope may be dying, but ultrasound is alive and thriving.” The next five years promise exciting change, provided we prepare today.