Endobronchial ultrasound knowledge, implementation, and perceived barriers after attendance at a dedicated hands-on...

Endobronchial ultrasound (EBUS) is a relatively new technology in the field of pulmonary medicine. To determine EBUS knowledge, current clinical utilization, and perceived barriers to EBUS implementation, we surveyed physicians who had previously attended a 2-day hands-on EBUS course in our center. Our survey response rate was 51%. Overall, we found that more than one-third of course participants were currently performing linear EBUS and that over half had access to EBUS for their patients through another physician in their center. EBUS knowledge was excellent and many physicians used EBUS in their current clinical setting in the diagnosis of sarcoidosis, mediastinal lymphadenopathy, and lung cancer. Reported barriers to EBUS implementation included the high cost of equipment (73%), high per procedure cost (23%), inadequate support staff (32%), and limitations regarding use of sedation and anesthesia (18%). Only 14% cited lack of adequate training as a barrier to EBUS implementation, and none believed that low patient volumes for EBUS was a barrier to its implementation. It seems that participation in an EBUS course is useful in helping physicians incorporate EBUS in their practice, but barriers remain, some of which may not be modifiable through such activities.