Page 101 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars
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                 Implementing ultrasound in Dutch emergency departments after a two-day training 99
A qualitative study by means of semi-structured individual interviews was conducted in January and February 2014, to explore the subjects’ perceptions and experiences. The Fontys University of Applied Sciences approved the study. Ethical approval was obtained from the institutional ethics review board of the Radboud university medical center, Nijmegen. Writ- ten informed consent was obtained from all participants.
Since this is a largely unexplored topic, the interviews were guided by an initial topic list aiming to identify the subjects’ motivation (intention) and ability (behavioral control) to perform US examinations on the ED. Topics were based on three sources. First, topics were formulated to identify three factors (attitude towards the behavior, the subjective (social) norm, and perceived behavioral control) that influence the intention to perform a given behavior (performing US on the ED) as conceived in the theory of planned behavior by Fish- bein and Ajzen.18,19 This also includes any incentives and barriers influencing the behavior. Secondly, topics were based on earlier discussions the researchers had with other course candidates. Finally, one topic was based on previously mentioned turf battles.16 The topic list is displayed in Table 4.1. Relevant new topics brought up by the interviewees were added to the list.
Recruitment and setting
We contacted randomly selected EPs who successfully completed the PREP course between one and four years preceding the study (2009–2012). After they agreed to participate they were further screened for possible inclusion.
Inclusion criteria were EPs employed at a Level 2 hospital for a minimum of 20 hours per week since completion of the course. In a Level 2 (ranging from 1–3, Level 1 being the highest) hospital seriously injured and critically ill patients can be treated although not all facili- ties, such as neurosurgery, are present. In these hospitals, EPs will have enough exposure to critically ill patients and opportunities to perform US examinations. Level 1 hospitals are generally well-equipped university hospitals where US examinations are typically performed by radiology residents. The interval between the course and interview was chosen to allow the EPs ample time to implement the use of US in their ED and to potentially experience any burden and challenges.

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