Motivation and barriers to the use of Point-of-Care Ultrasound (POCUS) among physicians in Bosnia and Herzegovina: a dual survey study

pstrongIntroduction./strong Point-of-care ultrasound (POCUS) is increasingly recognized as an extension of the physical examination, enhancing bedside diagnostic accuracy and real-time clinical decision-making. Although widely integrated into medical education and practice internationally, its routine implementation in Bosnia and Herzegovina remains inconsistent and structurally constrained. This study aimed to identify key motivators for POCUS utilization and to examine systemic and organizational barriers limiting its broader adoption in primary and secondary healthcare settings.br /strongMethods. /strongA cross-sectional study was conducted using two structured anonymous questionnaires administered to physicians attending an ultrasound training course during the ldquo;Dom zdravljardquo; Doboj symposium in September 2025. After data cleaning, 41 fully completed questionnaires were included in the motivation analysis (general practitioners n = 11; specialists n = 30), and 43 were included in the barriers analysis. The instruments assessed professional characteristics, self-reported ultrasound familiarity, motivators, perceived barriers, and institutional support. Descriptive statistics were applied, with chi;sup2; and Fisherrsquo;s exact tests used for subgroup comparisons (p lt; 0.05).br /strongResults./strong Respondents demonstrated strong motivation for POCUS use, particularly for rapid diagnostic clarification and disease monitoring. Most participants supported formal curricular integration and recognized the professional value of ultrasound practice. Major barriers included insufficient structured training, lack of mentorship, limited access to ultrasound devices, time constraints, absence of clear institutional guidelines, and the need for financial recognition. No significant differences were observed between general practitioners and specialists.br /strongConclusion./strong Physicians in Bosnia and Herzegovina show high motivation toward POCUS adoption. However, implementation is predominantly hindered by systemic and institutional barriers. Coordinated educational, infrastructural, and policy-level interventions are necessary to enable sustainable integration into routine clinical practice./p