Sono-starters: A qualitative study of pioneers in the field of point-of-care ultrasound.

Objectives: Point-of-care ultrasound (POCUS) within emergency medicine (EM) was a new field that has since developed into a robust discipline through the efforts of early EM POCUS pioneers. This study explored the experiences that led to POCUS pioneers' success. These data can inform emerging fields of study including non-EM specialties adopting POCUS as well as other new subspecialties within medicine. Methods: This was a qualitative study using semistructured interviews with physician pioneers in the field of EM POCUS. EM POCUS pioneers were defined as early key contributors to the field of EM POCUS and were identified using combined author networks and purposive, stratified sampling with a snowball sampling technique. A thematic analysis of interviews was performed using a modified grounded theory approach with a constructivist-interpretivist paradigm. Results: Twelve physicians were interviewed in this study. We identified four major themes: career motivators, barriers encountered, promoters of success, and advancement of the field. Career motivators included the need for representation and the ability to impact a new and growing field. Barriers encountered included discouragement by other colleagues, political battles, lack of funding, and rudimentary technology. Participants felt their career success was attributed to guidance from mentors, demonstration of initiative, work ethic, and skills in active listening. Participants felt the field advanced through the creation of national organizations, publication of training and credentialing guidelines, generation of research, and investment into the next generation of POCUS leaders. Conclusions: This study identified several key themes in EM POCUS pioneers' careers including motivators, barriers, and methods used to overcome obstacles. Based on these data, we recommend a comprehensive set of strategies to support the advancement of an emerging field. These include early content exposure, mentorship, funding, research and industry collaboration, diversity, national organization involvement, and investment into future leaders.