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PONE-D-20-19295

The Long-Term Effect of Short Point of Care Ultrasound Course on Physicians’ Daily Practice

PLOS ONE

Dear Dr. Sadeh,

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Etsuro Ito

Academic Editor

PLOS ONE

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Additional Editor Comments:

The reviewers think your manuscript is worth for publication. But before that please revise your manuscript slightly.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This manuscript primary's goal is to evaluate the incorporation of point-of-care ultrasound into the routine of physicians after a course given at Soroka University. The authors used a questionnaire to assess the primary outcome and other variables; each physician's pre-course time was used as control. The rate of responders was reasonable (55%), and overall, they felt the course had changed their practice.

Comments and suggestions to the authors:

Major comment:

From 116 responders(specified in the abstract and the results), 64 were residents, and 49 were specialists. What about the other 3? It is not specified throughout the manuscript.

Minor comments:

Figure 9: in the main text (pg 10, line 220), it is described that this figure is about previous training in this field. However, in the legend of the figure, it is not specified that it is previous training - consider specifying it.

Figure 12: it is not clear by the legend of the graphic's meaning. I realized it is the delta of changing in the answers, in which questions were categorized and attributed punctuation of 1. Although this information is in the main text, consider clarifying it.

Page 28: table "comparison of the answers to questions between the different years of the course" is without legend and enumeration. Also, this table is in the main text, readers are not aware of the questions' content. Consider moving this table to the appendix, as each question is described there.

Reviewer #2: Thankyou for the opportunity to review this manuscript.

This paper provides some evidence that attending an ultrasound course increases your use of ultrasound after. It also increase your confidence afterwards. Both these results are perhaps expected but may well not have been published before. My major concern is that you do not address the difference between the confidence of the respondents (which you present here) and their competence - the two are very different. And without assessing their competence we cannot know if patient care is improved, or morbidity reduced etc. We know that confidence and competence are not that well linked in educational terms (candidates who are confident and use much more ultrasound may not actually be competent to do so). This has to be acknowledged in the discussion in my view. The other things to be considered:

- I do not believe that the results section is the place to write that some results are controversial (line 209). Results should merely be stated in this section. The place to discuss their relevance (controversial or not) is the discussion. I would suggest this result is surprising rather than controversial

- I would be wary of stating that your response rate makes your results reliable. they are still subject to the extreme biases you mention (those that reply are by definition more likely to be interested in ultrasound and it's use). I agree the response rate is good, but I think a better phrasing would be that it reduces the chances of these biases' is a more appropriate sentence

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Reviewer #1: No

Reviewer #2: No

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The Long-Term Effect of Short Point of Care Ultrasound Course on Physicians’ Daily Practice

PONE-D-20-19295R1

Dear Dr. Sadeh,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Etsuro Ito

Academic Editor

PLOS ONE

Additional Editor Comments:

Thank you for your revision.