Canadian Physiotherapists' Views on Certification, Specialisation, Extended Role Practice, and Entry-Level Training in Rheumatology

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BMC Health Services Research 2009, 9:88 doi:10.1186/1472-6963-9-88

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Background: Since the last decade there has been a gradual change of boundaries of health professionsin providing arthritis care. In Canada, some facilities have begun to adopt new arthritis care models, someof which involve physiotherapists (PT) working in extended roles. However, little is known about PTs'interests in these new roles. The primary objective of this survey was to determine the interests amongorthopaedic physiotherapists (PTs) in being a certified arthritis therapist, a PT specialized in arthritis, oran extended scope practitioner in rheumatology, and to explore the associated factors, including thecoverage of arthritis content in the entry-level physiotherapy training.Methods: Six hundred PTs practicing in orthopaedics in Canada were randomly selected to receive apostal survey. The questionnaire covered areas related to clinical practice, perceptions of rheumatologytraining received, and attitudes toward PT roles in arthritis care. Logistic regression models weredeveloped to explore the associations between PTs' interests in pursuing each of the three extendedscope practice designations and the personal/professional/attitudinal variables.Results: We received 286 questionnaires (response rate = 47.7%); 258 contained usable data. Theaverage length of time in practice was 15.4 years (SD = 10.4). About 1 in 4 PTs agreed that they wereinterested in assuming advanced practice roles (being a certified arthritis therapist = 28.9%, being a PTspecialized in rheumatology = 23.3%, being a PT practitioner = 20.9%). Having a caseload of ≥ 40% inarthritis, having a positive attitude toward advanced practice roles in arthritis care and toward the formalcredentialing process, and recognizing the difference between certification and specialisation wereassociated with an interest in pursing advanced practice roles.Conclusion: Orthopaedic PTs in Canada indicated a fair level of interest in pursuing certification,specialisation and extended scope practice roles in arthritis care. Future research should focus on theeffectiveness and cost-effectiveness of the emerging health service delivery models involving certified,specialized or extended scope practice PTs in the management of arthritis.

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