Background The Advanced Clinician Practitioner in Arthritis Care (ACPAC) program prepares expereinced physical therapists and occupational therapists for extended practice roles.
Objectives This study assessed the practice behaviour and perceptions of ACPAC program-trained extended role practitioners (ERPs) and relevant members of their teams. Analysis evaluated the extent to which this new human health resource in arthritis care is perceived to function in the context of Interprofessional Patient-centred Collaborative (IPC) practice in Ontario, Canada.
Methods Mixed-methods were used. Three focus groups (n=20 ACPAC ERPs) and 18 interviews (n=18 clinical colleagues and administrators) were conducted. All were digitally audio-recorded, transcribed and coded for anticipated and emergent themes. Themes related to IPC were analysed using components of the evaluation of interprofessional education (IPE) initiatives framework (Barr et al., 2005) to evaluate behavior and modification of attitudes and perceptions, readiness for change in organizational practice and any benefit to patient. 24 ACPAC ERPs completed the Bruyère Clinical Team Self-Assessment on Interprofessional Practice (Patrick, 2010) and a single-item rating of their team’s readiness for IPC practice.
Results Qualitative data suggests that ACPAC program-trained ERPs are effective at promoting and contributing to IPC within arthritis care settings. Varying degrees of IPC exist within their arthritis care teams. Barriers such as institution-specific lack of medical directives, remuneration conflicts, and role recognition issues were barriers to role implementation. Quantitative survey: Seventy percent of respondents felt their team was actively working in an IPC practice model, 5% were prepared for action and 25% felt their team was in the precontemplation or contemplation phase. Mean Bruyère subjective subscale scores were high (all >3 [1-5=better perception of team’s IPC practice]) and objective scale scores were lower (mean 4.6 [0-9=more team practices associated with IPC actually in place]).
Conclusions ACPAC program graduates are effective participants in, and contributors to IPC care at select sites. Their presence appears to promote organizational change and impart general benefit to the collaborative care of patients with arthritis. ACPAC graduates are working on teams that are at varying stages of readiness for IPC practice. They appear to understand what is needed for IPC while fewer actual IPC team practices are in place. Intensive IPC components were recently added to the ACPAC curriculum to address this gap.
Patrick, L. Transitioning Clinical Teams to an Interprofessional Model of Care (IPC): A “How To” Manual. Appendix B. Clinical Team Self-Assessment on Interprofessional Practice. Ottawa: Bruyère Continuing Care, 2010.
Barr H, et al. Effective Interprofessional Education - Argument, Assumption, and Evidence. Centre for Advancement of Interprofessional Education (CAIPE). London: Blackwell Publishing, 2005.
Disclosure of Interest None Declared
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