Physiotherapy extended scope of practice – who is doing what and why?

Kersten, Paula; McPherson, Kathryn; Lattimer, Valerie; George, Steve; Breton, Alice; Ellis, Bridget

doi:10.1016/j.physio.2007.02.007

Cited by 86 publications

(105 citation statements)

References 20 publications

(10 reference statements)

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“…Physiotherapists specialised in dealing with respiratory pathology and its associated problems are not only central in the delivery of pulmonary rehabilitation but also provide strategies and techniques for exercise testing, airway clearance, breathlessness management, mobility and function improvement and pain management [2]. Published evidence-based recommendations have paved the way for standardised practice [1][2][3][4][5][6] while also unravelling the extended scope of responsibilities of the respiratory physiotherapist [7].…”

Section: A Core Syllabus For Postgraduate Training In Respiratory Phymentioning

confidence: 99%

“…Widening the scope of practice for allied health professionals is central to current changes taking place within postgraduate medical education and practice, and studies reveal that this is also true for the practice of respiratory physiotherapy [7]. International curriculum design within this field of practice requires consideration of the global competencies expected of the respiratory physiotherapist and what the respiratory physiotherapist is legally permitted to perform in a specific country or even region.…”

Section: Applicability and Acceptabilitymentioning

confidence: 99%

See 1 more Smart Citation

A core syllabus for post-graduate training in respiratory physiotherapy

Pitta¹,

Mitchell²,

Chatwin³

et al. 2014

Breathe

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Section: A Core Syllabus For Postgraduate Training In Respiratory Phymentioning

confidence: 99%

Section: Applicability and Acceptabilitymentioning

confidence: 99%

A core syllabus for post-graduate training in respiratory physiotherapy

Pitta¹,

Mitchell²,

Chatwin³

et al. 2014

Breathe

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“…1 In order to address workforce shortages and provide patients with more timely access to services, healthcare professionals are assigning specific tasks to trained assistants who can facilitate certain assessment and management processes. 2,3 Although the exact training, professional title and role of the assistant will vary according to the employment setting and the duties performed, [4][5][6][7][8] "health assistants" represent a rapidly growing sector of the health workforce in the UK and USA 9 as well as in Australia. 4,10,11 The Allied Health Assistant (AHA) is an individual within the subgroup of health assistants who, by definition "assists or provides any type of support to the work of a qualified allied health professional" 1 (page 144).…”

Section: Introductionmentioning

confidence: 99%

Training the allied health assistant for the telerehabilitation assessment of dysphagia

et al. 2012

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SummaryThe present study examined the impact of knowledge and task specific training provided to a certified allied health assistant (AHA), prior to their involvement in facilitating assessments of dysphagia (swallowing disorders) via telerehabilitation. The AHA received four hours of training which included basic theoretical information regarding dysphagia as well as hands-on training with simulated patients prior to commencing the telerehabilitation trials. A written test examining swallowing function and its evaluation was completed preand then immediately post-training and again after the 15 th and 30 th of 31 consecutive patient assessments to assess theoretical knowledge (n = 4). Additionally after each set of 5 clinical dysphagia assessments completed with patients following the training (n = 6 assessments), two speech pathologists rated the AHA's competency in relation to performing the tasks and activities required of them during the telerehabilitation swallowing assessment session. The AHA also self rated the perceived level of confidence at these time points. Minimum acceptable standards of at least 80% were achieved on the knowledge tests and the AHA's performance was rated as competent on each evaluation post-training. The AHA also expressed overall satisfaction with the initial training provided and reported to feel confident after the initial sessions with patients. This study provides insight into the training and preparation needs of AHAs involved in assisting dysphagia assessments via telerehabilitation.Future research should expand on this current work to explore the training needs of individuals who have no prior healthcare training. This evidence is required to fully understand the training needs of assistants who help to facilitate telerehabilitation assessment for dysphagia and to progress towards defining the role and level of professional knowledge and skills required by healthcare personnel involved in this form of service delivery.

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“…The introduction of a new expanded or extended role for a provider group can be based on intuitive, theoretical, or practical rationales; most often, however, the justifications cited for introducing these roles relate to the demands of the local or national health care system. 2 Yet evidence in support of implementing these roles in care settings, in the form of actual quantitative client or system outcomes data, is often not available, and the implementation planning often does not include a systematic approach to enabling the collection of evidence. Lineker and colleagues 1 are a notable exception.…”

mentioning

confidence: 99%

Clinician's Commentary on Lineker et al.

Taylor

2011

Physiotherapy Canada

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To adequately meet future health care needs, we need to explore alternative workforce models and evolved provider roles. The introduction of a new expanded or extended role for a provider group can be based on intuitive, theoretical, or practical rationales; most often, however, the justifications cited for introducing these roles relate to the demands of the local or national health care system. 2 Yet evidence in support of implementing these roles in care settings, in the form of actual quantitative client or system outcomes data, is often not available, and the implementation planning often does not include a systematic approach to enabling the collection of evidence. Lineker and colleagues 1 are a notable exception. It can be argued that isolating and understanding clinicians' behavioural changes in practice as a result of extended-role training is a critical precursor to understanding system changes created by the introduction of new roles. The article by Lineker and colleagues marks an initial attempt to compare the roles of extended-role occupational therapists and physiotherapists in the assessment and management of clients with inflammatory arthritis with those of experienced therapists who have not received such training. Through a retrospective chart review of practice variables related to documented physical findings, client goals, investigations, interventions, and outcomes measured, Lineker and colleagues investigated the behavioural practice variances between these two groups. Their exploratory study is a significant contribution to the ongoing discussion of available frameworks for evaluating practice changes resulting from extended scope education.Of the findings reported by Lineker and colleagues, two are particularly noteworthy in terms of future research. First, documentation by the extended-role practitioner group indicated a greater use of outcome measures than in the experienced practitioner group. That outcome measures were more routinely used by this group, albeit commonly only at the impairment level, suggests an opportunity for targeted proactive inclusion of other measures in future research. Second, the extended-role practitioners' enhanced collaboration with general practitioners and other primary care providers also creates a platform from which systemic impacts can be evaluated in the future. As the authors note, the data extracted from the chart audits may represent behaviours actually undertaken more often than they were documented by the experienced group. As reported, however, the latter finding is interesting, as it supports the need for further investigation into the potential differences in interprofessional practice and client advocacy that may be inherent outcomes of the extended-role training. Both these activities are arguably gaining increasing importance as elements of effective care delivery.Further, the findings of Lineker and colleagues' study should provoke an important reflective exercise for all clinicians currently working with adult clients with inflammatory a...

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Physiotherapy extended scope of practice – who is doing what and why?

Cited by 86 publications

References 20 publications

A core syllabus for post-graduate training in respiratory physiotherapy

A core syllabus for post-graduate training in respiratory physiotherapy

Training the allied health assistant for the telerehabilitation assessment of dysphagia

Clinician's Commentary on Lineker et al.

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