Lundon Katie, Shupak Rachel, Schneider Rayfel, Herold McIlroy Jodi
Katie Lundon, BScPT, MSc, PhD: Assistant Professor, Department of Medicine, Faculty of Medicine, University of Toronto; ACPAC Program Coordinator, St. Michael's Hospital, Toronto, Ontario.
Physiother Can. 2011 Winter;63(1):94-103. doi: 10.3138/ptc.2009-35. Epub 2011 Jan 20.
The Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program was developed to train experienced physical and occupational therapists within extended practice roles with the aim of facilitating optimal, timely, and appropriate delivery of health care to patients with arthritis. This paper presents (1) the development of the ACPAC Program and (2) performance across the programme, as well as early quantitative and qualitative changes in clinical practice roles for the 2006 through 2008 cohorts of ACPAC Program graduates (n=19).
Measurement of change in skills and knowledge involved standardized baseline and end-of-programme examinations as well as self-evaluation of a number of areas of clinical competence. Practice-focused surveys issued at baseline, mid-programme, and end of programme, as well as at 6 and 12 months after graduation, evaluated the practitioners' integration of advanced knowledge and skills acquired during the ACPAC Program into their extended practice roles.
Participants significantly increased their scores on examinations of clinical knowledge (p<0.001) and skills (p<0.001) from baseline through programme completion. There was an increase in frequency of performance of clinical tasks and assumption of responsibilities related to their extended practice roles from the beginning to the end of the programme. The five areas that changed in relation to these new roles were increased clinical responsibilities, efficiencies in practice settings, roles as educational leaders and mentors in the field of arthritis care, inter-professional collaboration, and improved access to care for patients with arthritis, particularly in remote areas.
Graduates of the ACPAC Program have demonstrated knowledge and skills for practising in extended roles that enhance the available human health resource pool for patients with arthritis.
关节炎护理高级临床从业者（ACPAC）项目旨在培养经验丰富的物理治疗师和职业治疗师，使其承担扩展后的实践角色，以便为关节炎患者提供优化、及时且恰当的医疗服务。本文介绍了（1）ACPAC项目的发展情况，（2）该项目的整体表现，以及2006年至2008年ACPAC项目毕业生（n = 19）临床实践角色的早期定量和定性变化。
通过标准化的基线和项目结束时的考试以及对多个临床能力领域的自我评估来衡量技能和知识的变化。在基线、项目中期、项目结束时以及毕业后6个月和12个月发放以实践为重点的调查问卷，评估从业者将在ACPAC项目中获得的先进知识和技能融入其扩展实践角色的情况。
从基线到项目完成，参与者在临床知识（p < 0.001）和技能（p < 0.001）考试中的分数显著提高。从项目开始到结束，与扩展实践角色相关的临床任务执行频率和责任承担有所增加。与这些新角色相关的五个变化领域包括临床责任增加、实践环境效率提高、在关节炎护理领域担任教育领导者和导师的角色、跨专业协作以及改善关节炎患者，特别是偏远地区患者的就医机会。
ACPAC项目的毕业生已展现出在扩展角色中执业的知识和技能，增强了为关节炎患者提供服务的人力健康资源库。
