Background/Purpose: The Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program is a post-licensure, competency-based academic and clinical educational program that prepares physiotherapists, occupational therapists, nurses, and chiropractors for extended practice roles in the diagnosis and management of patients with arthritis, autoimmune and other musculoskeletal (MSK) conditions. Since 2005, the program has graduated extended role providers (ERPs) to manage a growing population of patients with MSK conditions; address a progressive decline in MSK specialists and better utilize health professionals to improve access to care. The objective of this study was to profile the current ACPAC workforce with respect to 1) demographics, including aspects of ethnicity, diversity and inclusion; 2) practice setting and clinical roles; 3) health system integration and 4) remuneration.

Methods: ACPAC graduates from 2006 to 2022 were sent an electronic questionnaire from February to April 2023 using Research Electronic Data CAPture software. The questionnaire was developed based on review of workforce literature and was reviewed by the investigative team for face and content validity, clarity, relevance and format. Univariate statistics were used to summarize data. All analyses were conducted in SAS v9.4.

Results: Seventy-two of 103 graduates completed the questionnaire (response rate 69.9%). Demographics: Most respondents were from Ontario, Canada (95.8%) and were physiotherapists (78.8%). Mean age was 49.4 (SD 9.2) years. The majority identified as women (77.8%) and White-North American/European ethnicity (71.8%). No respondents identified as North American Indigenous. Practice setting and clinical roles:Most reported current employment in an ERP role (76.4%). There were inconsistencies regarding ERP title. The majority (80%) were working in hospital-based settings (80%). Across all settings, 89.1% worked with adult populations, and provided either orthopaedic (54.5%) or rheumatology (40%) care. Only 12.2% reported working in rural or remote settings. Health system integration: Respondents reported working in various orthopaedic and rheumatology models of care including triage, interprofessional collaborative care programs and transition clinics from paediatric to adult care. Remuneration: Most funding models were from government sources (90.9%) with almost half (47.2%) reporting an annual salary of at least $100,000 CAD.

Conclusion: Most ACPAC ERPs are physiotherapists working in urban publicly-funded, hospital-based practices providing adult orthopaedic and rheumatology care. Opportunity exists to maximize employment of existing graduates and further expand ERP roles beyond hospital-based settings, and in rural and remote areas. Examples include family medicine clinics, community-based clinics, geriatric care, and emergency departments. A small proportion of respondents identified as non-white, with Indigenous individuals not represented in this workforce. There is value in targeting recruitment strategies to attract program candidates representative of diverse ethnic backgrounds and inclusive of Indigenous populations.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/advanced-clinician-practitioners-in-arthritis-care-a-workforce-profile/