Session Type: ARHP Concurrent Abstract Session
Session Time: 4:30PM-6:00PM
Rheumatology is a cognitive specialty requiring years of clinical exposure and hands-on training to manage complex patients. However, there is no current standardized training model or understanding of the educational needs of an NP/PA entering rheumatology. An ACR-Association of Rheumatology Health Professionals (ARHP) task force (TF) was created to identify how best to prepare and train NP/PAs for rheumatology practice. A needs assessment was conducted to obtain data from experienced NP/PAs to inform the development of a curriculum for NP/PAs in their first year of rheumatology practice.
A Survey Monkey invitation was sent to current ARHP NP/PA members (n=317) by ARHP staff. The survey consisted of four multiple choice demographic questions to include years of experience in rheumatology, diseases treated, and practice setting(s). Five open ended questions were: best practices for learning joint injection technique, knowledge, skills, attitudes, and resources needed in the first year of rheumatology practice. An initial invitation was followed by a reminder one week later.
Response rate was 27% (87 responses). Regarding rheumatology years of experience, most respondents (45%) reported practicing < 5 years and 23% reported practicing > 15 years. Top ten rheumatic diseases that NP/PAs reported treating, in rank order, were RA, PsA, SLE, CTD, OA, gout, PMR, AS, FM and myositis. Most respondents worked in an outpatient setting (80%); treated new (74%) and follow-up (98%) patients; and treated adults (84%). Respondents also reported having research (36%) and teaching (37%) duties. Most respondents reported prescribing traditional (98%) and biologic (93%) DMARDs while a majority (69%) prescribe opioid analgesics. Elements deemed most important for a new rheumatology NP/PA were: KNOWLEDGE – disease states, recognizing disease presentation, and differential diagnoses; SKILLS – musculoskeletal physical examination and joint injection; ATTITUDE – openness to learning, knowing limitations and willingness to ask questions. The most impactful resource that contributed to NP/PA success was a physician preceptor and access to educational resources.
The NP/PA needs assessment demonstrated the depth and breadth to which NP/PAs are utilized in rheumatology practices and provides the underpinnings of training elements needed to ensure successful assimilation of NP/PAs into rheumatology practice. To meet the educational needs of NP/PAs new to rheumatology, educators need to focus on adequately preparing NP/PAs to: treat many diseases predominate in rheumatology; see inpatients and outpatients; maintain a varied clinical workload, to include new patients; ensure training in musculoskeletal exam and joint injections; establish a mentoring relationship with a rheumatologist; and offer adequate clinical resources. These aspects should be included in any rheumatology curriculum for NP/PAs.
To cite this abstract in AMA style:Slusher B, Scott J, Stamatos CA, Smith BJ, Schlenk EA, Benham H, Schaffer D, Smarr KL. Utilizing Needs Assessment Data to Establish Foundational Training for Adult and Pediatric Nurse Practitioners (NP) and Physician Assistants (PA) Entering Rheumatology Practice [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/utilizing-needs-assessment-data-to-establish-foundational-training-for-adult-and-pediatric-nurse-practitioners-np-and-physician-assistants-pa-entering-rheumatology-practice/. Accessed November 19, 2018.
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