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ACR develops rheumatology training tool for NPs, PAs
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The Association of Rheumatology Health Professionals, a division of the American College of Rheumatology, has developed an online education tool for nurse practitioners and physician assistants entering the rheumatology practice, according to findings published in Arthritis Care and Research.
“There is an acknowledged and requisite need to increase the number of trained rheumatology health professionals, including physicians, nurse practitioners (NPs) and physician assistants (PAs), in order to meet the demands for patient access to care,” Benjamin J. Smith, PA-C, DFAAPA, of the Florida State University College of Medicine, and colleagues wrote. “Specialty training is required for rheumatology physicians; however, NPs/PAs are not required to pursue postgraduate programs after completing generalist, primary care–focused training.”
According to Smith and colleagues, increasing the number of NPs and PAs in rheumatology has been an area of focus for the ACR and the Association of Rheumatology Health Professionals (ARHP). To help rheumatologists and other providers working in the profession provide specialty training to NPs and PAs who are entering rheumatology, the ARHP formed a task force to develop an online curriculum. Members of the task force included NPs, PAs, clinical rheumatologists and health professional educators, as well as ACR and ARHP staff.
Following a literature review and needs assessment, the task force conducted a survey of 317 NP and PA members of the ARHP, asking for key elements of their initial rheumatology training. The group received a total of 81 responses, who identified having a teacher or instructor — either an MD, DO or another NP or PA — as well as ACR products, textbooks and online resources as the most important sources of knowledge in entering rheumatology.
The task force then met with education leaders and stakeholders in various ACR committees to develop the training tool, called the Rheumatology Curriculum Outline (RCO).
“The RCO utilizes the core competencies for NPs/PAs, which parallel the Accreditation Council for Graduate Medical Education Core Competencies established for physicians,” Smith and colleagues wrote. “These NP/PA core competencies served as a framework for the RCO development. Recognizing the similarities between NP and PA core competencies, a crosswalk of the NP and PA competencies was performed and applied by the task force. Given these similarities, it was evident that a single curriculum could be developed for use by NPs/PAs joining rheumatology practice.”
According to Smith and colleagues, the RCO includes a toolbox with suggested learning activities, education resources and performance assessments that can be used in both private practice and in academic environments, which was endorsed by the ACR board of directors in February 2017, and is available online.
“The RCO for NPs/PAs is the rst specialty-specic curriculum outline for NPs/PAs both developed and endorsed by a professional medical specialty society, the ACR/ARHP,” Smith and colleagues wrote. “It will allow for the efcient integration of NPs/PAs into rheumatology practice and may provide opportunities to further enhance NP/PA specialty education. Most importantly, the RCO will help grow the team of health professionals dedicated to our common mission of advancing rheumatology.” – by Jason Laday
Disclosure: Smith reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
Perspective
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Adrienne Hollander, MD
The rheumatology community is anticipating a shortage in rheumatology providers over the next several years. As the prevalence of rheumatic disease rises and the supply of physicians decreases we will see an increase in demand for rheumatology providers. There will be a void in high quality rheumatology care. One solution to meet the needs of the widening supply demand gap is to utilize mid-level providers such as nurse practitioners and physician assistants. Currently, there is no formalized postgraduate rheumatology training for NPs/PAs similar to physician rheumatology fellowships; instead, NPs/PAs gain their experience by on-the-job training.
Even though the American College of Rheumatology (ACR) and its division, the Association of Rheumatology Health Professionals (ARHP) provides an online introductory 19 module training course for NPs/PAs, there is a need for additional training tools to improve integration of NPs/PAs into rheumatology practices. The ARHP convened a task force — composed of a diverse group of providers including rheumatologists, NPs, PAs and rheumatology educators — to evaluate the training needs of NPs/PAs entering rheumatology. The participants came from different geographical areas, stages in careers and different types of practices.
After conducting a needs assessment and literature review, the task force created a rheumatology curriculum outline (RCO). During the development process, the participants reviewed 81 survey results from NPs/PAs and utilized input from private and academic rheumatologists in both adult and pediatric areas. They reviewed core curriculum for rheumatology fellows and used established core competencies for NPs/PAs as a framework for development.
This RCO is intended to provide a curriculum to enrich the training of new rheumatology NPs/PAs with the ultimate goal of providing high quality care to patients. It is meant to be structured, yet flexible and practical, allowing practices to customize training to their specific needs, with suggested learning activities and feedback to the NP/PA via performance assessments.
The RCO was endorsed by the ACR in 2017 and will aid in providing rheumatologists and NPs/PAs with the resources they need to integrate mid-levels into practices. It will further enhance NP/PA education in the world of rheumatology. The RCO tool is available on the ACR website.
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