Mrs Louise Wellington1, Mrs Maree Raymer1, Mr Pat Swete Kelly1
1Metro North Hospital And Health Service, Herston, Australia
Background: Advanced musculoskeletal physiotherapy (AMP) roles have demonstrated value and high levels of support in specialist outpatient services but workforce readiness may limit their sustainability. This project aimed to 1) investigate the barriers and enablers to early career musculoskeletal practice development in Queensland and 2) identify the essential elements of an early career musculoskeletal (MSK) education and training pathway to prepare for role specific education and training for AMP roles.
Method: The project used explanatory mixed methodology. Quantitative data was collected initially from physiotherapists and service managers via structured surveys and subsequent focus group consultations provided further detail.
Results: Physiotherapists (n=361) and service managers (n= 27) identified workplace (lack of musculoskeletal rotations and protected time for education and training), financial (direct and indirect costs of education and lack of support and perceived financial return) and personal barriers. Factors enabling an early career musculoskeletal pathway included availability of specific clinical experiences at the individual’s own or other facilities, individual professional support, flexible work arrangements and financial support for education and training. Physiotherapists working in AMP roles identified the required elements of an early career MSK pathway are 1. Structured clinical experiences (Essential: MSK/Orthopaedic outpatient; Orthopaedic Inpatient and related secondary contact roles; Desirable: Pain, Rheumatology, Cardio-respiratory, Geriatrics and Community experience) 2. Relevant professional development 3. Professional support (supervision and mentorship) and 4. Relevant post graduate Masters qualification (or equivalent).
Discussion: Four essential elements of a pathway for physiotherapists to acquire the early career musculoskeletal practice expertise required for future AMP roles have been identified, along with barriers and enablers for each element of the pathway. These factors have important implications for health services for the design of an early career education and training pathway which would precede more role specific education to support the sustainability of AMP roles.
Acknowledgements: This project was funded by the Allied Health Professions’ Office of Queensland
Currently working at RBWH in an advanced practice role, screening the orthopaedic and neurosurgical waitlist.