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Standards, challenges and solutions: Developing a rheumatology core teaching set for undergraduate health professionals

Hewlett, Sarah; Clarke, Brenda; O’Brien, Anne; Hammond, Alison; Ryan, Sarah; Kay, Lesley; Richards, Pam; Almeida, Celia


Sarah Hewlett

Brenda Clarke

Anne O’Brien

Sarah Ryan

Lesley Kay

Pam Richards

Celia Almeida


Background: Rheumatological conditions are common, thus health professionals require at least basic rheumatology knowledge upon qualifying. The aim of this study was to develop a core set of teaching topics and potential ways of delivering them.

Methods: Phase I: A modified Delphi technique was used for rheumatology expert clinicians to develop preliminary core sets of teaching topics for nursing, occupational therapy and physiotherapy (N, OT, PT). Phase II: Telephone interviews with educationalists from each profession explored their views on the preliminary core set, and challenges and solutions for delivering it. Phase III: Inter-professional workshops enabled clinicians and educationalists to debate Phase I and II findings, finalize the core set, and generate realistic methods for delivery.
Results: Phase I: 39 rheumatology clinicians (12N, 14OT, 13PT) completed the Delphi consensus, proposing 3 preliminary core sets (N71 items, OT29, PT26). Phase II: 19 educationalists (6N, 7OT, 6PT) participated in telephone interviews, raising concerns about disease-specific versus generic teaching, and the ability to deliver a core set, but proposed many potential delivery methods. Phase III: Three inter-professional workshops involved 34 participants (Clinicians N12, OT9, PT5; Educationalists N2, OT3, PT2; Patient 1) who reached consensus on a single core set of 37 items taught as 6 topic units: Anatomy & physiology; Assessment; Management & intervention; Psychosocial issues; Patient education, and the Multi-disciplinary team. They recommended some specific items within these topics require greater depth for some professions (eg in Management, nurses need more detail on drugs, PTs on exercise, OTs on joint protection). Collaboration between clinicians, educationalists and patients was seen as key to delivery, using social learning theory (role models and inter-professional teaching). Several innovative delivery options were generated including a training package for universities, a peripatetic tutor, and a rheumatology chat show (in the classroom) or roadshow (in clinical placement). Rheumatology case studies could be used to facilitate the translation of generic skills into disease-specific clinical care.

Conclusions: Working together, clinicians and educationalists proposed a realistic core set of rheumatology topics for undergraduate health professionals. They proposed innovative delivery methods, for which collaboration between educationalists, clinicians and patients is essential. These potential interventions need testing.


Hewlett, S., Clarke, B., O’Brien, A., Hammond, A., Ryan, S., Kay, L., …Almeida, C. (2008). Standards, challenges and solutions: Developing a rheumatology core teaching set for undergraduate health professionals. Rheumatology,

Journal Article Type Article
Publication Date 2008
Deposit Date Oct 24, 2023
Journal Rheumatology
Print ISSN 1462-0324
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Publisher URL