The Role of the Upper Extremity Neuromusculoskeletal Evaluator at Peace and at War

Extended roles for allied health professionals: an updated systematic review of the evidence

“…One article related directly to occupational therapy ESP that did not make data extraction was a military case study that described the training, credentialing process, and tasks undertaken by an ESP. 44 The training process included formal coursework coupled with a period of internship, ie, a model similarly described for ESP within other professions. Tasks included direct access, limit duty, referral to specialist clinics, triaging, and conservative management/treatment.…”

“…Internationally, a number of innovative workforce redesign projects have explored the ability of allied health professionals to extend their scope of practice beyond traditional boundaries, for example, physiotherapists in an emergency department, physiotherapists in orthopedic clinics, physiotherapists and occupational therapists in arthritis care, occupational therapists in upper extremity management, and speech pathologists in fiber optic endoscopy. 13 , 15 , 18 , 32 , 39 – 41 , 44 Reports of additional skills acquired include increased clinical reasoning, ordering and interpretation of diagnostics (radiology, ultrasound and pathology), limited medication management (prescription, dosage changes, monitoring), and procedures (joint injections, passing endoscopes, removing K-wires, applying plaster of Paris, simple suturing). Changes to health care practice included first point of contact (direct access), additional context of care (emergency department, orthopedic triage), and an increased role in education of both patients and other clinicians.…”

“…11 Another strong image comes from the military context, where acquiring skills outside traditional roles through structured training and credentialing programs are described as a “force multiplier”. 44 …”