Upskilling Rheumatology Occupational Therapists in Work Rehabilitation: An Evaluation of a Job Retention Vocational Rehabilitation Training Course (the Workwell Trial).

Abstract

Objectives: The objectives were to assess current job retention vocational rehabilitation (JRVR) services for employed individuals with inflammatory arthritis (IA) in rheumatology therapy departments interested in participating in the Workwell trial. Additionally, to modify a JRVR training course to support therapists in delivering JRVR and to evaluate changes in therapists' knowledge, confidence, and ability following the training.

Methods: This was a mixed-methods study. Current work services were explored with lead therapists through a cross-sectional survey about their work rehabilitation service; and one-to-one interviews. Feedback from previous course attendees and trainers informed modifications to the training course. Participating therapists completed mailed questionnaires pre-and post-training.

Results: Lead therapists from 28 interested departments reported providing JRVR to a median of 7 patients per month (IQR 3-12) for an average of 60 min (IQR 41.25-90). Nine therapists participated in pre-trial interviews, with themes highlighting variability in referrals, the use of work assessment tools, and advice on ergonomic adjustments. The training course was shortened from three to 2 days by incorporating a pre-training self-study pack and reducing lecture time, while increasing practical content such as work assessment demonstrations and extended workshops. Following the training, 32 therapists showed significant improvements in their knowledge and confidence in delivering JRVR (p < 0.001).

Discussion: The need for training in work assessment and delivery of complex JRVR was identified. The therapist training course provided was favourably received. Post-training, therapists' ability to assess and plan complex JRVR improved.

Trial registration: WORKWELL Trial: ISRCTN: 61762297; Clinical Trials.Gov: NCT03942783.