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The INFORM (International Framework for Rehabilitation Medics) Project to Strengthen the Medical Specialty

The INFORM (International Framework for Rehabilitation Medics) Project to Strengthen the Medical... 1167482 RPO0010.1177/27536351231167482Rehabilitation Process and OutcomeSivan et al research-article2023 Advances in Rehabilitation Science and The INFORM (International Framework for Practice Volume 12: 1–2 Rehabilitation Medics) Project to Strengthen © The Author(s) 2023 https://doi.org/10.1177/27536351231167482 DOI: 10.1177/27536351231167482 the Medical Specialty 1,2 3,4 5 6 Manoj Sivan , Stefano Negrini , Carlotte Kiekens , Fary Khan , 7 8 Gerard E. Francisco and Francesca Gimigliano 1 2 British Society of Physical and Rehabilitation Medicine, London, UK. Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK. Department of Biomedical, Surgical and Dental Sciences, University ‘La Statale’, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, 5 6 Milan, Italy. Physical and Rehabilitation Medicine, IRCCS MultiMedica, Milan, Italy. Director Rehabilitation Royal Melbourne Hospital, Melbourne, Australia. Department of Physical Medicine and Rehabilitation, UTHealth McGovern Medical School, and TIRR Memorial Hermann Hospital, Houston, TX, USA. Department of Mental and Physical Health and Preventive Medicine, University of Campania ‘Luigi Vanvitelli’, Naples, Italy. DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential RECEIVED: March 16, 2023. ACCEPTED: March 18, 2023. conflicts of interest with respect to the research, authorship, and/or publication of this article. TYPE: Editorial FUNDING: The author(s) received no financial support for the research, authorship, and/or CORRESPONDING AUTHOR: Manoj Sivan, Academic Department of Rehabilitation publication of this article. Medicine, University of Leeds, Leeds, UK. Email: M.Sivan@leeds.ac.uk INFORM is a Task Force of the International Society of to chronic health conditions). This poses some challenges in Physical and Rehabilitation Medicine (ISPRM) to undertake a this modern era of super specialisation. The speciality is not as collaborative project that aims to unify and strengthen the easily recognised and understood as other medical specialities medical specialty of physicians working in the field of rehabili- such as neurosurgery, gastroenterology or orthopaedics. While tation. This effort is run in coordination with the European the European Bodies and other International groups like Society of Physical and Rehabilitation Medicine (ESPRM) ISPRM worked in the last 50 years to unify the scope of prac- 3,4 and the Physical and Rehabilitation Medicine Section and the tice and training requirements for the workforce, there is still Board of the European Union of Medical Specialists a lack of an international uniform framework for the name of 5,6 (UEMS-PRM). specialty. This also leads to confusion regarding influence The medical specialty is named Physical and Rehabilitation with regulatory and health policy bodies. Allied health profes- Medicine (PRM), or Physical Medicine and Rehabilitation sionals are an integral part of the work environment of physi- (PM&R), Physiatry, or Rehabilitation Medicine (RM). It cians in the specialty, even more than in other specialties. The relates to applying medical skills to improve functioning and rehabilitation multidisciplinary team includes physiotherapists, quality of life in individuals with musculoskeletal problems, occupational therapists, speech and language therapists, sports injuries, neurological conditions, cardiorespiratory prob- orthotists and prosthetists, specialised nurses, psychologists lems, trauma, chronic pain and other disabling health condi- and others. These professionals play a greater role in rehabilita- tions. The specialty is unique in placing less emphasis on the tion than other specialties and hence the role of physicians can organ system affected and greater emphasis on whole-person be relatively diminished with also a lack of clear identity in functioning considering impairments in body functions and some countries. structures, activity limitations and participation restrictions, The medical specialty however has several unique attrac- personal factors (such as age, culture and beliefs) and environ- tions. It is based on an excellent conceptual model of health mental factors (such as medical treatments and healthcare sup- cutting across the boundaries of medicine and therapy and port available). spanning the remits of biology and behavioural sciences. With The specialty is officially recognised in the USA, Canada, greater emphasis on daily functioning and well-being, the spe- some South American countries, some Asian countries, cialty will undoubtedly expand, gain more recognition and Australia, New Zealand and most European countries (all but have a bigger impact on patients’ lives. The specialty needs to one in the EU) but is not (yet) present in all countries across make its position and outlook clear to colleagues in other spe- the globe. Historically, the specialty originated from different cialties, allied health professionals, commissioners and most streams that constitute part of it, like manual medicine, exercise importantly, patients and carers. therapy, physical agents, or parent medical specialties like rheu- The INFORM project will comprise international surveys, matology, neurology or orthopaedics. consensus workshops and common frameworks development The specialty as a whole focuses neither on a specific organ involving all aspects of the specialty (Figure 1). The project pri- system (eg, neurology) nor a specific age (eg, paediatrics) nor marily aims to focus on: (1) investigating the feasibility of a uni- area of care (eg, emergency medicine), but on the optimisation versal name of the specialty and medical specialist; (2) of functioning throughout the continuum of care (from acute standardising the scope of practice as per available international Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 Advances in Rehabilitation Science and Practice Figure 1. INFORM project conceptual plan. RefeR ences standards and (3) implementing the common minimum ISPRM 1. Stucki G, Cieza A, Ewert T, et al. Application of the international classification training curriculum for physicians in training worldwide. of functioning, disability and health (ICF) in clinical practice. Disabil Rehabil. The project will facilitate an active participatory discussion 2002;24:281-282. 2. European P, Rehabilitation Medicine Bodies A. White book on physical and involving country representatives (members of the task force) to rehabilitation medicine (PRM) in Europe. Chapter 4. History of the specialty: share their views and contribute to consensus statements. The where PR M comes from. Eur J Phys Rehabil Med. 2018;54:186-197. recommendations will then be discussed locally in each country 3. ISPR M. ISPR M Core curriculum and Competencies. 2019. Accessed April 10, 2023. https://isprm.org/isprm-core-curriculum-and-competencies/ with an aim to adopt as much as possible in their setting. The 4. EUMS. Training Requirements for the Specialty of Physical and Rehabilitation project task force will help countries in the local implementation Medicine. European Standards of Postgraduate Medical Specialist Training. 2018. Accessed April 10, 2023. https://www.uems.eu/__data/assets/pdf_ phase of the project by helping them address barriers and chal- fi le/0 010/6 4396/ U EMS-2018.15-Counci l-Ma r ra kesh-Eu ropean-Tra ining- lenges. There will be active involvement of patients, training reg- Requirement-PR M-specialty.pdf 5. Sivan M, Haider J, Harriss J. Fostering a uniform global name for the specialty ulatory bodies, healthcare policy makers and other organisations of physicians working in rehabilitation. Eur J Phys Rehabil Med. which will facilitate the take up of the consensus recommenda- 2022;58:790-792. 6. Negrini S, Ferriero G. Neither “What’s in a name?” nor “Nomen omen”, but a tions locally in each country. unique identifier. A call for a single international name for the speciality and the Further details about the project and live results can be specialist in PRM, PM&R, RM, Physiatry or other. Eur J Phys Rehabil Med. found at www.informspecialty.com 2022;58:787-789. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Advances in Rehabilitation Science and Practice SAGE

The INFORM (International Framework for Rehabilitation Medics) Project to Strengthen the Medical Specialty

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SAGE
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© The Author(s) 2023
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2753-6351
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10.1177/27536351231167482
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1167482 RPO0010.1177/27536351231167482Rehabilitation Process and OutcomeSivan et al research-article2023 Advances in Rehabilitation Science and The INFORM (International Framework for Practice Volume 12: 1–2 Rehabilitation Medics) Project to Strengthen © The Author(s) 2023 https://doi.org/10.1177/27536351231167482 DOI: 10.1177/27536351231167482 the Medical Specialty 1,2 3,4 5 6 Manoj Sivan , Stefano Negrini , Carlotte Kiekens , Fary Khan , 7 8 Gerard E. Francisco and Francesca Gimigliano 1 2 British Society of Physical and Rehabilitation Medicine, London, UK. Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK. Department of Biomedical, Surgical and Dental Sciences, University ‘La Statale’, Milan, Italy. IRCCS Istituto Ortopedico Galeazzi, 5 6 Milan, Italy. Physical and Rehabilitation Medicine, IRCCS MultiMedica, Milan, Italy. Director Rehabilitation Royal Melbourne Hospital, Melbourne, Australia. Department of Physical Medicine and Rehabilitation, UTHealth McGovern Medical School, and TIRR Memorial Hermann Hospital, Houston, TX, USA. Department of Mental and Physical Health and Preventive Medicine, University of Campania ‘Luigi Vanvitelli’, Naples, Italy. DECLARATION OF CONFLICTING INTERESTS: The author(s) declared no potential RECEIVED: March 16, 2023. ACCEPTED: March 18, 2023. conflicts of interest with respect to the research, authorship, and/or publication of this article. TYPE: Editorial FUNDING: The author(s) received no financial support for the research, authorship, and/or CORRESPONDING AUTHOR: Manoj Sivan, Academic Department of Rehabilitation publication of this article. Medicine, University of Leeds, Leeds, UK. Email: M.Sivan@leeds.ac.uk INFORM is a Task Force of the International Society of to chronic health conditions). This poses some challenges in Physical and Rehabilitation Medicine (ISPRM) to undertake a this modern era of super specialisation. The speciality is not as collaborative project that aims to unify and strengthen the easily recognised and understood as other medical specialities medical specialty of physicians working in the field of rehabili- such as neurosurgery, gastroenterology or orthopaedics. While tation. This effort is run in coordination with the European the European Bodies and other International groups like Society of Physical and Rehabilitation Medicine (ESPRM) ISPRM worked in the last 50 years to unify the scope of prac- 3,4 and the Physical and Rehabilitation Medicine Section and the tice and training requirements for the workforce, there is still Board of the European Union of Medical Specialists a lack of an international uniform framework for the name of 5,6 (UEMS-PRM). specialty. This also leads to confusion regarding influence The medical specialty is named Physical and Rehabilitation with regulatory and health policy bodies. Allied health profes- Medicine (PRM), or Physical Medicine and Rehabilitation sionals are an integral part of the work environment of physi- (PM&R), Physiatry, or Rehabilitation Medicine (RM). It cians in the specialty, even more than in other specialties. The relates to applying medical skills to improve functioning and rehabilitation multidisciplinary team includes physiotherapists, quality of life in individuals with musculoskeletal problems, occupational therapists, speech and language therapists, sports injuries, neurological conditions, cardiorespiratory prob- orthotists and prosthetists, specialised nurses, psychologists lems, trauma, chronic pain and other disabling health condi- and others. These professionals play a greater role in rehabilita- tions. The specialty is unique in placing less emphasis on the tion than other specialties and hence the role of physicians can organ system affected and greater emphasis on whole-person be relatively diminished with also a lack of clear identity in functioning considering impairments in body functions and some countries. structures, activity limitations and participation restrictions, The medical specialty however has several unique attrac- personal factors (such as age, culture and beliefs) and environ- tions. It is based on an excellent conceptual model of health mental factors (such as medical treatments and healthcare sup- cutting across the boundaries of medicine and therapy and port available). spanning the remits of biology and behavioural sciences. With The specialty is officially recognised in the USA, Canada, greater emphasis on daily functioning and well-being, the spe- some South American countries, some Asian countries, cialty will undoubtedly expand, gain more recognition and Australia, New Zealand and most European countries (all but have a bigger impact on patients’ lives. The specialty needs to one in the EU) but is not (yet) present in all countries across make its position and outlook clear to colleagues in other spe- the globe. Historically, the specialty originated from different cialties, allied health professionals, commissioners and most streams that constitute part of it, like manual medicine, exercise importantly, patients and carers. therapy, physical agents, or parent medical specialties like rheu- The INFORM project will comprise international surveys, matology, neurology or orthopaedics. consensus workshops and common frameworks development The specialty as a whole focuses neither on a specific organ involving all aspects of the specialty (Figure 1). The project pri- system (eg, neurology) nor a specific age (eg, paediatrics) nor marily aims to focus on: (1) investigating the feasibility of a uni- area of care (eg, emergency medicine), but on the optimisation versal name of the specialty and medical specialist; (2) of functioning throughout the continuum of care (from acute standardising the scope of practice as per available international Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). 2 Advances in Rehabilitation Science and Practice Figure 1. INFORM project conceptual plan. RefeR ences standards and (3) implementing the common minimum ISPRM 1. Stucki G, Cieza A, Ewert T, et al. Application of the international classification training curriculum for physicians in training worldwide. of functioning, disability and health (ICF) in clinical practice. Disabil Rehabil. The project will facilitate an active participatory discussion 2002;24:281-282. 2. European P, Rehabilitation Medicine Bodies A. White book on physical and involving country representatives (members of the task force) to rehabilitation medicine (PRM) in Europe. Chapter 4. History of the specialty: share their views and contribute to consensus statements. The where PR M comes from. Eur J Phys Rehabil Med. 2018;54:186-197. recommendations will then be discussed locally in each country 3. ISPR M. ISPR M Core curriculum and Competencies. 2019. Accessed April 10, 2023. https://isprm.org/isprm-core-curriculum-and-competencies/ with an aim to adopt as much as possible in their setting. The 4. EUMS. Training Requirements for the Specialty of Physical and Rehabilitation project task force will help countries in the local implementation Medicine. European Standards of Postgraduate Medical Specialist Training. 2018. Accessed April 10, 2023. https://www.uems.eu/__data/assets/pdf_ phase of the project by helping them address barriers and chal- fi le/0 010/6 4396/ U EMS-2018.15-Counci l-Ma r ra kesh-Eu ropean-Tra ining- lenges. There will be active involvement of patients, training reg- Requirement-PR M-specialty.pdf 5. Sivan M, Haider J, Harriss J. Fostering a uniform global name for the specialty ulatory bodies, healthcare policy makers and other organisations of physicians working in rehabilitation. Eur J Phys Rehabil Med. which will facilitate the take up of the consensus recommenda- 2022;58:790-792. 6. Negrini S, Ferriero G. Neither “What’s in a name?” nor “Nomen omen”, but a tions locally in each country. unique identifier. A call for a single international name for the speciality and the Further details about the project and live results can be specialist in PRM, PM&R, RM, Physiatry or other. Eur J Phys Rehabil Med. found at www.informspecialty.com 2022;58:787-789.

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Advances in Rehabilitation Science and Practice – SAGE

Published: May 1, 2023

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