[Editorial] What attributes should a specialist in rehabilitation have? Seven suggested specialist Capabilities in Practice – Clinical Rehabilitation



Many services and professionals refer to themselves as providing rehabilitation. There is no agreed method for determining whether someone has specific expertise in rehabilitation. This makes it difficult for patients and payers to know whether professionals who claim to provide rehabilitation are specifically expert in rehabilitation.


Doctors have a medical speciality of rehabilitation. The medical training curriculum gives attributes that differentiate a rehabilitation specialist from other doctors. Until recently, these attributes were competencies to undertake activities associated with specialization. Apart from nurses, who have at least one, unofficial, curriculum identifying specific competencies, other professions involved in rehabilitation do not have any way to show specialization in rehabilitation.

Capabilities in Practice:

The U.K. General Medical Council accredits specialist medical training. It has moved from specifying multiple practical clinical competencies to specifying fewer high-level ‘Capabilities in Practice’. Six are generic to all doctors, eight identify the trained doctor as having specialist rehabilitation skills. This article adopts this approach to put forward seven generic and seven specialist capabilities to identify any professional as having special expertise in rehabilitation. The seven specialist capabilities centre on the biopsychosocial model of illness and multidisciplinary teamwork. Four of them could be used to define a specialist rehabilitation team.


Seven capabilities identifying specialization in rehabilitation are put forward for discussion. They could form the basis of a formal recognition that any professional has additional expertise in rehabilitation. A validating authority would be needed to provide oversight and governance.


How should one signify that a healthcare worker has expertise in rehabilitation? Healthcare professional titles refer to the profession, such as nurse, psychologist, doctor and so on. Additional descriptors may identify a special area of expertise, usually based on a disease group, such as cardiologist or oncologist (for a doctor) or cardiac or oncological (for a nurse or therapist). Professional qualification is validated by an appropriate state-recognized authority. Use of descriptors is not controlled.

The medical profession has formalized what differentiates a doctor specialized in rehabilitation from other doctors; it is enshrined in specialist training curricula and examinations. Curricula have usually been framed in terms of competencies at particular tasks, together with an accumulation of experience in rehabilitation.1 The Association of Rehabilitation Nursing (in the United States) has developed a set of 16 competencies shown in Box 1, defining specialization in rehabilitation nursing.2,3 I am unaware of any other professional bodies setting out criteria which validate specific knowledge and skills in rehabilitation.

Box 1. Nursing competencies in rehabilitation (Association of Rehabilitation Nursing).2,3

Box 1. Nursing competencies in rehabilitation (Association of Rehabilitation Nursing).2,3View larger version

Those using or paying for rehabilitation need some way of knowing whether any person with some healthcare qualification has the rehabilitation expertise claimed, in addition to their validated professional qualification. This article suggests a mechanism which recognizes that many professions, including carers, may have or gain expertise.[…]

Continue —-> Professional capabilityrehabilitation capabilityspecializationexpertise

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