A Global Competency-Based Model of Scope of Practice in Optometry

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A Global Competency-Based Model of Scope of Practice in Optometry Anthony F. Di Stefano, O.D., M.Ed., M.P.H.

Committee Dr. Norman Wallis, Chair Dr. Robert Chappell Dr. Patricia Kiely Dr. Thomas Lawless Dr. Leon Gross (Consultant) Dr. Anthony Di Stefano (WCO)

Introduction WTO and GATS MRAs Optometric activity ARBO and WCO coordinated effort WCO and ARBO board of trustees International Advisory Group on Optometric Competencies (IAGOC) (December 2003)

WCO Concept of Optometry Statement Optometry is a human services calling that is self-sufficient, taught, and directed (authorized/enrolled), and optometrists are the essential social insurance specialists of the eye and visual framework who give exhaustive eye and vision mind, which incorporates refraction and apportioning, recognition/determination and administration of ailment in the eye, and the restoration of states of the visual framework Developed Paris 1992 Approved Venice 1993

Background/Prior Work Do not "rehash the wheel" Model must address varieties in extent of practice Controversial point for some ECOO European Diploma perceived differences in locale with 3 phases

ECOO's European Diploma Structure Optical Technology (lab work and administering) Vision Care (refraction, BV, CLs) Ocular Disease (& systemic) (identification/conclusion and administration) Different words utilized for political reasons

after 10 years Global versus Provincial Therapeutic utilization of medications now normal in a few nations (Australia, Canada, Nigeria, UK, USA, and so on) Need an extra stage Evolutionary approach

Categories of Service Optical Technology Services Visual Function Services Ocular Diagnostic Services Ocular Therapeutic Services

Optical Technology Services Management and administering of ophthalmic focal points, ophthalmic casings and other ophthalmic gadgets that right imperfections of the visual framework

Visual Function Services Optical Technology Services and/in addition to Investigation, examination, estimation, determination and adjustment/administration of deformities of the visual framework

Ocular Diagnostic Services Optical Technology Services and/in addition to Visual Function Services and/in addition to Investigation, examination and assessment of the eye and adnexa, and related systemic variables to identify, analyze and oversee ailment

Ocular Therapeutic Services Ocular Technology Services and/in addition to Visual Function Services and/in addition to Ocular Diagnostic Services and/in addition to Use of pharmaceutical operators and different strategies to oversee visual conditions/malady

Competency Statements Work in Australia, Canada, UK, California IAGOC prescribed Australian competency proclamations and framework Allocate crosswise over 4 phases

Optometrists Association Australia Developed arrangement of competency articulations (1993, 1997, 2000) Tracked advancement of calling in one nation Has been connected in different nations, e.g., Norway

The System Units – 6 noteworthy segments of exercises inside calling Elements – sub-divisions of units Performance criteria – go with components, evaluative explanations Indicators – quantifiable and discernible elements of execution criteria (refinement for more specificity and appraisal)

The Units 1 – Professional and clinical responsibilities 2 – Patient history 3 – Patient examination 4 – Diagnosis 5 – Patient administration 6 – Recording of clinical information

Unit 1 – Professional and Clinical Responsibilities Elements Ensures that optometric learning, clinical skill and hardware stay current. Rehearses without the requirement for supervision Acts as per the models of conduct of the calling. Gives exhortation and data to patients and others.

Unit 2 – Patient History Elements Communicates with the patient. Mentions general objective facts of patient Obtains the case history. Gets and translates persistent data from different experts.

Unit 3 – Patient Evaluation Elements Formulates an examination arrange Implements examination arrange Assesses the visual adnexae and the eye Assesses focal and fringe tactile visual capacity and the respectability of the visual pathways. Evaluates refractive status. Surveys oculomotor and binocular capacity.

Unit 4 – Diagnosis Elements Interprets and examinations discoveries to build up a conclusion or judgments.

Unit 5 – Patient Management Elements Designs an administration anticipate every patient and actualizes the arrangement consented to with the patient. Recommends displays Prescribes contact focal points Prescribes low vision gadgets.

Unit 6 – Recording of Clinical Data Elements Ensures that information is composed in a decipherable, secure, open, changeless and unambiguous way. Keeps up secrecy of patient records.

Allocation to Categories Prefixes for each every Stage Optical innovation - OT Visual capacity - VF Ocular analytic - ODx Ocular helpful – OTx Denote particular significance of execution criteria When meaning regular crosswise over stages, bolt When no tantamount importance, clear

The System Units – 6 noteworthy segments of exercises inside calling Elements – sub-divisions of units Performance criteria – go with components, evaluative proclamations Indicators – quantifiable and perceptible elements of execution criteria (refinement for more specificity and appraisal)

Example Allocation of System UNIT 3: PATIENT EXAMINATION Element 3.3 Assesses the visual adnexae and the eye. Execution Criterion 3.3.1 The structure and strength of the visual adnexae and their capacity to capacity are surveyed. Pointers Assessment of skin sores, conjunctiva, tops, lashes, puncta, Meibomian organs. Screening for ailment; large scale perception, opening light biomicroscopy, loupe, interpupillary separate, top eversion, photography, analytic pharmaceuticals, tear elements.

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Example – 3