History of community health center affiliations with The New England College of Optometry

BackgroundSince the 1970s, The New England College of Optometry (NECO) has been a leader in community-based educational programming. This was accomplished through the development of affiliation agreements with health care facilities that care for the underserved, notably community health centers (CHCs). The college's clinical system, the New England Eye Institute (NEEI), develops CHC programs, manages professional services agreements, initiates teaching affiliation agreements, and leads staff recruitment and retention efforts.OverviewCHC collaborations, which effectively address disparities in access to health care and visual health status, represent a significant component of the college's primary care clinical training venues. Since their inception in 1972, these CHC academic–community partnerships have provided more than 650,000 eye examinations to the underserved and have trained more than 3,200 graduates in community-based eye care, interdisciplinary care management environment, clinical prevention strategies, and population health.ConclusionsThis report describes NECO's longstanding success with CHCs, explains the scope of practice at CHCs, explains how students are involved in the CHCs' eye care services, and discusses the various management and business arrangements. The benefits and challenges of CHC affiliations with optometry schools and colleges are also discussed.     

How can the optometric profession expand the pool of qualified applicants?

The health professions, including optometry, are facing a declining applicant pool. The American Optometric Association has taken steps to address the challenge of increasing the pool of qualified applicants to the schools and colleges of optometry. However, the most significant factor in the process will be the efforts of individual AOA members.     

Geriatric educational programs

Information on the geriatric patient is needed in the curricula of all health professional programs. During the 1988 Academy Meeting a Symposium on the Graying of America: Optometric Considerations, was held. The following paper will: (1) summarize a recent survey of geriatric education in the United States schools and colleges of optometry, (2) describe two continuing education projects on gerontology conducted for practicing optometrists, and (3) discuss two recently completed projects involving the training of optometric faculty.     

Optometry research. Part 1: Funding sources.

Part 1 of this report presents an overview of U.S. ophthalmic research in general and of optometry research in particular and identifies the National Eye Institute (NEI) as the dominant funder of both types of research. Part 2 examines how NEI funding has been distributed among the U.S. schools and colleges of optometry in the past, whereas Part 3 examines the production of published research from the schools and colleges and the Department of Veterans Affairs Optometry Service. Information is presented to indicate that the schools of optometry account for about 3% of all NEI funding and produce about 3% of all published ophthalmic research. Published optometry research results mainly from the activities of four schools and the VA Optometry Service, which has rapidly become the leading source of articles published in The Journal of the American Optometric Association and presenter of continuing education at the Academy's annual Ellerbrock Lectures. This study suggests optometry needs to husband its relatively small research base and, in the author's opinion, concentrate on the support of clinical trials and research directly relevant to primary eye care rather than basic biologic or physiologic research.     

Malpractice insurance at optometric institutions.

The optometric educator needs insurance against malpractice suits. A survey was made of the policies available at twelve schools and colleges of optometry in the United States. The object of this survey was to compare the various protections offered by the optometric institutions and also to inform the educators of what is available to them. It was found that coverage and premiums vary considerably between the institutions. At only one of the twelve schools and colleges of optometry responding to this survey were faculty members required to pay for their own policies, but to avoid undue risk, two other colleges highly recommended that their faculty purchase their own coverage. Implications of the low number of claims brought against optometric teaching facilities and other factors are discussed in light of the "malpractice insurance crisis."     

Relative importance of the components of the Canadian Residency Matching Service application

ObjectiveThe primary goal of this project was to investigate Canadian ophthalmology residency program directors’ and department heads’ perceptions about the relative importance of the various components of the Canadian Residency Matching Service (CaRMS) application package. Secondary goals were: (i) to investigate the perceptions of all program directors and department heads at Queen’s University’s residency programs; and (ii) to compare faculty’s perceptions with the perceptions of medical students at Queen’s University.DesignSurvey.ParticipantsQueen’s University medical students, Queen’s University faculty, and Canadian Ophthalmology faculty participated in this survey.MethodsA validated survey was administered to faculty and students. The study targeted program directors and department heads of 15 Canadian ophthalmology residency programs, 18 residency programs at Queen’s University, as well as 404 medical students at Queen’s University. Qualitative questions were included in the faculty survey. Quantitative data were analyzed with nonparametric tests. Qualitative data were organized according to primary themes.ResultsResponse rates ranged from 64% to 87%. On a scale of 1 to 4 in order of increasing importance, faculty and students respectively assigned the highest scores to the following components: interview performance (3.73, 3.89), electives (3.64, 3.83), reference letters (3.53, 3.74), and personal letter (3.27, 3.58). For all 4 components, student scores were significantly higher than faculty scores. First- and fourth-year medical students’ scores differed significantly in eight areas including research experience and volunteer experience. In both of these components, there were statistical differences between fourth-year student scores and faculty scores, whereas the first-year class had scores that were comparable with faculty scores. Queen’s University faculty and Ophthalmology faculty did not differ significantly. Faculty scores also did not differ significantly based on age or sex.ConclusionsFaculty and students agreed on the most important components of the application, but significant differences were found in their perceptions of the relative importance of other components.     

What are the appropriate skills and knowledge of reimbursement systems needed for the entry-level practice of optometry?

Health care reimbursement has increasingly become a major factor in the day-to-day practice of optometry. This paper, originally presented at the 1992 Summit on Optometric Education, outlines the various types of programs the optometrist should be familiar with, and emphasizes the importance of the integration of such knowledge into the curriculum of the schools and colleges of optometry.     

Use of the experience sampling method to measure nearwork.

PURPOSE: The purpose of this study was to use the Experience Sampling Method (ESM) to evaluate the daily visual activities of a group of optometry students and to determine whether the ESM could detect differences in visual activities when a difference was thought to exist. METHODS: Sixty-two optometry students, at four different levels of training, at The Ohio State University College of Optometry were tested using the ESM during a 14-day period. A subgroup of 18 subjects in their fourth year of study was asked to repeat the 14-day ESM on a second occasion. The two ESM periods were specifically chosen at times when the subjects were expected to have markedly different nearwork profiles. RESULTS: A comparison of members from the four optometry classes when the fourth-year students were taking final written examinations showed no significant differences in the proportion of nearwork among groups (p = 0.170); however, when the fourth-year students were primarily performing eye examinations during clinical rotations, there was a significant difference in the proportion of nearwork among training levels (13.8% for fourth-year students compared with 24.9%, 23.7%, and 30.4% for the other optometry classes; p = 0.0001). The percentage of time spent doing nearwork and performing eye examinations was significantly different between two ESM periods (paired t-test, p = 0.0001 for each activity). CONCLUSIONS: The ESM is capable of detecting differences in the proportion of time spent doing nearwork and performing eye examinations among groups of optometry students in different levels of training with different daily visual demands and between two ESM periods when these activities were expected to differ. The ESM can be used as an alternative method for nearwork quantification in future studies.     

The future of optometric practice? The results of a survey of optometrists and optometry students

BACKGROUND: There is an apparent increase in the number of private optometry practices that are closing due to a lack of interested buyers. We examined some of the factors that influence the market for optometry practices in a survey of practicing optometrists and third- and fourth-year optometry students. METHODS: Optometrists in six states, and students at four schools and colleges of optometry, completed a mailed or faxed survey regarding attitudes toward optometric practice, including fair/reasonable compensation for a new optometrist, the value of optometric practices, and preferred mode of practice on graduation. RESULTS: Doctors and students differed significantly in the amount of money they reported as fair/reasonable compensation for a recently graduated optometrist joining a practice. Comparing students to doctors in specific categories of compensation, students chose a higher fair/reasonable compensation compared to doctors. Students were more likely than doctors to choose >$70,000 as fair/reasonable compensation, while doctors were more likely than students to choose $40,000 to $69,000. Doctors tended to overvalue their practices for the purpose of selling the practice when using percentage of gross income as a valuation method. Students' choices for mode of practice changed dramatically from their ideal when taking their current financial situation into consideration. Students were more likely to choose corporate practice as their preferred practice mode when considering their current financial situation than when not restricted. CONCLUSIONS: There are many factors that affect the value and marketability of an optometric practice. In order to sell a practice, the owner must consider the effects of the needs and desires of recently graduated optometrists.     

Assessment of knowledge,attitude, and practice of glaucoma among different cadres of optometrists

Purpose:To assess the level of knowledge, attitude, and clinical practice of glaucoma among optometry students and optometry practitioners with different years of clinical experience and academic background.Methods:A survey with 20 questions on knowledge, attitude, and practice (KAP) of glaucoma was prepared and self-administered to optometry students and optometry practitioners practicing in an eye hospital/clinic/optical with varied years of clinical experience and education qualification.Results:Among the 558 participants, 57% were optometry practitioners and 43% were students. The knowledge scores among optometry practitioners increased significantly with an increase in the years of clinical experience (P < 0.001). Participants with master’s degrees scored higher than participants with bachelor’s degrees (P = 0.12). There was no statistically significant difference in knowledge scores based on the type of clinical practice - hospital, private practice, or optical (P = 0.39). Practicing optometrists who performed slit-lamp examination, gonioscopy, IOP measurements, and disc evaluation for the detection of glaucoma had significantly higher knowledge scores than those who did not perform these tests in their practice (P < 0.05). A positive attitude toward glaucoma learning through workshops and hands-on training was reported by optometrists and students.Conclusion:Knowledge about glaucoma was good among optometrists and optometry students and was better among those who handled the diagnostics. All the optometrists had a positive attitude toward enhancing their practice through proper training.     

Impact of COVID-19 on Indian optometrists: A student,educator, and practitioner‘s perspective

Purpose:The optometry profession has experienced massive changes amid lockdown in COVID 19 pandemic. This study gauges the impact of COVID-19 on optometry education and practices in India.Methods:The impact of COVID-19 among key stakeholders of Indian optometry that included educators, students, and practitioners was surveyed. The content validity of the survey tool was achieved through a focused group discussion with experts.Results:Of the 1408 responses, 118 were educators, 845 were students and 445 were practitioners. Post COVID-19 lock-down, a high percentage of students (96%) and educators (94%) were now using online mode of education to learn and teach. The blended learning methods were reported to be used by 81% of educators. Practical skills were the most difficult to teach by educators and to learn by students. Almost a third of the students were concerned about their internships and job opportunities amid the pandemic. Practitioners felt confident in performing routine eye examinations with personal protective equipment (PPE). Telemedicine was found to be adopted by 55% of the private practitioners and 49% of the eye hospitals.Conclusion:The COVID-19 pandemic has provided an opportunity to reform Indian optometry education through blended learning methods. Optometry practices changed and adapted instantly to the new hygiene norms that have raised the standard of care provided to patients. Telemedicine emerged as a mode of providing care by optometrists. Overall, all key stakeholders of optometry in India were found to have adapted well to the sudden changes due to COVID 19 pandemic.     

Workforce projections for optometry.

BACKGROUND: A 1995 workforce study conducted by RAND estimated a large current surplus of eye care providers in the United States. Due to data limitations of the RAND study and the outdated optometric workforce information available, the American Optometric Association contracted with Abt Associates to conduct a study to project future workforce requirements for optometry. METHODS: We collected extensive data on both the supply (work hours, retirement rates, new entrants) and demand (patient encounters and associated time requirements) of optometrists. These data were collected from a survey using stratified random sampling of 1,100 practicing optometrists and were used to develop workforce projections for optometry through the year 2030. Projections were calculated using a forecasting tool that can be used to derive workforce and training requirements under a range of future scenarios. RESULTS: Workforce projections suggest an excess supply of optometrists is likely over the next 20 years. Over the next five years, approximately 550 optometrists are expected to retire each year, while more than 1,100 optometrists enter practice annually. Patient encounter volume is projected to increase steadily, but the effects of this increase are largely offset by an anticipated decrease in optometrist time requirements for routine eye examinations. DISCUSSION: To reduce the size of the anticipated excess supply, optometry may want to focus on ways that demand can be increased. One way to increase demand is through greater convergence between the actual demand for eye care services and the underlying public health need for eye care.     

The expanding scope of optometry and the impact on the curriculum of schools and colleges.

The expansion of the profession of optometry has placed pressures on the schools and colleges of optometry to reduce traditional curricular elements, add new ones, obtain faculty trained for the new scope of the profession, and provide additional patient experiences for hands-on learning. While the schools have adapted to these pressures and are leading the profession into new areas, the traditional 4-year optometry curriculum is critically filled. Further expansion will require difficult decisions.     

Optometric manpower resources--1973. Part III.

The Optometric Manpower Resources Project, funded under government contract since June of 1971, has completed its 1973 national census of licensed optometric manpower in the United States. The first article in this series of three reported on the distribution of optometrists by census region and the current ratios of practicing optometrists to civilian population. The second article reported on the principal forms of employment of active optometrists, the number of years in practice and practice size. This third article reports on the age and sex distributions of licensed optometrists, their racial/ethnic composition, their pattern of specialization, and the schools/colleges of optometry from which they graduated. The data indicate that almost 50% of active optometrists were over 50 years of age. Approximately 90% of male optometrists and only 58.5% of female optometrists were active. The data also indicate that one-third of all optometrists active in 1973 graduated from four schools/colleges of optometry.     

A nationwide evaluation of the academic performance of male and female optometry students

The number of women entering optometry has risen steadily over the last two decades. The present study is a nationwide evaluation of the academic performance of male and female optometry students graduating in 1986. The data presented was obtained through the cooperation of 12 of the 15 U.S. schools and colleges of optometry. Factors which were investigated include preoptometry grade point average (GPA), GPA at the end of the first two years of optometry school, GPA for the second two years of optometry (calculated independently from the first two years GPA), Optometry College Admission Test (OCAT) scores, class rank at graduation and awards received at graduation. This analysis revealed very little difference in overall academic performance between male and female optometry students.     

An interdisciplinary course for optometry students specializing in vision training.

The practice of primary-care optometry often necessitates interaction with professionals from varied backgrounds. This is especially true in the area of vision training, in which close coordination between professionals in schools, agencies, and clinics is necessary. Too often a communcation problem prevents beneficial interdisciplinary liaison. One way of ensuring that optometrists acquire communication and interaction skills is to provide seminars and courses in schools and colleges of optometry. The program described in this paper has helped optometry students refine their communication and referral skills.     

Coordination of outreach eye services in remote Australia

Background: This paper aims to describe models for service integration between ophthalmology and optometry when conducting outreach eye services. The effect of good coordination on clinical activity and cost‐effectiveness is examined. Design: Cross‐sectional case study based on remote outreach ophthalmology services in Australia. Participants: Key stake‐holders from eye services in nine outreach regions participated in the study. Methods: Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' levels of coordination. Records of clinical activity were used to statistically compare the effects of good coordination. Main Outcome Measures: Clinical activity (surgery and clinic consultation rates), waiting times and costs per attendance. Surgical case rate being the proportion of surgery that results from a clinic. Results: Service integration between optometry and ophthalmology resulted in an increased surgical case rate for ophthalmology clinics (R² = 0.57). There were trends towards increased clinical activity and reduced waiting times, and costs/attendance were stable. Conclusions: Coordination of eye services with better integration of ophthalmology and optometry roles may improve efficiency of services for patients. Coordination of eye services has multiple facets including facilitating engagement with the local community, eye professions and health facilities. The varied roles of eye health coordination require further definition and appropriate funding.     

Eye health service access and utilization in the National Indigenous Eye Health Survey

Background: To determine access to and utilization of eye health services for indigenous Australians. Design: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 indigenous people. Participants: A total of 1189 indigenous adults aged 40 and above were examined, representing 79% of the target population. Methods: Eye health services data including nature and availability of facilities and workforce supply were collected for comparison with eye health prevalence data. The data were collected in 2008. Main Outcome Measures: Low vision prevalence and coverage rate for distance refractive correction. Results: The full‐time equivalent availability of an optometrist working in an Aboriginal Medical Service was significantly associated with both a decrease in the prevalence of low vision (t = ?2.41, P = 0.02) and an increase in the coverage rate for distance refractive correction (t = 2.99, P = 0.006). These associations were not replicated when comparing availability of private or hospital‐based optometry in each community. Regional eye health coordinators appeared to provide an improved utilization of Aboriginal Health Services and therefore improved access to Aboriginal medical service optometry. Conclusions: Eye health services for indigenous Australians need to be provided in culturally appropriate facilities with clear links to the indigenous community to optimize access to care and reduce the prevalence of vision impairment. The adequate provision of accessible eye care services is an important component in ‘closing the gap’ in vision loss for indigenous Australians.     

Optometric education in Nigeria

A 3-year optometry program was established at the University of Benin, Nigeria in 1973. The program is considered from the standpoint of curriculum, faculty, clinical instruction, and grading. Some background is given about Nigeria itself. Present eye care facilities are reviewed as well as the increasing requirements of a developing nation. The need of strong support from established optometry schools is indicated.