A GLOBAL COMPETENCY BASED MODEL OF THE SCOPE OF PRACTICE IN OPTOMETRY EDITED BY PATRICIA M KIELY BSC OPTOM ROBERT CHAPPELL OBE MPHIL DSC FCOPTOM OPTOMETRY AUSTRALIALRS COMMITTEE WCO

nnnn  Why Competencies  The Global Model Review  What is optometry?  What is an optometrist  Inclusion of Indicators Background

nnnn  World Trade Organisation – General Agreement on Trades in Services  European Union  Association of Regulatory Boards and World Council of Optometry Background

nnnn  Recognition of overseas qualifications  Historical problems  Matching competencies  Recognition of EU national qualifications  Defined by European Directive Background

The ability to perform the activities within an occupation to the standard expected in employment What is Competency

 It enables countries to develop at their own pace in manageable stages  It provides a common language, i.e. we all understand precisely what is meant when we talk about a particular skill, and the standard  Europe needs a step by step approach The Benefits of a Competency Based Approach

Describe what skills and knowledge a person needs to be regarded as sufficiently qualified to be registered to practise optometry Entry Level Competency Standards

 Develop a common standard of competencies worldwide  Acceptance of the definition and standard of each competency, irrespective of whether a particular competency is practised in a particular country The Solution

 Each country can then identify which competencies are relevant to it within its current scope of practice  Each country can then work towards ensuring that its competencies match the defined standard  Enables countries to match their competencies with those in other states The Solution

Based on Australian Competency Standards 10 2

 Units  Elements  Performance Criteria  Indicators 11 2 The Division of Competencies

 Major components of activities within a profession  Unit 1 – Professional and Clinical Responsibilities  Unit 2 – Communication and Patient History  Unit 3 – Patient Examination  Unit 4 – Diagnosis and Management  Unit 5 – Health Information Management 12 2 Units

 Sub divisions of units – the lowest logical, identifiable and discrete sub groupings of actions and knowledge, which contribute to and build the Unit  Unit - Communication and Patient History  Elements:  Communicates with the patient  Makes general observations of patient  Obtains the case history 13 2 Elements

 Accompany elements  Evaluative statements specifying the required level of performance  Used by an assessor to determine if person performs to required level  Communication and Patient History » Communicates with the patient Modes and methods of communication are employed, which take into account the physical, emotional, intellectual and cultural context of the patient 14 2 Performance Criteria

Measurable and observable features for each performance criterion, can assist in determining whether a competency is achieved Indicators

 Unit – Communication and Patient History  Element –Communicates with the Patient  Performance Criteria Modes and methods of communication are employed which take into account the physical, emotional, intellectual and cultural background of the patient  Indicators The ability to: Communicate proficiently in spoken language(s) Reflect on personal communication style and adjust as required 16 2 Indicators

Optometry is a healthcare profession that is autonomous, educated and regulated and optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes refraction and dispensing, detection/diagnosis and management of diseases in the eye, and rehabilitation of conditions of the visual system Concept of Optometry - Paris What is Optometry

The minimum broad competencies required for individuals to call themselves optometrists are:  Dispensing  Refraction  Prescribing  Detection of disease/abnormality 18 2 Who is an Optometrist

Four stages recognising the evolutionary and hierarchical stages of optometry’s development and expanding education with each stage assuming the inclusion of the prior stage 19 2 Global Model 2015

The management and dispensing of ophthalmic lenses, frames and other devices that correct defects of the visual system Optical Technology Services

 Optical Technology Services plus:  The investigation, examination, measurement, recognition/diagnosis and correction/management of defects of the visual system* *This is the minimum level of competency set by the WCO for an individual to call themselves an optometrist Visual Function Services

 Optical Technology Services plus  Visual Function Services plus  The investigation, examination and evaluation of the eye and adnexa, and associated systemic factors to detect, diagnose and manage disease Ocular Diagnostic Services

 Ocular Technology Services plus  Visual Function Services plus  Ocular Diagnostic Services plus  Use of pharmaceutical agents and other procedures to manage ocular conditions/disease Ocular Therapeutic Services

 Accept a common standard of competencies, not just within Europe, but worldwide  Acceptance of the definition and standard of each competency, irrespective of whether a particular competency is practised in a particular country  Review the structure and detail of the Global Competency model  Consider how the free movement of optometrists can be assisted 24 2 The Way Forward

 Common language  Structural differences  Assessment of Clinical Experience  Development of portfolio – lifelong record of education and clinical experience 25 2 Matching Competencies

The competency model alone will not enable reciprocal recognition of qualifications. The standards set may and do vary from country to country. This means that for the scheme to work there has to be full accreditation of qualifications which means physically visiting institutions. Although a scheme has been developed in Europe to do this the global challenge is much greater BUT ………………………