C L I N I C A L
A N D
E X P E R I M E N T A L
OPTOMETRY EDITORIAL
Australian competencies: twenty-one years on and still at the heart of our profession Clin Exp Optom 2015; 98: 1–2
Christine Nearchou BScOptom PGCertOcTher GradCertUniTeach FACO FCOVD Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia E-mail: [email protected]
The first Australian entry-level competency standards for the profession of optometry were published 21 years ago in 1993.1 They have had a profound impact on the profession of optometry and have probably affected every practising optometrist in this country, as well as having an impact further afield. I had the privilege of being involved in some stages of the development of the standards, from the first workshops through to the most recent review sessions that have produced “Competencies 2014” featured in this issue of Clinical and Experimental Optometry.6 Witnessing the evolution of this pivotal document over the years, including the first therapeutic practice add-ons in 2000,2 has been personally very satisfying. It is also testament to the many years of collaboration within the profession to produce a document that represents a consensus on what is competent entry-level practice. The competency standards document has found its way into many aspects of our professional endeavours, as a guide for practitioners to reflect upon their own clinical practice and for educators to use as a foundation for curriculum development and assessment. The standards have also become a valuable guide to assist with the objective evaluation of the performance of individual optometrists.
HISTORY The original project to develop national competency standards for optometry was born out of an Australian government process of micro-economic reform that
DOI:10.1111/cxo.12244
began in 1989 and involved a restructure of industrial awards and vocational training. This gave rise to a need to have a competency-based approach for determining the requirements for entry into the professions and trades, and to facilitate midcareer movement between occupations in response to changes in demand for work skills. It was designed to encourage workforce flexibility in a changing economy and to enable recognition of skills acquired, other than by obtaining a specified qualification. Two particular issues were the need to enhance workforce mobility across Australian States and to increase flexibility in recognising the skills of migrants arriving in this country. The original project to develop entry-level qualifications for optometry was led by Dr Patricia Kiely and Mr Joseph Chakman and was funded by the National Office of Overseas Skills Recognition (NOOSR). The project was administered by the then Australian Optometrical Association (later named Optometrists Association Australia and from July 2014, Optometry Australia). The project involved bringing together diverse members to develop the profession’s ‘own’ standards and to create a means of evaluating the competency of any individual who was seeking registration to practise optometry in Australia. The standards were based on the expected performance of an entry-level or beginner optometrist, who upon graduation is registered to practice without direct supervision. The beginner optometrist would possess a set of knowledge, skills, attitudes, ethics and values (competencies) identified and described by the profession as necessary to begin optometric practice.3 The original working party and steering committee leading to the workshops was made up of a number of prominent colleagues, namely, Associate Professor Peter Swann (Chairman), representing the heads
© 2014 The Author Clinical and Experimental Optometry © 2014 Optometry Australia
of the Australian schools of optometry, Mr Joseph Chakman representing the Australian Optometrical Association, along with representatives from various professional state registration bodies and other key stakeholders. My involvement began in 1992, as a member of a working group, made up of optometrists from around Australia, who had been invited to undertake an analysis of optometric practice based on the ‘modified functional analysis’ technique.4 The functional analysis working-group participants were Professor Swann, Mr Peter Montgometry, Mr Emmanuel Calligeros, Ms Susan Larter, Dr Paul Levi, Mr John Rees, Mr Daryl Guest, Mr Ian Bluntish, Mr Peter Dwyer, Mr Graham Hill, Dr David Cockburn, Mr John Farmer, Mr Chakman, Dr Kiely and myself. As an early career optometrist (four years post-graduation), I felt very privileged to be involved and sitting in the same room with such distinguished and experienced optometrists. Dr Paul Hager, who at the time was the Deputy Head of the school of adult vocational education at the University of Technology in Sydney, facilitated the original workshops along with Dr Kiely and Mr Chakman, both of whom continued to be the driving force behind the further work and publications as the competencies expanded in response to a changing profession. During the workshops, the members worked in groups, with butcher paper and felt tip pens to determine which attributes (elements) were to be included in the competencies and the performance criteria for each. The aim was to create a set of competencies based on a consistent template/formula of elements, performance criteria and key indicators (measurable features) that would together create a competency and a means of evaluating it. This was a novel approach Clinical and Experimental Optometry 98.1 January 2015
1
Editorial Nearchou
for me, to break down even the simplest day-to-day elements of clinical practice and to consider how each one could be evaluated. This approach is well known to us today and widely used in appraising staff and evaluating students. After several days and hundreds of pieces of butcher paper later, there was the mammoth task to battle through the ideas to identify the multiple elements, criteria and indicators that were to become our first working document of entry-level competency standards. APPLICATIONS The original goals set for producing the first competency standards were published with the standards themselves in 1993.1 Interestingly, the original working party thought the primary use of the competencies would be limited to the assessment of overseas applicants for registration to practise optometry in Australia. In fact, they have also proved invaluable for curriculum development in the schools of optometry, as well as accreditation of optometric programs in Australia and New Zealand by the Optometry Council of Australian and New Zealand (OCANZ). From my perspective, the competencies have assisted me in diverse areas. I have used them to benchmark the performance of the optometrists I employ and even found them helpful in training support staff, so they have an appreciation of the standards expected in my practice. I have served on professional panels for the Australian Health Practitioner Regulation Agency (AHPRA) and the competencies are often referred to when evaluating a practitioner’s professional conduct to help determine whether core competencies were being met. One of the major developments in Australia that expanded our scope of practice has been the introduction of rights to have, use and prescribe therapeutic pharmaceutical agents. The biggest modification to the competencies was made in 20002 to reflect this change and the expansion of the scope of optometric practice. This addition served to define expectations of a therapeutically endorsed optometrist, as an add-on to the basic competencies. INTERNATIONAL RECOGNITION In 1992, the World Council of Optometry5 developed a ‘concept of optometry’ Clinical and Experimental Optometry 98.1 January 2015
2
statement to describe what the profession of optometry did: ‘Optometry is a healthcare profession that is autonomous, educated and regulated (licensed/registered) 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 disease in the eye and the rehabilitation of conditions of the visual system.’ With this statement in mind, four categories of optometric practice were defined by the World Council of Optometry. 1. Optical Technology Services (OT) 2. Visual Function Services (VF) 3. Ocular Diagnostic Services (ODx) 4. Ocular Therapeutic Services (OTx) This parallelled a structure that had been developed for the European Diploma in Optometry by the European Council of Optometry and Optics (ECOO) in the mid1990s but also added the category of optometrists who treat ocular disease with pharmaceutical agents, as they now do in several countries. Global competencies were developed by the World Council for each category and the main resource used for their development came from the revised competency standards by Kiely, Chakman and Horton2 that focused on practice for therapeuticallyendorsed optometrists in Australia, now a standard of practice for all graduating optometrists at Australian schools of optometry. Dr Kiely was also a member of the planning committee for the development of the global competencies.5 This is a testament of the excellent standards set by Optometry Australia and its continued commitment to ensuring the competencies stay current and continue to reflect our profession’s evolution. In the twenty-one years since their inception, the competencies have demonstrated their relevance and application well beyond their original perceived benefit, as a means of assessing competency in overseas trained professionals wishing to practise in Australia. The competencies are not only here to stay, they are at the heart of education, policy and clinical practice in Australia and are relied upon as a ‘go to’ document to help and guide our profession, here and abroad. What new role might the competencies have in the future? They might be the foundation of increased reciprocal recognition of qualifications between countries,
as optometric courses around the world move toward teaching to a common set of competencies. No doubt, the Competencies 20146 will be as valuable to our evolving profession as have been the past editions. The competencies are a contemporaneous statement of what the profession does in Australia and in many other countries and what all optometrists should be doing. They are at the heart of our profession. REFERENCES 1. Kiely P, Chakman J. Competency standards for entry level to the profession of optometry 1993. Clin Exp Optom 1993; 76: 150–181. 2. Kiely P, Chakman J, Horton P. Optometric therapeutic competency standards 2000. Clin Exp Optom 2000; 83: 300–314. 3. Penna RP. What are the appropriate skills and knowledge required for entry into the practice of optometry? J Optom Educ 1992; 18: 9–10. 4. Gonczi A, Hager P, Oliver L. Establishing competency based standards in the professions. National Office of Overseas Skills Recognition, Research paper 1. Aust Govt publishing service, Canberra; 1990. 5. World Optometry Council. A global competencybased model of scope of practice in optometry. 2005. Available at www.worldoptometry.org/ filemanager/root/site_assets/governance _documents/global_competencies_model.pdf. {Accessed 3 December 2014]. 6. Kiely P. Optometrists Association Australia Universal (entry-level) and Therapeutic Competency Standards for Optometry 2008. Clin Exp Optom. 2009; 92: 362–386.
© 2014 The Author Clinical and Experimental Optometry © 2014 Optometry Australia
Copyright of Clinical & Experimental Optometry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
A N D
E X P E R I M E N T A L
OPTOMETRY EDITORIAL
Australian competencies: twenty-one years on and still at the heart of our profession Clin Exp Optom 2015; 98: 1–2
Christine Nearchou BScOptom PGCertOcTher GradCertUniTeach FACO FCOVD Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia E-mail: [email protected]
The first Australian entry-level competency standards for the profession of optometry were published 21 years ago in 1993.1 They have had a profound impact on the profession of optometry and have probably affected every practising optometrist in this country, as well as having an impact further afield. I had the privilege of being involved in some stages of the development of the standards, from the first workshops through to the most recent review sessions that have produced “Competencies 2014” featured in this issue of Clinical and Experimental Optometry.6 Witnessing the evolution of this pivotal document over the years, including the first therapeutic practice add-ons in 2000,2 has been personally very satisfying. It is also testament to the many years of collaboration within the profession to produce a document that represents a consensus on what is competent entry-level practice. The competency standards document has found its way into many aspects of our professional endeavours, as a guide for practitioners to reflect upon their own clinical practice and for educators to use as a foundation for curriculum development and assessment. The standards have also become a valuable guide to assist with the objective evaluation of the performance of individual optometrists.
HISTORY The original project to develop national competency standards for optometry was born out of an Australian government process of micro-economic reform that
DOI:10.1111/cxo.12244
began in 1989 and involved a restructure of industrial awards and vocational training. This gave rise to a need to have a competency-based approach for determining the requirements for entry into the professions and trades, and to facilitate midcareer movement between occupations in response to changes in demand for work skills. It was designed to encourage workforce flexibility in a changing economy and to enable recognition of skills acquired, other than by obtaining a specified qualification. Two particular issues were the need to enhance workforce mobility across Australian States and to increase flexibility in recognising the skills of migrants arriving in this country. The original project to develop entry-level qualifications for optometry was led by Dr Patricia Kiely and Mr Joseph Chakman and was funded by the National Office of Overseas Skills Recognition (NOOSR). The project was administered by the then Australian Optometrical Association (later named Optometrists Association Australia and from July 2014, Optometry Australia). The project involved bringing together diverse members to develop the profession’s ‘own’ standards and to create a means of evaluating the competency of any individual who was seeking registration to practise optometry in Australia. The standards were based on the expected performance of an entry-level or beginner optometrist, who upon graduation is registered to practice without direct supervision. The beginner optometrist would possess a set of knowledge, skills, attitudes, ethics and values (competencies) identified and described by the profession as necessary to begin optometric practice.3 The original working party and steering committee leading to the workshops was made up of a number of prominent colleagues, namely, Associate Professor Peter Swann (Chairman), representing the heads
© 2014 The Author Clinical and Experimental Optometry © 2014 Optometry Australia
of the Australian schools of optometry, Mr Joseph Chakman representing the Australian Optometrical Association, along with representatives from various professional state registration bodies and other key stakeholders. My involvement began in 1992, as a member of a working group, made up of optometrists from around Australia, who had been invited to undertake an analysis of optometric practice based on the ‘modified functional analysis’ technique.4 The functional analysis working-group participants were Professor Swann, Mr Peter Montgometry, Mr Emmanuel Calligeros, Ms Susan Larter, Dr Paul Levi, Mr John Rees, Mr Daryl Guest, Mr Ian Bluntish, Mr Peter Dwyer, Mr Graham Hill, Dr David Cockburn, Mr John Farmer, Mr Chakman, Dr Kiely and myself. As an early career optometrist (four years post-graduation), I felt very privileged to be involved and sitting in the same room with such distinguished and experienced optometrists. Dr Paul Hager, who at the time was the Deputy Head of the school of adult vocational education at the University of Technology in Sydney, facilitated the original workshops along with Dr Kiely and Mr Chakman, both of whom continued to be the driving force behind the further work and publications as the competencies expanded in response to a changing profession. During the workshops, the members worked in groups, with butcher paper and felt tip pens to determine which attributes (elements) were to be included in the competencies and the performance criteria for each. The aim was to create a set of competencies based on a consistent template/formula of elements, performance criteria and key indicators (measurable features) that would together create a competency and a means of evaluating it. This was a novel approach Clinical and Experimental Optometry 98.1 January 2015
1
Editorial Nearchou
for me, to break down even the simplest day-to-day elements of clinical practice and to consider how each one could be evaluated. This approach is well known to us today and widely used in appraising staff and evaluating students. After several days and hundreds of pieces of butcher paper later, there was the mammoth task to battle through the ideas to identify the multiple elements, criteria and indicators that were to become our first working document of entry-level competency standards. APPLICATIONS The original goals set for producing the first competency standards were published with the standards themselves in 1993.1 Interestingly, the original working party thought the primary use of the competencies would be limited to the assessment of overseas applicants for registration to practise optometry in Australia. In fact, they have also proved invaluable for curriculum development in the schools of optometry, as well as accreditation of optometric programs in Australia and New Zealand by the Optometry Council of Australian and New Zealand (OCANZ). From my perspective, the competencies have assisted me in diverse areas. I have used them to benchmark the performance of the optometrists I employ and even found them helpful in training support staff, so they have an appreciation of the standards expected in my practice. I have served on professional panels for the Australian Health Practitioner Regulation Agency (AHPRA) and the competencies are often referred to when evaluating a practitioner’s professional conduct to help determine whether core competencies were being met. One of the major developments in Australia that expanded our scope of practice has been the introduction of rights to have, use and prescribe therapeutic pharmaceutical agents. The biggest modification to the competencies was made in 20002 to reflect this change and the expansion of the scope of optometric practice. This addition served to define expectations of a therapeutically endorsed optometrist, as an add-on to the basic competencies. INTERNATIONAL RECOGNITION In 1992, the World Council of Optometry5 developed a ‘concept of optometry’ Clinical and Experimental Optometry 98.1 January 2015
2
statement to describe what the profession of optometry did: ‘Optometry is a healthcare profession that is autonomous, educated and regulated (licensed/registered) 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 disease in the eye and the rehabilitation of conditions of the visual system.’ With this statement in mind, four categories of optometric practice were defined by the World Council of Optometry. 1. Optical Technology Services (OT) 2. Visual Function Services (VF) 3. Ocular Diagnostic Services (ODx) 4. Ocular Therapeutic Services (OTx) This parallelled a structure that had been developed for the European Diploma in Optometry by the European Council of Optometry and Optics (ECOO) in the mid1990s but also added the category of optometrists who treat ocular disease with pharmaceutical agents, as they now do in several countries. Global competencies were developed by the World Council for each category and the main resource used for their development came from the revised competency standards by Kiely, Chakman and Horton2 that focused on practice for therapeuticallyendorsed optometrists in Australia, now a standard of practice for all graduating optometrists at Australian schools of optometry. Dr Kiely was also a member of the planning committee for the development of the global competencies.5 This is a testament of the excellent standards set by Optometry Australia and its continued commitment to ensuring the competencies stay current and continue to reflect our profession’s evolution. In the twenty-one years since their inception, the competencies have demonstrated their relevance and application well beyond their original perceived benefit, as a means of assessing competency in overseas trained professionals wishing to practise in Australia. The competencies are not only here to stay, they are at the heart of education, policy and clinical practice in Australia and are relied upon as a ‘go to’ document to help and guide our profession, here and abroad. What new role might the competencies have in the future? They might be the foundation of increased reciprocal recognition of qualifications between countries,
as optometric courses around the world move toward teaching to a common set of competencies. No doubt, the Competencies 20146 will be as valuable to our evolving profession as have been the past editions. The competencies are a contemporaneous statement of what the profession does in Australia and in many other countries and what all optometrists should be doing. They are at the heart of our profession. REFERENCES 1. Kiely P, Chakman J. Competency standards for entry level to the profession of optometry 1993. Clin Exp Optom 1993; 76: 150–181. 2. Kiely P, Chakman J, Horton P. Optometric therapeutic competency standards 2000. Clin Exp Optom 2000; 83: 300–314. 3. Penna RP. What are the appropriate skills and knowledge required for entry into the practice of optometry? J Optom Educ 1992; 18: 9–10. 4. Gonczi A, Hager P, Oliver L. Establishing competency based standards in the professions. National Office of Overseas Skills Recognition, Research paper 1. Aust Govt publishing service, Canberra; 1990. 5. World Optometry Council. A global competencybased model of scope of practice in optometry. 2005. Available at www.worldoptometry.org/ filemanager/root/site_assets/governance _documents/global_competencies_model.pdf. {Accessed 3 December 2014]. 6. Kiely P. Optometrists Association Australia Universal (entry-level) and Therapeutic Competency Standards for Optometry 2008. Clin Exp Optom. 2009; 92: 362–386.
© 2014 The Author Clinical and Experimental Optometry © 2014 Optometry Australia
Copyright of Clinical & Experimental Optometry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
