ATTRIBUTES OF STUDENTS GRADUATING FROM
SCHOOLS AND COLLEGES OF OPTOMETRY

An Association of Schools and Colleges of Optometry Report

Accepted by the Board of Directors:
20 June 2000

Committee on Attributes Membership:

David A. Heath, O.D., Ed.M. (Chair)
Vice President & Dean for Academic Affairs
The New England College of Optometry
Boston, MA

Kent M. Daum, O.D., Ph.D.
Associate Professor of Optometry
University of Alabama at Birmingham,
School of Optometry
Birmingham, AL

Anthony F. DiStefano, O.D., M.P.H.
Vice President & Dean for Academic Affairs
The Pennsylvania College of Optometry
Elkins Park, PA

Charles L. Haine, O.D., M.S.
Vice President & Dean for Academic Affairs
Southern College of Optometry
Memphis, TN

Steven H. Schwartz, O.D., Ph.D.
Vice President & Dean for Academic Affairs
State University of New York,
College of Optometry
New York, NY

Doctors of Optometry
(American Optometric Association definition)

Doctors of optometry are independent primary health care providers who examine, diagnose, treat and manage diseases and disorders of the visual system, the eye and associated structures as well as diagnose related systemic conditions.

Optometry - A Responsible Profession

Summit on Optometric Education
Scope of Optometric Practice (1992)

Endorsed by the
American Optometric Association (1996)
and
The Association of Schools and Colleges of Optometry (1996)

The profession of optometry fulfills the vision and eye care needs of the public through clinical care, research and education, all of which enhance the quality of life.

The scope of optometric knowledge and practice includes the prevention, examination and evaluation, diagnosis, rehabilitation, treatment and management of disorders, dysfunctions and diseases of the visual system, the eye and associated structures; and the evaluation and diagnosis of related systemic conditions.

Optometric practice is dynamic, with the emphasis on patient care services at the general practice level. Responding to the changing needs of society, the profession must have access to all methods and modalities of contemporary practice.

Entry-level competencies include the professional attitudes, skills and knowledge to ensure safe and effective patient care outcomes and to support life-long learning. The maintenance of continuing competencies and professional growth must be ensured by continuing learning and assessment and thereby it sustains the integrity of professional licensure. Additional education and training provide advanced practice skills and knowledge in specialized areas beyond those requisite at entry.

Attributes of the Graduating Student from
Schools and Colleges of Optometry

Over the past decade the profession has moved towards a better delineation of the scope and role of optometry within the broader health care system. A key element of this process has been the elucidation of entry-level competency, or in the case of Doctor of Optometry degree programs - the exit competencies needed for a new optometrist beginning in general practice.

This report, "Attributes of Students Graduating from Schools and Colleges of Optometry," provides, as a national resource, a series of competency statements that broadly define the attributes expected of students graduating from any one of the schools or colleges of optometry in the United States. The Faculty of each institution holds the responsibility to develop curriculum, and to assess and verify that each graduate has demonstrated the attributes described.

Background

Over the past several years, the Association of Schools and Colleges of Optometry (ASCO), with the support and participation of the American Optometric Association (AOA), has worked to develop a clearer understanding of entry-level competency and/or the competencies expected of students graduating from optometry degree programs in the United States. The purpose of the effort has been to provide a nationally accepted statement of common goals for Doctor of Optometry degree programs. With the development of a common set of competency statements, the curricula of optometry's schools and colleges will be more clearly understood in terms of purpose, content and outcomes expectations.

The impetus behind this effort may be traced to an increasing need to effectively communicate the goals and nature of optometric education to the public, the health care industry and government agencies, as well as changing expectations in the accreditation process. Similarly, there has been a need for schools and colleges of optometry to better understand the changing nature of the health care environment and to adapt their curricula to the changing realities of optometric practice.

In October 1998, the Association of Schools and Colleges of Optometry formed a Committee on Attributes to define the attributes of graduating students. The creation of this Committee followed the acceptance of the ASCO white-paper, " A Model for Entry-Level Determination (MELD)." The model drew from several conferences and the efforts of a number of organizations to establish a process, which would guide the development of professional competency statements, particularly as they related to entry-level practice. With the acceptance of the white paper, the process for determining the broad attributes of students graduating from the nation's schools and colleges of optometry was established.

The Committee on Attributes was composed of five chief academic officers of schools or colleges of optometry. After an assessment of efforts among other health care professions, the committee chose to organize the attributes within three categories: Knowledge, Skills and Professionalism. Each of the five Committee members worked independently with their faculty to develop draft statements. These were then merged, reviewed as a first draft and subsequently shared with the chief academic officers of the schools and colleges of optometry. The resulting document was then referred to all Schools and Colleges of Optometry for review and comment, and subsequently to other optometric organizations for external review and comment. The final report was presented to the ASCO Board of Directors on 20 June 2000.

Assumptions:

The attributes expected of the new graduate reflect a body of knowledge, skills and professional attitudes at one point in a professional career. The knowledge, skills and attitudes that are appropriate at the point of entry into the practice of optometry are not defined in isolation; rather they are affected by many variables including state laws, the nature of the educational process, the structure of the profession, health care policies, the economy, and technology, to name but a few. In addition to applying the decision rules developed in the MELD report, it is important to define the environmental assumptions used at the time the attributes were defined.

What follows are the planning assumptions upon which the report "Attributes of Students Graduating from Schools and Colleges of Optometry" has been based. These may be classified into two broad categories: 1) the nature of the Doctor of Optometry as a health care provider, and 2) the nature of the educational and professional environments.

The Nature of the Doctor of Optometry as a Health Care Provider

Doctors of Optometry are:

• expected to manage every relevant condition in a manner that assures safe and effective care for the patient. However, the level at which the condition is managed is expected to differ from entry-level following practice experience or supplemental education.
• aware of their individual competencies and conduct themselves accordingly ("as taught").
• responsible for ongoing self-learning and for remaining current and competent in their knowledge and skills.
• expected to utilize all resources, including ancillary personnel, intra- and inter-professional consultation, co-management and referral in securing the best possible care for their patients.
• expected to commit themselves to the profession as expressed in the Optometric Oath and AOA Code of Ethics.
• expected to manage their practices in a manner that is appropriate within the health care delivery system and that promotes patient access to eye and vision care.

The Nature of the Educational and Professional Environments

• The central goal of Doctor of Optometry degree programs is to prepare students to enter into the general practice of optometry.
• The Doctor of Optometry will continue to be a post-baccalaureate degree program, which is four years in duration.
• Additional post-graduate education and training opportunities provide advanced practice skills and knowledge in specialized areas beyond those required for the general practice of optometry.
• The practice of optometry is regulated by State Boards of Optometry and requires an independent assessment of competencies prior to licensure.

THE NEW DOCTOR OF OPTOMETRY MUST BE PROFESSIONAL & ETHICAL

To serve the public and the profession well, new graduates must embrace and demonstrate the ethical and professional standards appropriate to being recognized as a health care provider. The new graduate must also recognize that the completion of the Doctor of Optometry degree program is only the first step in a life-long commitment to self-directed learning and continual professional improvement.

The School or College of Optometry shall ensure that before graduation each student will have demonstrated critical professional and personal attributes, including:

Personal attributes

• A commitment to life-long learning and providing the highest standard of care.
• The ability to incorporate ethical principles into decisions affecting patient care and the practice of optometry.
• The ability to acquire, analyze and apply new information while making reasonable and informed decisions that are consistent with the interests and needs of the patient and broader community.
• Problem-solving and critical thinking skills that integrate current knowledge, scientific advances, and the human/social dimensions of patient care to assure the highest quality of care for each patient.
• The ability to recognize personal limitations regarding optimal patient care and to work with the broader health care community in providing the best care possible.

Professional attributes

• An understanding and application of professional ethics and standards in the practice of optometry, always keeping patient's welfare foremost.
• Professionalism, by demonstrating honesty and integrity in all interactions with patients and their families, colleagues, and others with whom the optometrist must engage in his/her professional life.
• A respect for the dignity of every patient and a commitment to empathetic and confidential care.
• Professionalism in understanding the challenges to the optometric profession posed by potential conflicts of interest inherent in health care delivery.
• A commitment to be actively involved in organized optometry and the community.

THE NEW OPTOMETRIST MUST BE KNOWLEDGEABLE

To provide quality eye and vision care to their patients, graduating Doctors of Optometry must have an established knowledge of the basic and clinical sciences. The foundation must be broad and include the biological, medical, vision and optical sciences, as well as a basic understanding of the health care delivery system. The Doctor of Optometry must recognize the dynamic nature of knowledge, and possess the commitment and skills needed to responsibly assess and apply new information and treatment strategies throughout his/her career.

The School or College of Optometry shall ensure that before graduation each student will have demonstrated knowledge of:

• Basic body systems, with special emphasis on the ocular and visual system and their interrelationships to the body as a whole.
• The various processes and causes that lead to dysfunction and disease, and the effect that these processes can have on the body and its major organ systems, with special emphasis on the ocular and visual systems.
• Mechanisms of actions of the various classes of pharmaceutical agents. Their interactions and their safe and effective use for the treatment of disease and conditions affecting the eye and visual system.
• The structures and processes contributing to the development of refractive error and other optical and perceptual abnormalities of the visual system.
• The optics of the eye and ophthalmic lens systems (including spectacles, contact lenses and low vision devices) used to correct refractive, oculomotor and other vision disorders.
• Visual development and vision function with respect to deviation and enhancement such as, but not limited to, strabismus, amblyopia, oculomotor, accommodation, and visual perception.
• Vision therapy and other rehabilitative methods used for the management of common visual disorders.
• The psychosocial dynamics of the doctor/patient relationship and an understanding of the social, psychological, and economic forces affecting diverse patient populations.
• Practice management structures and strategies as they pertain to the various practice settings.
• The critical elements of verbal and written communications and, clear and appropriate documentation of patient encounters.

THE NEW OPTOMETRIST MUST BE SKILLFUL

To provide the highest quality of care to their patients, Doctors of Optometry must possess appropriate cognitive and motor skills needed to prevent, diagnose, treat and manage clinical conditions which are within the scope of their professional responsibilities.

The School or College of Optometry shall ensure that before graduation each student will have demonstrated:

• All the skills required for the diagnosis, triage, management and/or treatment of common visual conditions and ocular diseases, including or resulting from:
  • refractive anomalies
  • abnormalities of accommodation
  • abnormalities of monocular or binocular vision skills
  • oculomotor and sensory/perceptual dysfunctions
  • ocular disease and trauma
  • prior ocular surgery and/or laser intervention
  • systemic disease
  • environmental or occupational conditions
• The ability to order and interpret frequently needed laboratory and diagnostic procedures.
• The critical thinking skills needed to assess the patient's visual and physical status and to interpret and synthesize the data to formulate and execute effective management plans.
• The ability to prescribe and/or use ophthalmic materials, contact lenses, vision therapy, low vision systems, pharmaceuticals, and certain surgical procedures, to treat and otherwise manage common vision disorders and disease.
• The ability to recognize and initiate the coordination of care for patients requiring advanced medical or specialty care.
• The ability to recognize life threatening conditions and to initiate intervention.
• Effective communication skills, both orally and in writing, as appropriate for maximizing successful patient care outcomes.
• The ability to realistically assess personal competencies and limitations.
• The ability to appropriately use all resources including the use of ancillary personnel, intra- and inter-professional consultation, co-management and referral in ensuring the best quality patient care.
• The ability to access knowledge, (including through the use of information technology), and manage information, and to apply that information in making decisions about patient care and health care delivery.