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The main aim of this 'enhanced CET' is 'to encourage greater interaction with peers and to reduce the risk of professional isolation'. While much of the focus among both providers and registrants in recent months has been upon peer review, it is also important to recognise the new emphasis on other modalities of training which will necessarily represent a significant number of the CET points eye care professionals will need in the coming years. One tried and tested means of CET provision, which will in future be an important part of registrants' 'non-text based learning' will be clinical workshops.
Clinical workshops
I have been involved in running CET courses for some years. Based on both my own observations and having to plough through what must now be thousands of feedback sheets after events have taken place, I can safely say that practical sessions such as clinical workshops are popular among participants. However, for them to work properly, they need to be focused upon a specific goal, be well designed especially with regard to timing and pre-tested to iron out any glitches.
The current working definition of a workshop is an event that 'requires the successful demonstration and the application of hands-on techniques and skills in optometric, ophthalmic dispensing and specialist procedures and instrumentation. Because of the hands-on nature of such events there is a required ratio of no more than one demonstrator to six participants and adequate levels of appropriate equipment must be provided'. In other words it is a small group actually doing something under the close guidance of somebody skilled in that technique.
The advantages of clinical workshops, and the reasons why they generally result in higher feedback scores than lectures, include a general perception that they are 'more interesting' and that delegates 'actually learn something'. This may not always be guaranteed from a lecture. From an organiser point of view it might seem an obvious idea to fill any agenda with workshops, but bear in mind the ratio of demonstrator to participants of one to six. If you are organising an event with a large number of participants all wishing to take part in workshops then you either need to run each one several times or ensure that you have a reasonable number of experienced demonstrators and a sufficient number of sets of duplicate equipment and instrumentation to run multiple workshops.
A poorly run workshop, and one which will score less well in feedback, tends to be more of a demonstration than a workshop. Take for example the following hypothetical proposal for accreditation of a dry eye workshop. 'Demonstrator Bill Harvey will demonstrate to six delegates both invasive and non-invasive ways of assessing tear quality and volume, including non-invasive break-up time, fluorescein break-up time, phenol red thread test, tear prism height measurement and use of dyes and stains. Each delegate will have the opportunity to practise the techniques under discussion.'
In theory, such a proposal is likely, under the current system, to get accreditation. However, I have attended workshops fitting this description that have reflected scores at both extremes of the feedback scoring scale. A poorly constructed workshop would involve me sitting at a single slit lamp and talking through each of the techniques. I would ask for a volunteer from the participants to act as a patient. After discussing each technique in detail I would leave just enough time to allow participants to try out the techniques on each other and ask any questions.
The emphasis here is on teaching rather than participation. Many participants would be comfortable with this format and its relaxed construction allowing them to melt into the background, but the lack of patients, adequate equipment and requirement to undertake a minimum of supervised specific activities makes it a poor teaching and learning event.
A better designed session would have a pre-defined structure with the emphasis on participant activity and the didactic element reined in somewhat. For example, there will now be four slit-lamp stations each with a pre-assessed patient. I find pre-registration optometrists perfect as patients, as it is often possible to recompense them with free attendance at the event where the workshop is taking place.
One station will have a slit lamp with imaging system linked to a data projector at which I will sit and all four stations will be set to a single task. One might, for example, be for fluorescein BUT and prism height, one for non-invasive BUT and prism height measurement, one for phenol red thread use and one for lissamine green staining analysis. This would allow four 15-minute tasks. I could demonstrate the technique initially and then each pair at a slit lamp would attempt the same. Moreover, they would be required to record their result on a pre-written sheet. In my experience, actually asking a participant to make a record of their findings or to print a data sheet ready to report their findings makes for a much better learning experience.
Table 1 summarises some key points to running a successful clinical workshop. Next year the CET cycle will emphasise the importance of interactivity and participants will be required to offer feedback before they are given their CET points. Workshops that are poorly defined and tend towards mini-lecture/demonstrations will be less tolerated in future.
? The Vision Care Institute is a provider set up to run workshop learning where attendees get hands-on interactive education and support. TVCI runs a range of programmes including OSCE preparation courses for pre-reg optometrists.
