A month into the pre-reg period, the eager trainee should keep their eyes peeled for the arrival of a key person in their development and maturation as an optometrist – the stage one assessor.
Getting properly acquainted with the assessor can be a somewhat nerve-racking experience. If like myself you are prone to being somewhat Frank Spencer-like it can only make matters worse. So the most important thing to do when making the first impression is to relax. Think of this as a friendly visit.
Where to be
To ensure the trainee has sufficient experience in order to demonstrate confidence in the areas being assessed it is a good idea to have a fair share of experience before the visit. Sitting around at reception and booking appointments in the period immediately before the visit probably won’t be the most useful use of professional time. It is suggested by the College of Optometrists that the trainee has completed 20 refractions and 20 dispenses by this point.
10 stage one elements
Visit one will see the assessor examining 10 stage one elements based around: professional conduct, methods of ocular examination, optical appliances, contact lenses and ocular disease. It is important to prepare well for this initial visit as it may set the tone (and possibly pace) of future visits. A well prepared smooth visit now may well mean trainee and assessor are more confident in subsequent visits.
Professional conduct
Being part of the healthcare profession, whether in private practice or hospital, often includes a great degree of responsibility and professionalism. The assessor will at this point examine the trainee to ascertain whether they are able to display this level of professionalism. The trainee will likely be asked questions around the Data Protection Act (1998) and how this impacts their practice. In addition in this area, the trainee will need to understand the role of the optical regulator (GOC) and demonstrate knowledge of advice and guidance set by respective professional bodies, standards set by the local clinical commissioning group and relevant law relating to the role. This unit of competence will also involve questions around working within a multi-disciplinary team and the trainee should also demonstrate knowledge of shared-care schemes, local and national.
Methods of ocular examination
There will be three competencies assessed in this area via a mix of direct observation and patient records presented (see College Trainee Handbook 2015). The trainee will need to: Use instruments to measure corneal curvature and assess its regularity (accurate results to within ±0.1mm radius), assess the tear film, and assess pupil reactions. It should also be expected that array of questions can be asked around the element being assessed to prove further there is competence in that area. The trainee should ensure they have their ‘simulated patient’ eg member of staff ready and willing for the assessment.
Optical appliances
For this element the trainee will have 10 minutes to verify a pair of multifocal spectacles provided by the assessor. The trainee should take into account BS tolerances and verify all aspects of the frame and lenses. As this is a work-based assessment, the trainee is able to use a manual or automated focimeter. In my visit, I saw this as an opportunity to show off with newer technology and opted for the automated focimeter (perhaps I was being lazy), but each to their own – decide and be confident in the appliance to be used.
Contact lenses
This part will include the trainee producing a patient record to prove they are able to instruct the patient in soft lens handling and how to wear and care for them. This is of course an important element as poor patient knowledge of contact lenses can result in a greater chance of contact lens related pathology. The trainee should demonstrate they are confident enough to educate the patient and understand soft lens care products. In addition they should also have knowledge of their own lens banks and solutions and sufficient general knowledge of materials and care regimes.
Ocular disease
This unit involves the ability to identify and manage ocular abnormalities and visit one is an introduction to this unit. Some trainees may thrive in this area as a large chunk of university study was based around this. In this visit, the trainee should understand risk factors for the common ocular conditions including glaucoma, cataract, diabetic retinopathy and AMD. The trainee should also understand the treatment of a range of common ocular conditions.
Reflection
After a (hopefully pleasant) two-hour acquaintance with assessor, the end of the visit will present an opportunity for a meeting between assessor, trainee and supervisor. This is a great time to take a breath and absorb all the information given by the assessor in order to improve future practice and visits. Further dates will be agreed for subsequent visits at this point.
While this article is a guide of what to expect in this visit, it is in no way a substitution for further study. Consult the College Trainee Handbook to understand further what is expected and ensure a sufficient amount of further reading has been done. Finally, relax, it’s just a friendly visit.
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