Time to take stock

Bryony Pawinska provides an interim evaluation of the new pre-registration period six months into the pilot scheme.

As the new scheme develops apace - 581 trainees, each with their own supervisor, and 49 assessors - New Year is a good time to start to take stock of where we are. The College is working to a very tight workplan for the pilot, and we are achieving our targets. But those targets alone do not tell us how it is for the participants - the trainees who are keeping their logbooks and experiencing the assessment visits, their supervisors, and the assessors themselves.

Why the change?
It may be helpful to reflect on why the College has proposed the introduction of such a radical new approach to assessing the fitness to practise and clinical skill of pre-registration trainees. Under the provisions of Section 13 of the Opticians Act 1989, the GOC approves any scheme for the registration of UK-trained optometrists. But approval is not a one-off process - the GOC's education committee visits the PQE Part II regularly and comments to the College on its findings. The visitors shared the aim of the College that the pre-reg period should encompass a more structured phase of post-degree education and training aimed at establishing fitness for practice.

First and foremost the change provides ongoing support from the College for trainees. The issue of having to pass all 10 sections of the examination first time has perhaps been overemphasised - while it is true that the first-time pass rate has been consistently low at around 30 per cent, the majority of trainees do pass at the second attempt. However, for many trainees the first formal assessment of their progress was when they took the PQEII. It seemed self-evident that, if there was more structured support, and ongoing assessment throughout the pre-reg period, not only could the final assessment be reduced in length and still retain its rigour, but the trainee and the supervisor would be able to assess more formally how well the trainee was developing in terms of clinical skill.

The end result for all parties must always be the assurance that the trainee is clinically competent and safe to practise. While the PQEII did a good enough job of providing that assurance, a competence-based approach to assessment takes account of far more than a good grasp of the theory. It ensures that it is the application of that theory to practice, ie during the patient episode, which is primarily assessed, rather than the theory itself.


Involving the wider optical community
From the outset, the College has been determined to involve all stakeholders in the development of the new scheme. Indeed, change, and especially such profound change, is only effective when key stakeholders are involved. The interests of employers, universities, the hospital eye service, the regulator and practitioners have been represented on a Steering Group (now transmuted into an Advisory Group) comprised of the College, the AOP, FODO, BUCO (British Universities Committee for Optometry) and the GOC. The Advisory Group receives the College's workplan, updated regularly, and is consulted, sometimes collectively and sometimes individually, on issues that have included data protection and quality assurance.