Optometry Education in Australia - Essay Example

OPTOMETRY EDUCATION IN AUSTRALIA INTRODUCTION, ASPECTS AND THE CHALLENGES Education standards in Australia related to optometry are under rigorous scrutiny to meet the global standards in this profession. This has lead to various debates of numerous topics ranging from the type and standards of optometry courses at universities, to the need for national examinations for graduates and overseas trained optometrists. Simply put, this field is showing increased educational advancement, and by increasing its standards of clinical performance in Australia and as a result increased demand in the quality of the services. In an order to gain insight into the thoughts and opinions of optometrists in Brisbane on this topic, a survey was conducted regarding the core issues that faced the optometric profession in Australia (Appendix 1). The survey was based on information obtained from the personal interview with an optometrist which was a mandatory component of this assignment. The question type survey involved opinions of practitioners in Australia and internationally regarding the educational standards of the current university programs; the need for a national board examination system; and the opinion whether the profession was ensuring competence in practitioners. Also asked in the survey were the questions related to the need for national examination for overseas graduates, and if it is appropriate to conduct periodical mandatory examinations for practitioners. The results of the survey will be referred/referenced to throughout the essay. So what are the educational standards A concern is whether the current optometry programs taught in Australia are appropriate. The four to five year course that leads to the degree of bachelorhood in optometry can then be furthered by undertaking MSc, MOptom, PhD in the same field. Experiments/research has been undertaken to improve the learning process of the students in this regard and new experiments and studies are being conducted. The introduction of WebCT (Web Course Tools) i.e. learning by the help of E-learning by Herse at the undergraduate level has been successful and highly educational to students (Herse ,2003). In another study, Anjou showed written communication that is letters of referral and report between healthcare providers to be one of the most competent means of communications between the health care providers and has insisted in implementing the structure at the graduate level. (Anjou, 2003). An introduction to problem based learning in Queensland University of Technology has also been carried out. (Azer, 2001) These studies are examples of the various techniques being introduced to increase the educational standards in the field of optometry. However, there are many who believe the system is not up to par. Take Carney for instance. Carney holds the view that the current challenges the universities face require a better strategy in education and teaching. He blames the slow legal status of Australia. "We are all aware that to accomplish change in the legal status of the health professions in Australia is a frustratingly slow process." He maintains the need to "further evolve the profession and develop it further. (Carney,2000) Comparing to the USA standards, Carney states that the model of entry-level competency adopted by ASCO (The Association of Schools and Colleges of Optometry), should be followed by a similar strategy in Australia to improve its educational standards. Carney believes Australia can reach to the levels of USA and UK (Carney, 2000). The US and UK standards are very good and are globally accepted and appreciated. He also maintains that the scope of the practice cannot be defined by entry level competencies alone (because) and stresses the need for further learning studies after graduation.(Carney ,2000). These skills and attitudes, in the author's view, will necessarily become integral and assessable attributes of graduates of the future. All these points hold merit but there are issues to the contrary.According to the survey, a majority of the optometrists were satisfied with the current curriculum and programs offered by the universities. The survey also showed that most practitioners were satisfied with the ongoing level of competence in this field. When asked if periodic mandatory examinations to learn new skills and new advancements should be introduced, many disagreed. This topic has been a much debated issue in recent times. The reason may be the belief in the competency of the current system to be adequate in providing the necessary requirements and the needs for a graduate and a professional. Another may be the lack of will to adapt to the new approaches. As since it is a general tendency among practitioners to practice and rely on what experience has proven to be safe, effective and predictable. Yet another reason the practitioner may not be interested is the amount of time and effort he or she will have to put in these exams. The conflict therefore remains in this regard. The issue of competency has also raised questions regarding the accreditation of university teachers. In the future, Schmid (1998) claims that university teachers will have to undergo training and courses in order to be recruited in the faculty of the universities. (Schmid, 1998). Schmid (1998) found in his study that this concept received the approval of many students, with only a minority stating it was unnecessary. One of the reasons the students gave was a general dissatisfaction in the way the lectures were given. This was either because the teachers were," although skilled, not able to get the point across", or taught at the level more advanced than the level of the students. (Schmid,1998). This motion has also been appraised by a majority of universities. The main supporters are the Queensland University of Technology (QUT) and the Higher Education Research and Development Society of Australasia (HERDSA). (Schmid, 1998). Professional teaching accreditation usually has two essential elements: a set of approved training courses and a body which decides on their suitability and awards certificates to individuals successfully completing such courses (Schmid ,1998). For such purposes, the ASDU (Academic Staff Development Units) and QUT have run the Graduate Certificate in Education (higher education) since 1993(ASDU, 1997). This course last year became the first course of its kind in Australia to be recognised by SEDA (Staff and Educational Development Association). The course is formulated so as to give an international recognition to the teacher, enabling him or her to apply and teach any where in the world, and bring Australia to the international level at par with UK and USA. These steps are anticipated to increase the standards of university optometry teaching. In an article in The Australian newspaper (October ,1997), the author Ramsden reflected that over the years there has been a decline in the teaching standards at universities. He states the factors are many, including "larger classes and higher workloads, which must be addressed". (Ramsden ,1997) However, Schmid holds the view that the changes in the education sector are rapid." (Schmid ,1998). She states that due to the diverse backgrounds of the students and decreased "staff to student ratios", the use of problem based learning structures and the increased amount of knowledge available, it is necessary that the teachers be kept up to date with the changing educational and teaching trends. She disagrees with taking a risk in dealing with teaching issues."(Schmid ,1998) Though many favor the above suggestions made by Schmid (1998), some argue against it. Kugel (1993) does not deem the accredition process necessary and warns that in the case of teachers, forcing them when they are not ready to accept change can lead to a counter effect. (Kugel, 1993). Kugel (1993) gives the reason that the universities already have systems in place to ensure teacher quality. The processes from appointment seeking to probationary period, to seeking tenure and promotion that follows the process of teacher selection render the accredition system unnecessary. (Sharpham, 1997) Assessment of competency of both the student and practitioner is another area to be evaluated if proper standards are desired. Assessment, like good teaching, encourages interest, commitment and intellectual challenge in an individual. The Optometry Council of Australia describes competency as being skilled in task and task management skills, contingency management, and skills in job or role environment. (NTB 1991) To achieve these goals, Optometric Practice Standards were devised by the Australian government which comprised of seven (7) sections. These sections include practice administration, quality assurance, rights and needs of the patient, practice services, practice facilities, communication, and patient records (Kiely, 2003). These standards were devised to ensure quality optometric practices and may be used as a basis for licensing authorities. The methods of assessment and performance criteria formulated included having an interview with the optometrist/s and the other practice staff, direct observation, review of patient records, review of practice documentation or policy and procedures manual, review of patient feedback and appointment schedule review. (Kiely, 2003) After the National Council ratified the Optometric Practice Standards by National Council, Optometrists Association Australia (OAA), it started working in collaboration with Quality in Practice (QIP), which in turn is a subsidiary company of AGPAL (Australian General Practice Accreditation Limited). The objective of AGPAL was to "provide consultancy services on accreditation and quality improvement to different healthcare organisations." (Kiely, 2003). Both organisations developed new methods to document and provide assistance in the application of the standards in the accredition process. For this purpose tools like assessment kits, surveyor workbook and information sheets were provided to the optometrists' offices. (Kiely, 2003). This Practice Accreditation Program based on the optometric practice standards developed by Optometrists Association Australia, allows an external source of surveying the practice of optometry, thereby helping to correct and suggest ways to improve the practice standards (QIP, 2002) These competencies can also assist in designing and improving the undergraduate and postgraduate courses. The assessment of a graduate of whether he or she is competent is another issue to address. A heated debate follows the question of whether there should be a uniform national examination for graduates. This issue has been debated across Australia and the opinion still remains fiercely divided. Australia has formulated a separate Optometrists' Registration Act for each state. This act is administered by the Registration Board regulates controls of practice of the registered optometrists. The Board is also ensures the behavior of the optometrists in accordance to the Act and ethical behavior.(Optometrist's association Australia 2006) Duffy (2001) states that if true form of standardisation is to be achieved, both Australian and New Zealand students must appear in the same exams conducted for the overseas optometrists applying for registration. (Duffy 2001). Others state the process as unnecessary since the universities where they graduate from ensure their competence before awarding them with a bachelor's degree. Furthermore, the process will highly stressful on the professional resources, and time and finance of the graduates. Duffy (2004) proposed that if the schools of optometry were to agree on making the Competency in Optometry Examination mandatory, and ensure the closure of the "TTMRA (The Trans-Tasman Mutual Recognition Arrangement) loophole", it would increase the probability of achieving uniformity in registration of all the optometrists. (Duffy 2004). TTMRA formulates that optometrists which have registered themselves in New Zealand automatically get registered in the Australian states. TTMRA works as the law in these states and territories. However, the Membership of the College of Optometrists in the UK MBCO/MCO), as it is still recognised as a qualification suitable for registration, poses the problem. (Duffy 2004) These holders in increased numbers continue to register (with the help of TTMRA) with the Australian boards and are not required to appear for the council's examination. This problem created by the TTMRA must be addressed and a more common basis of registration is required for all overseas trained optometrists. (Duffy 2004) The opinion in this regards becomes much divided as seen by the responses from the survey. Half of the survey takers approve the idea for a uniform national examination for graduates, where as the other half object to it. However, when asked of a national examination for all overseas trained optometrist appropriate, a majority said yes to the question. It should be noted that if such a practice was started, the benefits would no doubt be positive. This would mean equal job, teaching and studying opportunities for all professionals throughout Australia. The board of registration can become a single administrative body, which will help to unify and bring together the states in a more cooperative environment. Further, a more transparent system of merit will ensue where it would be easier to assess and evaluate the clinical competency of any professional through the same system. This would also facilitate the legislative processes for overseas employees and increase their scope to practicing anywhere in Australia without registering separately for each state. ***This lack of consistency and uniformity in professional registration is not limited just to the field of optometry, nor is it limited to Australia. From personal experience, podiatry in Canada.engineering, teaching etc. A uniform approach would also remove bias based on institutional systems and foster a feeling of equality among peers. A healthy competitive environment will increase the pace of research. A much smoother system of transfers and studies will help in more people interested in postgraduate studies and researches. And the increased exposure will increase performance in the professionals, thereby increasing the overall level of achievement of Australia in the field. These systems have become a norm for most of the institutes around the world. For example, on September 9th 2003 hearing, the witnesses acknowledged the importance of the graduate education programs. These programs are under the Title VII of the Higher Education Act. They praised the efforts by House of Republicans in this regard and stated that these will create and increase innovation and promote in depth study at graduate levels. NEWS 2003) Dr. Earl Lewis, graduate school dean at the University of Michigan, stated that thegraduate programs of America are renowned world wide and are the source of education to domestic as well as international students.(NEWS 2003) This policy has also been implemented for teachers, where there is a need to recognise and highlight the achievements and work of teachers and to encourage those who have the potential to teach. (NBPTS 2004) The national board for professional teaching standards of America , is currently the main body deciding policies related to education. It describes its mission to increase the quality of teaching and learning by maintenance of high standards for "what accomplished teachers should be able to know and be able to do." It also considers its responsibility to provide a "national voluntary system certifying teachers who meet these standards", and "advocating related education reforms to integrate National Board Certification in American education and to capitalise on the expertise of National Board Certified Teachers." (NBPTS2004) The advantages this certification provides are numerous; National Board Certification will enable the teachers to move from state to the next by removing the barriers that make the effort difficult. It will especially highlight the uncovered talent, and schools will have a better opportunity to claim for competent professionals. It will help in creating teaching as a more appealing career and increase the interest of the older age group American citizens. (NBPTS2004) An introduction of this type of system into Australia would bring positive changes in this regard. As a uniform standard is developed within the different institutes, there would be better understanding of the requirements and objectives. There would be a standard to which comparisons can be made, and these standards, if and when appropriate, may be modified or improved as required. The problems faced by overseas applicants should also be considered for revision. The council's examination for overseas trained optometrists is called the Competency in Optometry Examination and was first held in November 1997 (Duffy, 2001). It has been conducted twice-yearly since then. Of interest, the NSW Board of Optometrical Registration offers an alternative examination for overseas-trained optometrists. However, this examination, as not recognised by the other registration boards "undermine the national character of the Optometry Council's examination." (Duffy 2001) This situation affects the whole of the medical profession in Australia as well. Wroe in his article, cited Bob Birrell, a social researcher at the Monash University who said that "Australia compares badly to the US, Britain and Canada in assessing overseas-trained doctors because the states are desperate to fix their shortages." (Wroe 2004). This shortage has been evident, particularly in Queensland, with hospital closures (e.g. Cabolture Hospital) due to the lack of doctors available and other administrative problems in the past few years. Queensland's "health crisis" is in such a desperate predicament that the Queensland Premier (Peter Beattie) traveled to the UK in an attempt to recruit doctors to come to Queensland to fill the shortages. This was despite evidence that some doctors had "English language deficiencies, gaps in medical knowledge or lack of clinical experience relevant to Australian patients needs".(Wroe 2004) Birell in his People and Place report, calls for national assessment standards, claiming no state government will unilaterally enforce tougher benchmarks for fear of missing out on overseas recruits. He claims that "The Federal Coalition is currently confronting the dilemma of escalating health costs."(Birell 2004) He also points out that "questions concerning the number and location of doctors offering their services are central to health policy debates about both budgetary and health service matters. Every extra GP practicing full-time generates, on average, some 7,000 services annually and costs the government close to $200,000 in Medicare receipts. Currently, the net number of doctors billing under Medicare is growing by just over two per cent, or more than 1,000, per year. If the extra doctors are located in already oversupplied urban areas then the community benefit will be minimal but the cost to the taxpayer will be high. Not surprisingly, successive governments have sought to slow the rate of increase in the doctor workforce and to ensure a fairer distribution between urban and rural locations." (Birell 2004). Birell (2004) also claims that the employers, such as hospitals and GP clinics, usually recruited by reading CVs while the applicants were still overseas and not on the applicant's medical knowledge or clinical skills. (http://www.theage.com.au/articles/2004/10/03/1096741904984.htmlfrom=moreStories) In conclusion, it can be deduced that although Australia has shown immense capability in the field of optometry, there is much left to be done. Australia still has much to accomplish to reach to the level of UK or USA. It needs to assemble a national graduate level like the USA to increase its standard. The need for a better system of graduate assessment, the issues for overseas applicants require a better planning for and an improved competency and scrutiny system for standards evaluation are needed. As is the need of a mutual consensus between the professionals and the students about ways to improve the current system. References ASDU. Graduate Certificate in Education (Higher Education). Information Booklet. Brisbane: QUT Publications and Printing, 1997 http://optometrists.asn.au/gui/files/ceo813104.pdf accessed on 09 Sep 2006 Bob Birrell MEDICAL MANPOWER: THE CONTINUING CRISIS 2004 site http://elecpress.monash.edu.au/pnp/free/pnpv4n3/birrell.htm accessed on 09 Sep 2006 John Boehner News from the Committee on Education and the Workforce Chairman September 9, 2003 http://edworkforce.house.gov/press/press108/09sep/hied090903.htm Accessed on 09 Sep 2006 Canberra site name http://www value MD.com link http://www.theage.com.au/articles/2004/10/03/1096741904984.htmloneclick=true October 4, 2004 Accessed on 09 Sep 2006 Careers in optometry Optometrists Association Australia http://www.optometrists.asn.au/optometry/careers Accessed September 21, 2006 Leo G Carney 2000 Meeting the educational challenges of enhanced professional responsibilities www.optometrists.asn.au/ceo/backissues/vol83/no6/841 - 9k Accessed on 09 Sep 2006 Jane Duffy BSc (Optom) LLB (Hons) Clinical and Experimental Optometry 84.4 July 2001 www.optometrists.asn.au/gui/files/ceo844179.pdf accessed on 09 Sep 2006 P Herse An experience of using WebCT in undergraduate Learning School of Optometry and Vision Science, University of New South Wales How professors develop as teachers. 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Brisbane: DeputyVice-Chancellor's Office QUT, 1997. http://optometrists.asn.au/gui/files/ceo813104.pdf Accessed on 09 Sep2006 Ramsden P. Those who can't teach. The Australian. Higher Ed Suppl , 1997: October 22: 40.Clinical and Experimental Optometry, 1998 -www. optometrists.asn.au Accessed on 09 Sep 2006 Katrina Schmid, The accreditation of university teachers: an optometric viewpoint 1998 http://www.optometrists.asn.au/gui/files/ceo813104.pdf#search=%22The%20accreditation%20of%20university%20teachers%20in%20optometry%22 Accessed on 09 Sep 2006 Quality in Practice. http://www.qip.com.au (5 December 2002). accessed on 09 Sep 2006 David Wroe 2004 Doubt over overseas-trained doctors - National - www.theage.com.au http://www.theage.com.au/articles/2004/10/03/1096741904984.html Accessed September 21, 2006 Release - Graduate Programs Provide a Valuable National Resource, Improve Education at All Levels, say Witnesses 2003.htm http://edworkforce.house.gov/press/pressindex.htm Accessed September 21, 2006 National board for professional teaching standards 2004 www.nbpts.org Accessed on 09 Sep 2006 Read More