Optometry and the Future of Health Care: Schools and Colleges Embrace Interprofessional Education
The curriculum for any student entering optometry school today will in some way include interprofessional education (IPE). IPE is a hot topic throughout medicine and an area of much activity in optometry. The Association of Schools and Colleges of Optometry (ASCO) is a leader in working to ensure optometry students are prepared to participate in interprofessional care (IPC) when they graduate. The Association’s “Attributes of Students Graduating from Schools and Colleges of Optometry” calls for recipients of the Doctor of Optometry degree to have the ability to appropriately use all resources, including ancillary personnel, intra- and interprofessional collaboration, co-management and referral, in ensuring the best quality of patient care and to be committed to working as an integral member of the larger interprofessional healthcare team to improve patient care outcomes.
Carole Timpone, OD, Distinguished University Professor and Associate Dean of Clinical Programs at Pacific University College of Optometry (PUCO), and Jennifer Coyle, OD, MS, PUCO Professor and Dean, and Chair of ASCO’s Interprofessional Education and Collaborative Practice Committee, explain the importance of IPE and IPC: “The demographics and needs of patients have changed dramatically. Chronic disease, which has a major impact on quality of life, has replaced acute illnesses as the leading burden to the healthcare system, including cause of death. Addressing these new needs and achieving the best outcomes requires a more comprehensive and ongoing approach to care with a focus on prevention. This is best delivered by a team of providers.”
Optometry Plays a Key Role
Optometry schools and the future optometrists they’re training have a distinct responsibility in building interprofessionalism. “Eye health and vision are significantly impacted by chronic diseases,” says Dr. Timpone. “The Doctor of Optometry is an integral member of the healthcare team in all aspects of care, from initial diagnosis and treatment to ongoing management, with the goal of ultimately improving or maintaining quality of life.” Melissa A. Vitek, OD, FAAO, Director of International and Continuing Education at Salus University Pennsylvania College of Optometry (Salus/PCO) and member of ASCO’s Interprofessional Education and Collaborative Practice Committee, elaborates, “Due to the fact that vision is so critical for even a basic level of functioning, an optometrist’s office is the point of entry into the healthcare system for many patients. To fully meet the needs of patients, optometrists need to be positioned to communicate effectively and efficiently with members of several different healthcare professions.”
Every school and college of optometry that’s a member of ASCO is currently engaged in some form of IPE. According to Dr. Timpone, the experiences range from sharing core courses with students from other health professions to integrated clinics that provide true team-based care. Many programs include interactive interprofessional case conferences, some beginning as early as the first year. For example, PUCO currently offers an elective course in interprofessional care for third-year students that blends face-to-face and online instruction with a clinical practicum. To complement IPE coursework, the University runs the Interprofessional Diabetes Clinic (IDC), which helps low-income, under-insured individuals manage their diabetes by bringing together healthcare providers from across the professions to provide care. Students, staff and faculty from PUCO, with other Pacific University health professions, including occupational and physical therapy, mental health, dental health science, physician assistants and pharmacy work in the IDC one Saturday each month. In addition, says Dr. Timpone, “We are developing an ‘IP Concentration’ recognition for students who have pursued IPE and IPC beyond the basic curriculum.”
Salus/PCO has a long history of interdisciplinary thinking, beginning in the 1970s in the field of low vision rehabilitation. Today, more than 300 students from the optometry, physician assistant, occupational therapy and speech language pathology programs are enrolled in the “Evidence-Based Practice: An Interprofessional Team-Based Approach” course, which is a requirement for first-year students. Salus/PCO students also participate in several interprofessional practice initiatives, which include a collaboration with a nursing school. Two interprofessional pilot programs, one involving the Veterans Administration and another involving clinical problem-solving via patient cases, are ongoing projects.
At Southern California College of Optometry at Marshall B. Ketchum University (SCCOMBKU), first-year students take Professional Ethics and Population and Public Health courses with physician assistant (PA) students. In their third year, they participate with PA students in interprofessional case conferencing in each of three quarters, notes Raymond H. Chu, OD, MS, Associate Dean for Academic Affairs. During the first session, the students get to know one another and address common misconceptions about their respective professions. In subsequent sessions, they tackle cases involving issues such as smoking cessation, diabetes and cultural competence. “The overarching objective with the IPE curriculum is to develop the primer in which students and eventually professionals have the comfort and ability to communicate with one another in an effort to support wellness and coordination of care,” Dr. Chu says.
Dr. Timpone points out that evidence of the benefits of IPE and IPC is beginning to appear in the professional literature. Studies are showing that IPE provided during the training of the healthcare workforce enables effective collaboration among professionals once they’re practicing and that the competencies they develop translate into improved health and patient care outcomes. Ongoing work in the area of IPE includes further development of curricula and assessment of effectiveness. The upcoming ASCO Interprofessional Education and Collaborative Practice Summit (Feb. 5-6, 2016, in Fullerton, Calif.) will assist in charting a course for the future.
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What Optometry Students and Residents are Saying about Interprofessional Education and Care
Warren Morton, a first-year student at SCCOMBKU and President of the Class of 2019, says “It’s easy to see how important concepts from IPE can be in the real world when ultimately the patients have the most to gain from a more complete healthcare team.” Warren says it’s been interesting to see via the IPE curriculum how valuable PAs are for the country’s healthcare system and how OD and PA students approach ideas differently. He also says he’s realized that “failure to recognize the importance of working with other professions will leave our own profession at a disadvantage.” Because of her exposure to IPC at PUCO, Alexandra Bavasi, OD, now a Pediatric Optometry/Vision Therapy/Vision Rehabilitation resident at PUCO, feels as if she can provide more guidance to patients regarding choices affecting their overall health. She says she can see how IPC is especially important in traumatic/acquired brain injury and in pediatric cases involving developmental/learning concerns. “However, she says, “any patient with a systemic disease with multiple manifestations would benefit from IPC.” Dr. Bavasi plans to foster IPC as a practicing optometrist in a variety of ways, including providing in-service education to other healthcare professionals/specialties in her community so they are better educated about the specialized services optometrists deliver. The same goes for Sheila Morrison, OD, a fellow PUCO graduate and resident, in Cornea and Contact Lenses. Discussing her view of IPE and IPC, she says, “Right out of residency I’d like to participate as a provider in an interprofessional clinic in my community, with the intent to promote the model and potentially develop as an educator for students in the future. I believe there are varying levels of involvement, all of which are positive. Simply respecting other professions and being informed about what they do is positive, as is being an active member of an institution providing interprofessional care or education. In either case, I value IPC and will carry it forward with my career.”