Development of a competency framework for optometrists with a specialist interest in glaucoma

Abstract

Purpose To develop a competency framework, using a modified Delphi methodology, for optometrists with a specialist interest in glaucoma, which would provide a basis for training and accreditation. Methods A modified iterative Delphi technique was used using a 16-member panel consisting almost exclusively of sub-specialist optometrists and ophthalmologists. The first round involved scoring the relevance of a draft series of competencies using a 9-point Likert scale with a free-text option to modify any competency or suggest additional competencies. The revised framework was subjected to a second round of scoring and free-text comment. The Delphi process was followed by a face-to-face structured workshop to debate and agree the final framework. The version of the framework agreed at the workshop was sent out for a 4-month period of external stakeholder validation. Results There was a 100% response to round 1 and an 94% response to round 2. All panel members attended the workshop. The final version of the competency framework was validated by a subsequent stakeholder consultation and contained 19 competencies for the diagnosis of glaucoma and 7 further competencies for monitoring and treatment. Conclusions Application of a consensus methodology consisting of a modified Delphi technique allowed the development of a competency framework for glaucoma specialisation by optometrists. This will help to shape the development of a speciality curriculum and potentially could be adapted for other healthcare professionals.

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

“…133,134 However, the process of establishing a specialist qualification for optometrists is lengthy, requiring the drafting of a syllabus, core competencies, training programmes and assessment procedures. 135 The viability of a specialist qualification should be a topic for further research. Through the CoO Higher Qualifications framework, optometrists can already obtain Professional Certificates in low vision, medical retina and glaucoma, and Professional Higher Certificates in low vision, glaucoma and contact lenses.…”

Developing standards for the development of glaucoma virtual clinics using a modified Delphi approach

“…Third, assigning a ‘score’ to the level of agreement facilitates a statistical approach to quantifying consensus 18. This method has been used in ophthalmology to develop competencies for UK optometrists involved in glaucoma shared care,17 to identify areas of consensus and disagreement in paediatric cataract management19 and to define the minimum set of outcome measures required following cataract surgery 20…”

“…Since the Delphi methodology does not specify at what point consensus is deemed to be achieved, we chose to exclude statements that scored  < 5 from the standards (Myint et al 17). Free-text comments from round 1 were also considered when revising the standards statements.…”

A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress)

“…In each round, the opinions are summarised and fed back to respondents in subsequent round(s) in order to reduce disparity and achieve an expert consensus. The technique has been used to standardise and improve diagnosis and has been used in optometry to develop competency frameworks 33, 34…”