In recent years, the optometric profession has seen many changes take place, especially amidst this year’s Covid-19 pandemic. New opportunities as well as the myriad disruptors within the profession have made for a challenging, unpredictable, but ultimately exciting future for today’s primary eye care providers.
Today we’re interviewing three leaders in optometric education regarding their unique perspectives on the current state of our profession: Mark K. Colip, OD, Elizabeth Tonkery, OD, MPH, and Jennifer Coyle, OD, MS, FAAO. We’ll discuss what future changes in eye care we can anticipate for both optometry students and practicing ODs.
Dr. Colip has spent the majority of his career working in optometric education and is currently the sixth president of the Illinois College of Optometry.
Dr. Tonkery has spent over a decade in various leadership roles within optometric education and is currently Associate Dean for the Accelerated Scholars Program at the Pennsylvania College of Optometry at Salus University.
Dr. Coyle is the Dean of Optometry and professor at the Southern California College of Optometry at Marshall B. Ketchum University and has also spent a significant portion of her career in optometric education.
Aside from COVID-19, what are some of the biggest disruptors to the optometric profession for today’s optometrists? How are optometry students being prepared to tackle these?
Dr. Colip:
- Perhaps the single biggest disruptor to optometric education, and subsequently the profession, is the limited pool of highly qualified and diverse applicants to our programs that we have all been experiencing for the past few years. At ICO, we have decreased our entering class size for the past few years in order to maintain admissions standards. The ASCO Board is in agreement that the applicant pool is our number one challenge and we have been working on trying to attract the best and brightest towards a career in optometry via the “Optometry Gives Me Life” campaign. Students are getting involved by participating in the Admissions processes at each school and by encouraging young people about the benefits of this wonderful career. We need practicing OD’s to do the same and encourage bright young people to consider a career in optometry.
- Telehealth. One of the silver linings of COVID has been the rapid evolution of telehealth technology and workflow. Students are gaining experience in the use of telehealth platforms both for urgent eyecare, comprehensive eye examinations and specialty care. Last year ICO faculty conducted and published a study utilizing a planned synchronous telemedicine/tele-optometry platform and students participated. The results were favorable and now we are moving forward with an initiative that will allow ICO faculty and students to gain additional hands-on experience using that same platform.
- Vision Care Plans. Students gain experience coding for care provided and learn about various plans in didactic lecture and practice management curricula.
- Retirements of ODs and OMDs have been accelerated as a result of COVID. Students are learning that even a pandemic can create opportunities for their future practice plans.
- Private equity acquisition of practices. Alumni are telling us about these transactions. Some seem to work out well, others are not so happy one year down the road. Students learn of the various means to transfer practice ownership via ICO’s Practice Management curriculum, which now spans all 4 years.
- Diversity, equity and inclusion. Students are participating in DEI initiatives, surveys, discussions and training and increasing their awareness of the presence of healthcare disparities in the populations they are treating as students.
- Access to care was limited during the early days of COVID. Utilization of PPE and strict protocols has demonstrated that eyecare can be delivered safely during a pandemic. By participating in patient care during the pandemic, students are learning how to manage patients in this challenging environment.
- The FTC Contact Lens rule has created unnecessary and duplicative requirements in delivering optimal patient care. Students are learning to jump through the hoops necessary to meet these burdensome government mandates by their involvement in patient care and seeing first-hand the disruption to patient care. ICO students have long been encouraged to be involved in Advocacy efforts and are automatically enrolled in the AOSA/AOA as part of their ICO enrollment.
- Importance of optimizing practitioner health and mental self-care. The pandemic has placed additional burdens and worry on everyone, including students, faculty, and staff. Fortunately, as students, they have access to professional counselors and are encouraged to utilize those resources while they are students.
- New optometry schools. In short, they are not needed. They risk over-supplying the market in the future. There is no doubt there will be increasing needs for quality, comprehensive eyecare in the future. Basic demographics support this. The existing schools of optometry have both the capacity to meet any such growth in demand and capabilities to meet current and future needs for the education of ODs. Additional schools create unnecessary additional costs and overhead and strain the supply of quality educators.
Dr. Tonkery: I think that technology poses perhaps the biggest disruptor as well as the biggest opportunity for optometry. Never before has the profession been challenged in such a way as it is today with not only keeping up with the ever-changing technology in our offices, but also the technology on our patients' cell phones. As a society, we are spending countless hours on our phones without understanding if there is a significant impact on not only the visual development of children but also on adults' health. In our offices, we are continually upgrading equipment to allow us to do a better job serving our patients' needs.
PCO is focusing on incorporating technology wherever possible into our student education both in the classroom and the patient exam room. We are moving towards greater emphasis on telehealth, as well as utilizing the newest technological advances for patient care that are available.
Dr. Coyle: It was interesting to watch how one of our biggest disruptors in the profession became one of our most important tools, as optometrists stepped up to provide outstanding urgent and emergent primary eye care through telemedicine. We have incorporated it into our vision therapy, low vision, and primary care clinics, so our students are getting exposure to alternative care delivery models. At MBKU we are refining the use of our available platforms, including problem-solving what we can from the patient end of the technology experience, along with proper billing and coding, and we plan to integrate it into our didactic and laboratory curriculum next.
Speaking of technology, we also have the opportunity with artificial intelligence and the incredible advancements in computer-driven imaging systems to really give the doctor the gift of time to focus on patient communication, in addition to improved accuracy in our diagnoses and better long-term management of ocular disease. In many respects advancing technology lets us get back to the basics of why patients routinely say they enjoy seeing us—doctors of optometry spend time talking to them. In optometric education, we are being thoughtful in making sure our students are prepared to competently communicate effectively with their patients, as well as other health care providers in interprofessional settings. We are purposefully engaging in cultural and generational humility training, promoting equity and inclusion, and promoting interprofessional communication and collaborative care.
How has optometric education changed in the face of the pandemic? Will any of these adaptations be advantageous to faculty and students over the long run?
Dr. Colip: The biggest change has been in the delivery of content. Virtual didactic training through online, on-demand lecture platforms will continue to evolve. Pre-COVID, many of our students had already migrated to viewing didactic lectures online at their leisure. Information is being delivered in virtual formats and traditional lecture time is being used more for discussion/problem solving/application of material. It is likely that education will be provided in this hybrid format in the future. However, much of optometric education is still best delivered in a “live” hands-on format (labs, patient care) and will probably continue in that mode. Patient care delivery has evolved as well, with much more emphasis on infection control protocols within the practice. Telehealth was implemented due to the pandemic and it is here to stay.
Infection control protocols and government stay-at-home orders have limited our ability to meet in groups in-person and discuss challenges and issues. While we can still meet via various online virtual meeting platforms, nothing compares to getting a group of intelligent people together in one room and discussing issues openly and with the goal of making improvements.
Continuing education went from mostly live, conference-based lecture delivery to mostly online lecture delivery. Many states have adapted their annual CE requirements accordingly and many ODs are adapting as well.
Dr. Tonkery: COVID has forced the faculty into teaching entirely in a virtual world, until very recently when we went back into face to face clinical and laboratory experiences. However, the ability for faculty to move their entire classroom with lectures, exams, quizzes, laboratores, and recitations to a virtual format will provide us with the flexibility that we need into the future to meet any challenges that arise. While our students miss the opportunities that face to face instruction afforded such as the socialization with peers, connection with faculty, and confidence building in group work, the education they have received during the pandemic has met all of the expectations we have had as faculty for student education. This versatility will enable us to meet the needs of our students well into the future.
From a clinical standpoint, we have worked hard to capture experiences that the students could apply to the clinical environment. We have spent considerable amounts of time developing cases for them to work through, paper topics for them to research, as well as recording face to face examinations and editing them for more simulated patient care experiences. This has enabled us to focus on critical thinking skills, medical decision making, chart completion, and any social/ethical issues that arise during patient care. While we don't suggest this is a substitute for in-person clinical training, it has served our students well to be able to focus so keenly in these areas while in their clinical training. This allows us to carefully control and monitor everything from developing an assessment/plan to making sure students get to see the specific specialty cases that we want them to experience.
Dr. Coyle: I believe our strict reliance on the traditional face-to-face, multiple hour sessions of lectures will morph now that faculty are adapting to virtual classrooms. We will get back to lecturing in classrooms, but I anticipate the integration of more hybrid-style courses across our curriculum that will allow students to preview lecture material, and then spend more time in-person honing their clinical and critical thinking skills. Our comfort levels with using technology both in the didactic and clinical setting has increased and that will only continue now that everyone has been forced to try new ways of delivering education and patient care. At MBKU, we have two campuses and multiple clinics in our Ketchum Health Network, and the use of ZOOM for office hours and study sessions has really opened up time for creative scheduling of meetings for everyone. It has become such a part of our daily lives that no doubt the good aspects will be retained.
What future changes to optometric education are you most excited to see unfold over the next 5 years?
Dr. Colip: As we have more advancements in technology, we will continue to have more and more emphasis on interpretation of data and the application of information in developing increasingly complex treatment plans for patients, and less on actual data collection. More teaching of critical thinking skills and problem solving. While there will always be the need to learn to examine a patient, it will be tempered with more advanced interpretation and application of assessment findings. Utilization of learning technology and advanced imaging will continue to grow.
Dr. Tonkery: I'm excited to see optometric teaching and learning become more progressive and move towards all sorts of alternative delivery models for didactic and clinical care. With the increase of telehealth services for patient care, and the expanded availability for technology to be used in virtual education and assessment. In addition to this, I think optometry will continue to see the expansion in scope as educational systems also expand to train the future generations in areas such as lasers/minor surgical procedures, and optometric technology.
Dr. Coyle: We have embraced assessment models that focus on the demonstration of competency rather than seat time. Old school education was focused on the number of hours a student sat in their chair and listened to lectures on a specific topic as our gauge of student knowledge. We all recognize that each learner’s pace is unique and what truly are measures of student learning are outcomes that have demonstrated they are competent with their skills and they are clinical thinkers throughout our curricula in optometry school.
What is the most rewarding aspect of your job?
Dr. Colip: I have been involved in various aspects of optometric education for over 28 years. Education is a people-based enterprise. The creativity and brilliance of students, faculty, and staff working together, never ceases to amaze me. I truly enjoy getting smart people together to address challenges and working through potential solutions and improvements and then empowering them to make those things happen. I also still love seeing new students arrive to campus excited and anxious about what lies ahead. Then seeing those same students grow and mature and meet their successes on their own journey. Commencement is the fitting and grand culmination of their evolution and transition into becoming Doctors of Optometry. Witnessing those transitions is most rewarding and a true joy.
Dr. Tonkery: I enjoy being able to see the product of PCO's curriculum and clinical training walk across the stage and become the future of optometry. I enjoy teaching courses and seeing patients, but the most rewarding aspect is by far watching students graduate with the knowledge and skills to move the profession forward into the next generation of practitioners.
Dr. Coyle: Watching alumni find their bliss! I truly love meeting or catching up with alumni and hearing how their time at SCCO “changed their lives” and provided opportunities they never imagined. I always tell applicants who are interviewing for a seat in our entering classes that they have already made the best decision of their life by choosing optometry as a career. It is amazing to me to hear all of the different ways our colleagues practice and use their optometric education in ways that they find personally fulfilling and in turn change the lives of their patients and take our profession forward.
Conclusion
Despite the challenges of the Covid-19 pandemic and myriad other emerging disruptors, there has never been a more exciting time to be part of the optometric profession. The strong sense of camaraderie and resiliency within the optometric profession will help us overcome the challenges of these trying times. Rapid advancements in telehealth, virtual education, and artificial intelligence continue to have a positive impact on optometry, allowing today’s eye care providers to be more versatile than ever before.
