Competence in use of Diagnostic Pharmaceutical Agents (DPAs)
When the optometry scope of practice was set, the scope included (among others), these three tasks:
Examination of the eye and visual system
Detection, measurement and diagnosis of variations, anomalies, defects and diseases of the eyes, adnexae and visual system and
Patient management including any or all of the following: treatment including prescribing; therapy; referral; review; rehabilitation; education; counselling & advice
Every task in the scope of practice has elements and performance indicators associated with it. Included in the performance indicators for the task of examination of the eye and visual system above, is:
screening for disease: (including)
gonioscopy
direct and indirect ophthalmoscopy (including binocular indirect ophthalmoscopy (BIO) and indirect (slit lamp) fundoscopy using a 90D or similar lens).
These techniques were specifically recognised as facilitating the optometrist’s capacity to examine the eye in order to be able to make a diagnosis and manage the patient appropriately.
The Board set standards and recognised certain qualifications as illustrating competence in the above techniques. The Board also introduced a recertification programme (as per section 41 of the HPCA Act) to ensure that optometrists who had not previously shown competence in these areas had a pathway to do so. The cut-off date for optometrists to prove competence in this area is 2010. To date a group of practising optometrists are yet to complete such a programme.
The programme available is the Department of Optometry and Vision Science (DOVS), the University of Auckland endorsement programme in DPAs. This programme is in two parts: a didactic (or theory) distance based learning component with an assessment at its completion; and a practical component that culminates in an Objective Structured Competence Examination (OSCE) in gonioscopy, BIO, and slit lamp fundoscopy.
Exemptions
However, registered optometrists in New Zealand come from many backgrounds of education and experience and the Board recognises that some optometrists, although not holding the relevant Board approved qualification(s) may be eligible for an exemption to either the didactic or the practical component of the DOVS endorsement programme (or to both) because of previous education (or experience).
Details of the avenues for exemption and a link to the application for an exemption forms are available below.
DPA Didactic Component
There will be two more opportunities to undertake the DPA didactic courses through DOVS, both in 2008. Course material will be the same in both courses (distance based study), but assessment will be in two formats. Optometrists will chose to participate in one or other of these courses. One format will be similar to the DPA recertification course already completed by DOVS, with the practitioner sitting a two-hour examination of multichoice and short answer questions. The other assessment format will be in the form of assignments that cover areas in which the practitioner must be safe, followed by a 10-15 minute oral with their peers. The first of these courses will be held early in the year. The Board will publish further information on this soon.
DPA Practical Component
There are two ways you can do the practical DPA component, the first being the DOVS Objective Structured Clinical Examinations (OSCEs). This will be available on various dates in August 2007, and other dates in the future. The Board will publish the dates as they become available. Please see below for information on the OSCEs.
OSCE assessment templates May 2007
Alternatively, you can choose to have an Ophthalmologist sign a declaration that you are competent in the examination techniques required with effective use of DPAs.
The Ophthalmologist must:
- be resident in New Zealand and hold a current practising certificate
- use and complete the appropriate examination sheets
- have access to the appropriate equipment that facilitates observation of the applicant’s diagnostic skills, or utilize another appropriate method by which competence can be assured
- sign a declaration stating they have observed the applicant to be competent in the area of binocular indirect ophthalmoscopy, slit lamp fundoscopy; and gonioscopy
SUPERVISION GUIDELINES FOR OPTOMETRISTS WITHOUT DPA ENDORSEMENT
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