New optometry degree addresses recruitment and retention problems in Scotland

Head of optometry at the University of Highlands and Islands, Alison MacPherson, tells OT  about plans for a new optometry course


What is the optometry degree the University of Highlands and Islands (UHI) is developing?

It is a four-year undergraduate BSc honours degree programme in Scotland with a high amount of clinical content from year one that uses a problem-based learning approach. We’re in the process of accreditation with the General Optical Council (GOC) and are hoping to start in September 2020.

Because of the structure and ethos of the university, students will be based at two campuses for this programme to make it accessible for a wide range of local students. They will be taught as one cohort with around two-thirds of the students based at Inverness College and a third at Moray College UHI in Elgin (pictured).

Why was the decision taken to launch a BSc in optometry?

The main reason is to do with the workforce in Scotland for optometry. When you look at the North and the North East of Scotland in particular, there is huge difficulty in recruiting and retaining clinicians in a number of disciplines. The university has been working in conjunction with health boards and industry on degree provision to address this.

How does the course address this issue?

If you think about the geography of Scotland, the land mass of the Highlands and Islands covers about half the area of Scotland, so in terms of the communities that the university serves, it is a massive area. In terms of eye care provision, there are huge issues around workforce and access to services. That combined with an ageing population who have more potential for eye disease means that you are able to look after people as much as possible in their communities. That’s been the driver for the programme.

This is an exciting clinical degree programme that will attract locals and others, which will lead to greater recruitment and retention. The university has great experience of this in other disciplines and have an established BSc degree programme in nursing. There’s data on recruiting students from the local area and if you do this retention is very high. If you are giving people the opportunity to study in their local area, they are more likely to stay. This is really important when doing workforce planning.

There is huge difficulty in recruiting and retaining clinicians in a number of disciplines


What makes this course unique?

We’re creating a new type of optometry degree. We’re working in conjunction with Deakin University in Australia who has created a curriculum that is very clinically-based from the start and it is centred around the problem-based learning approach to clinical cases. It’s an approach that has been used for a long time in medical education. Deakin’s programme combines problem-based learning and team-based learning. That’s the structure of the curriculum we’re looking to bring in for the optometry programme at UHI.

It’s a different type of programme to those that already exist in UK optometry education. We want students to be very clinically-orientated, become critical thinkers, be able to solve relevant clinical problems and to deal with patients in a holistic way. Reflection and lifelong learning are key drivers for the way this programme is run. While they are still learning about individual eye conditions, they’re also learning how to apply that to real life situations.

In year one, there are a series of modules that will prepare students to take on problem-based learning, which is a very different way of being taught. We’ve designed the programme to support people coming from secondary to tertiary education with the skills that are required to do this. In years two to four, the students are given cases each week to work on both individually and in teams with a lot of support and guidance.

We want students to be very clinically orientated, become critical thinkers, be able to solve relevant clinical problems and to deal with patients in a holistic way


What practical experience will students gain on the programme?

Students will receive clinical skills training at the university in specifically designed workshops but they will also go out on clinical placements from year one. Over the course of the programme, students will be out for at least 19 weeks in total on a combination of community and hospital placements. They will go on an extended placement in their fourth year in community practice, which will be at least 12 weeks – 10–11 weeks in community practices and at least one to two weeks in ophthalmology clinics in the hospital eye services across the North of Scotland. They will gain the necessary patient episodes as required by the GOC with experienced optometrists as supervisors and also undertake the core competencies required by the GOC in the university setting. From year one they will be seeing real-life patients in real-life settings, which is vital for their future practice.

How will the course prepare students to lead the future of the profession?

If students are taught in a linear fashion where they learn about eye conditions in isolation, it is difficult for them to put all of that together in practice. The fact that they are going to be taught in a problem and case-based way means they are well equipped to be critical thinkers. That’s really important for the way that optometry is changing in terms of there being more of a focus on shared care. The ability to solve and differentially diagnose clinical problems presenting to them is critical. Reflection by the students, university staff and placement staff on all aspects of clinical practice are built into this programme and are key to GOC requirements for all. We believe that the way this programme is designed will equip students to deal with all of this. They will understand from an early stage what being an optometrist actually means. It’s not just about clinical skills, it’s about their ability to develop good communication skills and work in a multi-disciplinary team – all of the things that will make them a good optometrist.