How three optometry schools have adapted their teaching for the future

What the future holds for optometry students’ clinical placements was a key discussion point during an education training requirements (ETR) focused session at the AOP’s Hospital and Specialty Optometrists Conference (HSOC) 2024.

During the session, university representatives Will Holmes (University of Manchester), Rupal Lovell-Patel (University of Central Lancashire, UCLan) and Dr Andrew Logan (Glasgow Caledonian University) outlined the different approaches that their institutions have taken in adapting their courses to align with the new optometry degree requirements implemented by the General Optical Council (GOC).

HSOC 2024 was held at Emirates Old Trafford, Manchester, on 21 and 22 September.

The joint presentation aimed to highlight where optometry schools were before ETR changes were implemented, and what shape these changes have taken.

Holmes, a reader in optometry at the University of Manchester, began by giving an overview of how optometry education currently works, via an explanation of the Opticians Act and the work of the GOC.

The Opticians Act allows the GOC to accredit all or part of an optometrist’s education, Holmes said.

Traditionally, this has meant optometry education is a two-stage process, Holmes noted: a bachelor of science, followed by completion of the Scheme for Registration.

In theory, an alternative scheme could be established by an organisation other than the College of Optometrists and could be accredited by the GOC, Holmes said.

Discussing the process of updating optometry education via the ETR, he explained that a call for evidence was made by the GOC in 2016, with changes eventually coming into force from 2023 onwards.

Holmes identified the key changes required by the regulator: that optometry degrees would need to be at Master’s, rather than undergraduate, level; that 48 weeks of patient-facing experience must be integrated, and that training must be administered by one single, accountable organisation.

He also noted that new outcomes and quality assurance standards for institutions were laid out by the GOC.

Clinical placements from year one at Glasgow Caledonian University

The optometry degree course at Glasgow Caledonian University is now a five-year integrated Master’s and includes the independent prescribing (IP) qualification, Logan, senior lecturer in vision sciences at the university, told attendees.

He noted that the first students on the new programme were welcomed to the university in September 2024.

Students will spend the first four years of their degrees based at the Glasgow Caledonian University campus, where there are patient-facing clinics already established, Logan explained.

They will also complete short clinical placements during their first and second years, before moving onto a day release programme with the hospital eye service in their fourth year.

The course integrates a 52-week clinical placement in the fifth year of study, which will be taken in two six-month blocks to allow students to experience different practice settings.

At least one of these placements will be alongside an IP optometrist and the placement will be carried out alongside NHS Education Scotland (NES), Logan said.

Whilst undertaking their fifth-year placement students will be in clinics for four days per week and have one day of protected study, and will be expected to complete their IP qualification via distance learning at the same time.

They can expect support from a clinical supervisor and an educational supervisor, both of whom will be appointed by NES and will visit placement settings to assess learning outcomes, Logan said.

He also noted that Glasgow Caledonian University is consulting with the only other institution to provide optometry degrees in Scotland, the University of the Highlands and Islands (UHI), to ensure consistency for employers taking on clinical placement students.

The university will also move to a ‘spiral curriculum’ model of teaching, where knowledge and skills established early in the degree are expanded upon in later years.

“We are giving them the theoretical foundations,” Logan said.

He also noted that, because NES is funding clinical placements for students at Glasgow Caledonian University and UHI, these placements will need to be undertaken in Scotland.

Salaries for students on clinical placements in Scotland will be standardised as they will be paid by the Scottish government, Logan added.

“Pressure is on” for future UCLan students

Lovell-Patel, the academic lead for vision sciences at UCLan, outlined the different responsibilities that universities, the College of Optometrists and employers have under the new degree programmes.

Universities act in the capacity of an award provider, and are responsible for short clinical placements, remote learning during these placements, pastoral care, and decisions on student progression, Lovell-Patel said.

She explained that the College of Optometrists is responsible for approving optical practices for student placements, the application process, professional formation, quality assurance, assessing students in the workplace, and administering students’ results.

Meanwhile, employers will take on responsibility for employee matters, pay, specialist supervision, insurance, employment contracts, and the students’ overall workplace experience.

All information on clinical placements will be provided on the College of Optometrists’ CLiP portal, through which students will also make their applications, Lovell-Patel said.

She added that UCLan has moved towards a teaching model that values ‘outcomes,’ as they are broader than the ‘competencies’ required to complete the traditional pre-registration placement.

She acknowledged that, because the pre-registration placement that historically may have taken up to 15 months must now be completed in 44 weeks, “the pressure is now on” for students.

This will mean there are certain markers that employers must meet in order to keep students on track, Lovell-Patel said.

She noted that, because the Scheme for Registration will no longer exist under the new degree scheme, the College of Optometrists is working with the 12 universities who are using the CLiP system to ensure consistency for employers.

Lovell-Patel also outlined the timeline that students should expect, with their first CLiP placements taking place from July to December of their final year of study, followed by a second placement between January and May.

Students should be paid above the living wage whilst on placement, Lovell-Patel emphasised.

A final assessment, in the shape of the current objective structured clinical examination, will take place after completion of the second clinical placement, she said.

Students who fail the assessment will be afforded one more attempt, Lovell-Patel said. Those who fail for a second time may be awarded a non-registerable degree, such as vision sciences.

She noted, though, that students who appear unlikely to qualify will be offered the opportunity to repeat a year.

A “portfolio of feedback” will be used to assess whether students are in a position to progress through the course, she added.

Registrable degrees from graduation at Manchester

The University of Manchester has had a Master’s level optometry course since the late 1990s, Holmes told attendees, noting that this course has also been registrable with the GOC since the mid-2000s.

This has meant that students graduating from the master’s in optometry at Manchester have not needed to complete the Scheme for Registration via the College of Optometrists for the past two decades.

With all optometry degrees now at master’s level, the decision has been taken to move to this model of providing a registrable degree “from start to finish” under the ETR, Holmes said.

This is why the University of Manchester will administer its own clinical placements, rather than utilising the CLiP programme.

The university already has close relationships with organisations including Optegra and Manchester Royal Eye Hospital, Holmes noted.

He explained that the course will focus on team and case-based learning, with basic anatomy in the first year, built on through further focus on pathology in proceeding years, before students encounter patients for the first time in year four.

Students will engage with patient case studies in a team, similar to peer reviews undertaken by qualified optometrists as part of their continued professional development, Holmes said.

He also noted that the university is moving away from assessing single skills on a one-off basis.

In terms of short clinical placements, half will be undertaken in university clinics and the other half at Manchester Royal Eye Hospital, allowing for a number of different points of feedback.

This gives students good exposure across different settings and should reassure those who take them on for placements of their competence, Holmes said.

Students will complete a six-month placement in their fourth year and will be paid a salary for this.

Holmes encouraged optometrists throughout the country to express their interest in hosting Manchester students on clinical placements.

“[It is] really important to realise that, just because this is a Manchester programme, that doesn’t mean you have to be based around Manchester or the north west of England to be involved,” Holmes said.

“Inevitably, students of ours are going to come from across the UK and be willing to move to different parts of the UK.”

“We’re really keen to build a community in Manchester, around the north west of England, but more widely across the UK as well,” he added.

He described the supervision of optometry students on placement as “a piece within a picture” of a wider experience.

He also noted that the University of Manchester will have a smaller cohort of students going forward than they have had previously, as the 300 students admitted will be on a four-year, rather than three-year, course.

This will allow for more support, particularly for those who are struggling, Holmes believes.