Second day of WCOG meeting focuses on education, standardization of goods and services

ORLANDO, Fla. – On Tuesday here at the World Council on Optometric Globalization (WCOG) meeting, presenters from around the word discussed optometric education and assessment strategies at the global level as well as international standardization of ophthalmic goods and services.

Keynote speaker Marjorie Peace Lenn, executive director of the Center for Quality Assurance in International Education, Washington, said the purpose of the morning session was to present a global context in which optometry could assess its current state and determine what steps it might wish to take for the future direction of the profession.

According to George Woo, dean and faculty member, Health and Social Sciences, Hong Kong Polytechnic University, and a member of the World Council of Optometry Education Committee, Hong Kong, the development of optometric education in China has been slow relative to medical education. He pointed out that while the development of optometry in Hong Kong is very different than in China and Taiwan, the role of optometrists should be the same. He urged regular interaction among leaders of the profession to harmonize the differences.

The European Council of Optometry and Optics (ECOO) established the European Diploma in Optometry to establish a performance and competence level, said Kjell Inge Daae, professor in the Department of Optometry, Buskerud College University, Kongsberg, Norway. However, because Europe represents diverse cultures and languages, it is necessary to establish a decentralized accreditation system for schools. Further diversification must be avoided as a result of these efforts, Dr. Daae said, instead, concentrating on the Bologna Declaration, which says: “It is a commitment freely taken by each signatory country to reform its own higher education system in order to create overall convergence at the European level.” He said it is likely that an accreditation body will be proposed as part of ECOO.

Any optometrist seeking licensure in Canada must pass the Canadian Standard Assessment in Optometry (CSAO), according to J. Martin McDowell, executive director of the Canadian Examiners in Optometry, Ontario. He said the Canadian Examiners in Optometry is responsible for setting these exams, which were designed from statements that articulate the competencies necessary for optometric practice. Mr. McDowell said the CSAO is distinguished from exit examinations of professional educational institutions or examinations based on curriculum.

Setsuya Tsuda, president of All Japan Optometric and Optical Association, Tokyo, said that the AJOOA has adopted a private-sector, self-certification system that depends on each person’s amount of education and training, to use as a first step toward a national licensing system. The AJOOA also seeks to establish an official licensing system by upgrading and continuing optometric education, obtaining consumers’ support for the system and obtaining cooperation from international optometric organizations.

Lane Hallenbeck, vice president of conformity assessment for the American National Standards Institute (ANSI), Washington, described the role of the ANSI as a member of the International Organization for Standardization (ISO). He said that the activities of standards committees relevant to the World Council of Optometry are being influenced by globalization, deregulation and convergence of technology.

After establishing basic standards for optical and geometrical properties, the Spectacle Lens Group of the ISO is focusing on the characteristics of lens coatings, said Werner Koeppen, director of quality and norms for Essilor International and convener of the ISO Spectacle Lens Group. Another priority is frame requirements and tests to ensure physiological compatibility.

The American Optometric Association’s Jeffrey L. Weaver, OD, MBA, MS, director of the Clinical Care Group, focused on the implications of internationalization of optometric clinical practice guidelines. The AOA now has 20 guidelines available. They are reviewed on a regular basis to keep them current. Dr. Weaver said the key to the effectiveness of these guidelines is an evidence-based approach. And because patients also look at these guidelines on the AOA’s Web site, they can play a role in quality assessment and improvement. Potential harms of clinical practice guidelines could be flaws with inaccurate guidelines or the use of accurate guidelines as evidence in malpractice cases. Such guidelines can also establish optometry in the national arena of health care reform and managed care as well as offering implied standards of care, Dr. Weaver said. Clinical practice guidelines are beginning to proliferate internationally, he said. The Conference on Guidelines Standardization identified eight requirements for such guidelines: validity, reliability, clinical application, flexibility, clarity, documentation, development by multidisciplinary participants and plans for review.

Jorge Cuadros, OD, PhD, an assistant clinical professor at the University of California, Berkeley Optometric Eye Center and Informatics consultant, told attendees that telehealth will soon become a regular part of health care. Geographical location is no longer important with distance education; online continuing medical education is growing. He pointed out two different ways to practice telehealth and distance education: synchronous, where participants can interact at the same time, anywhere, with real-time communication; and asynchronous, using store-and-forward technology any time, anywhere. Quality requirements include interoperability, accessibility, adaptability, security and sustainability. A number of other groups around the world, including the G8 Global Healthcare Applications sub-Project 4, are adopting similar requirements.