The Changing Face of Continuing Professional Development

The value of continuing professional development is a given. In these days of continuous research and development where new technologies and knowledge sharing are providing greater insights into complex disease and corresponding management or treatment strategies, it’s essential that optometrists do all they can to keep abreast of ocular health.

As primary eye care practitioners, optometrists must have a broad knowledge of pretty much all eye conditions and are expected to know how to identify them, know when it’s appropriate to commence treatment or refer on (and how quickly to do so), understand complex therapeutics and the ramifications these may have on individuals with systemic conditions, and/or those taking other medications – or with allergies.

In 2010 the Australian Health Practitioner Regulation Agency introduced compulsory continuing professional development (CPD) in an effort to have greater control over optometrists who, until then, had been self-managing their professional learning.

This type of event wasn’t around 10 years ago… They talk about all different subjects – nothing necessarily too complicated

It made sense. While many optometrists had the very best of intentions when it came to growing their knowledge, time would often slip away from them. As well, the need to pay a fee for professional education, while at the same time losing income by being away from the practice, was a disincentive.

One optometrist (whose name I was forbidden to publish) told me that 30 years ago he took a particularly relaxed approach to CPD. “I’d attend a few product launches, maybe go to SRC, read a few articles and that was about it,” he said.

Optometry Australia’s National Professional Services Manager Luke Arundel said back then, the Association’s approach to CPD was relatively relaxed.

“CPD was viewed as an essential part of optometry to maintain and improve the standard of care provided to patients and keep practitioners ‘up to date’ in a rapidly changing professional environment, but it wasn’t enforced.”

In 2007, for example, an official Association document indicated that if a member failed to meet the annual CPD requirement, the penalty would include removal from lists published on the website, and higher excess payments on professional indemnity insurance. Hardly tough when compared to today’s approach by the Optometry Board of Australia (OBA).

More Teeth

The OBA’s continuing professional development registration standard states: “Optometrists must complete a minimum of 80 points of CPD activities over two registration periods… All registered optometrists must make a declaration at annual renewal that they have or have not completed the CPD required under this standard over the previous two registration periods. Registered optometrists who fail to make such declaration, or who cannot satisfy the requirements, may be refused renewal of their registration and/or endorsement for scheduled medicines… In order to determine compliance with this standard, the Board may at any time request a registered optometrist to provide their CPD records for audit by the Board.”

Optometry Australia (OA) administers the CPD accreditation program on behalf of the Optometry Board Australia. Two optometrists supported by administrative staff review, assess and accredit CPD applications based on the Board’s criteria. An independent CPD assessment panel and external auditor have also been introduced to ensure that accredited CPD delivers high quality education.

Mr. Arundel said the introduction of random auditing by OBA had given the CPD requirements “more teeth” because CPD “now really is compulsory and officially linked to registration”. As a result, he said, everyone has begun to take the requirements more seriously.

That can be evidenced by mivision’s online CPD program, participation of which has continued to climb since its introduction in 2011. In 2014 (up to CPD deadline 30 Nov), mivision provided more than 18,000 CPD points to optometrists in Australia, an increase of 20 per cent on 2013. The number of optometrists participating in mivision distance learning also increased – from 986 to 1,218 – with each optometrist completing an average of seven and a half modules and earning 15 points towards their 40 point total. In the first two weeks of October 2014, a record 1,201 optometrists visited mivision’s learning centre.

More Providers

Compulsory continuing professional development has also led to an explosion of CPD providers who have entered the foray offering face to face CPD, conferences, online courses, webinars, in print and via product launches. These include special interest groups and societies, business trainers, universities, equipment and product suppliers, ophthalmology clinics, corporate optometry groups, Optometry Australia, allied health groups, and others who can assist optometrists with their ongoing professional development,
within the scope of the Optometry Board of Australia’s CPD registration standard and the guidelines.

Specsavers, for instance, makes about 80 CPD points available that include 50 face-to-face points plus online activities. The organisation’s conference is open to the non-Specsavers community and this year part of its CPD program will be accessible via education articles published in mivision. Optometrists can also plan self-directed learning objectives and undertake activities themselves to meet the CPD requirements.

Kylie Harris, President of Optometry Victoria, said the wide range of CPD options available for optometrists provides the luxury of choosing areas which are really of interest. “Optometrists are able to select CPD options that facilitate a wide range of themes, including inter-professional relationships, clinical and therapeutic topics and practice management – all of which are equally valuable. Importantly, they can access these options in different formats and timeslots – and that allows them to continually challenge their learning.”

That flexibility is of greatest importance for optometrists working in regional locations where it is costly and a challenge to find locum cover in addition to the burden of travel. There are also many who simply prefer the convenience of being able to further their learning at a time that suits them, while at the same time juggling the needs of a demanding practice and busy family life.

Out of 750 CPD programs available each year, an optometrist can pick up 2,750 points. “December and January are quiet periods for CPD,” Carey Meagher who currently works as a locum optometrist told mivision. “However once we get into February and March, there are many occasions where two CPD evenings or more are held on a weekly basis.”

Mr. Meagher wasn’t complaining: “The more choice you have, the merrier. It means no matter how busy you are, you can find the topic, the location and the time to suit you.”

That competition to win the attention and participation of delegates is driving providers to evolve their offerings in an effort to better meet the needs of optometrists and exhibitors.

Centre for Eye Health for instance, provides the majority of its CPD as webinars. Since 2013 CFEH’s Learning for Vision Centre has offered 10 webinars a year, which for a total outlay of AU$199 and an hour a month online, can give optometrists 30 CPD points – many of them therapeutic. Michael Yapp, Chief Staff Optometrist at CFEH, said webinars are increasingly popular and perhaps, a way of the future, because they satisfy the requirement for face-to-face. In doing so they obviate the need to travel to conferences or seminars.

“A lot of people find it difficult to get to conferences. They are geographically isolated and have family commitments as well as their practice to manage so being able to get their face-to-face CPD via a webinar works well for them. We try to include a wide variety of topics in the program by gathering case studies from the optometrists who work at the Centre for Eye Health, the aim being to make the sessions interesting and clinically relevant,” said Mr. Yapp.

SRC Opts for Intimacy

Established CPD providers are also responding to the changing landscape of CPD. Australia’s largest optometry conference, Southern Regional Conference, is an example of a conference undergoing evolution. In 2016, it will move from the Melbourne Exhibition Centre to the more exclusive Pullman Hotel in Albert Park and run for two days, from 5–6 March, instead of the traditional three.

Optometry Victoria CEO Pete Haydon said the change was all about meeting the needs of delegate optometrists as well as the exhibitors by “creating a discreet, professional event”. He said there were several reasons to do so, and while the move had been considered for some time by the Board, it was now the right time to make the change.

“I got feedback from more than 100 delegates at SRC this year and their main concern about any conference was the program. They want a good, clinically relevant, yet broad-based program. So they want to hear about the cutting-edge technological aspects of their work, but equally, a large cohort of high street independent optometrists also want sessions on practice management, changes to Medicare and so on.” Mr. Haydon said the Pullman Hotel’s meeting rooms offered a variety of spaces that could be customised to suit intimate meetings of 10 or 20 guests up to seminars for around 800, as opposed to the vast plenary rooms at the MEC, which seat 1,500, and therefore can feel a little sparse during many of the more “niche” sessions.

“The best speakers these days run interactive sessions, so sometimes smaller rooms that are full, generate the energy; the vibe needed to help make these interactive sessions really successful,” said Mr. Haydon.

Tony Martella, Chief Executive Officer of Optometry Western Australia and Chair of Optometry Australia’s Education and CPD Working Group, said it was important to constantly review conference formats. “CPD has to be dynamic and constantly evolving over time to be responsive as to the needs and expectations of the profession”.

Mr. Martella said Optometry Australia and the State divisions collectively have been offering CPD for decades. They understand its importance for the profession and the role it plays in improving the scope of practice and skills.

“There’s a spirit of cooperation and commitment between the divisions to develop the best possible education and conferences – both in quality and content – for our members. We want our CPD to be viewed as the best available in the country.”

He said to this end, conferences and CPD were designed and planned by optometrists for optometrists, with content that was evidence-based and promoted best practice. “Wherever possible we also utilise technology in the delivery of our CPD – keypad assessments, smart phone apps, online access to presentations and webinars for instance, have all proved popular and easy to use by delegates. The use of clinical workshops involving real life pathology and clinical examples, including the use of patients, is also a key example and differentiation of how OA CPD is delivered.

“In addition to a strong suite of optometry speakers, both domestically and internationally, our intention is always to engage with individual members as well as the broader health community by drawing on the expertise of ophthalmologists and general practitioners.”

Seminars and Webinars

The Australian College of Optometry in Melbourne was originally founded in 1939 to train optometrists. Although optometry training is now undertaken in tertiary institutions, the College continues to
work closely with the University of Melbourne, and other universities,
in optometric education.

In addition to its traditional seminar lecture series, the ACO offering has evolved to include clinical workshops, online courses, face-to-face webinars, an annual national conference and CPR courses. Some of these programs contain assessment components. Maureen O’Keefe, CEO of the College, said, “of particular interest and relevance is the introduction of an OCANZ accredited therapeutics course, which is up and running and proving highly popular as a result of the therapeutic endorsement of optometrists. This course is available to ACO members and non-members across Australia and New Zealand.

“We’ve also found that our face-to-face webinar series is very popular and has the advantage of enabling optometrists from interstate, rural and overseas locations to access timely relevant programs whilst earning CPD points,” said Ms. O’Keefe.

She said technology had changed the expectations of participants considerably with entire courses now conducted online through ACO CORE, which is the College’s Centre of Online Reference and E learning. “Online learning courses and webinars have increased the participation of members and non-members from across Australia and overseas,” said Ms. O’Keefe.

“Presentations from seminar series and webinars can be made widely available. They can be downloaded as podcasts so members can revisit topics of interest or use the material as a remote learning option if unable to attend the seminar in person.”

Strategic Choices

NSW optometrist Emanuel Spanos said despite many conferences running throughout the country, he rarely attends more than one a year. That one conference, he said, is SRC, primarily because, for the past 10 years, he and his wife have used it as an opportunity to spend time in Melbourne.

“There are plenty of opportunities to acquire the necessary points, I typically attend SRC, get 28 points from mivision and then I’ll attend seminars by ophthalmologists, which normally come with six points each.”

He said he picks and chooses topics according to his interests and areas he believes will give the best knowledge.

“Everyone needs to get some education – there are always different ways to look at a treatment or a condition and so I always walk away from a CPD activity knowing something I didn’t already know.”

At Specsavers, franchisees have been asking for even more CPD options and according to the company’s Optometry Development Manager Dr. Ben Ashby, the organisation has responded by delivering more education sessions at its annual Specsavers Clinical Conference.

“This year we will also be running ‘speed dating’ CPD and we will release a number of Specsavers-sponsored CPD articles.”

Dr. Ashby said the CPD program is developed based on feedback and requests from optometrists. “The content is broad ranging – from Grand Rounds where our optometrists present cases to their peers – (to) clinical Masterclasses delivered by either ophthalmologists or optometrists (who have) specialised in their field, and events on growing the business through professionalism.”

He said the annual Specsavers Clinical Conference grows in size every year, attracting delegates from around Australia and New Zealand, including “quite a large group” of non-Specsavers optometrists.

Mixing It Up

Having been out of university for 35 years, Carey Meagher said he prefers mixing his CPD program up between online, one-day seminars, ophthalmology events, Contact Lens Society evenings and product launches. “I know a lot of people like SRC – many go to a conference like that, get all their points then don’t do any further CPD across the year. Personally, I don’t think that’s the best way to go about it… I find the prospect of attending a multi-day lecture program/conference somewhat of an information overload
and relatively expensive.

“The online courses I do are through mivision – the topics interest me and it’s convenient to sit down, read the magazine, complete the questions and get the points. It’s also free. There are plenty of international online CPD programs out there but if you can get the same level of education at no cost, why would you pay?”

Mr. Meagher has been acquiring approximately 75 points each year for the past four years – well over the required 80 points every two years, with 30 per cent of those acquired online. He said the Contact Lens Society evenings are usually very interesting and attract a younger, vibrant crowd.

“Ophthalmology groups such as Eye Surgery Associates, Eastern Retinal Services and Vision Eye Institute put on nights that are also beneficial – we learn more, it works well. It’s also a good way to put names to faces – it gives you an idea of who they are and their specialties – so we get an understanding of who we should be referring to.

“These types of events weren’t around 10 years ago… the ophthalmologists talk about all different subjects – nothing necessarily too complicated – they make it relevant to optometry – the latest in cataract surgery, glaucoma management, diabetes etc. When we were studying at Melbourne University, technology like OCTs weren’t invented, so at these evenings we often have hands on sessions with small groups so you really get to understand the technology.”

Ms. Harris said the increasing number of CPD events means some providers offer courses to meet their own strategic needs, as well as optometric learning needs. “A device company, for instance, might offer CPD on interpreting OCT because they want people to buy an OCT – but that doesn’t mean they are not offering quality education. The criteria set down for CPD are stringent and optometrists provide the checks and balances by providing feedback on the learning experiences.”

Question the Value

Ms. Harris said it was important that optometrists continue to challenge information presented and provide feedback on the CPD activities they participate in. “It is very easy to attend or complete an activity, to soak up the information without questioning its validity or relevance. I encourage optometrists to take absolute responsibility for their learning. Challenge what you are being told, ensure the information you’re receiving is robust and fulfilling.”

Maureen O’Keefe at ACO and Colin Waldron, Chair of Optometry Board of Australia agree.

“Many presenters are not trained educators so there will always be some variability. This is one reason why the Board has a process for accrediting CPD, which will encourage quality improvements in content and delivery in all formats,” said Mr. Waldron.

Ms. O’Keefe said: “The question we should ask ourselves is ‘Does CPD matter or is it simply about maintaining compliance to meet registration requirements?’ Quality CPD is about enabling practitioners to deliver the best possible care. CPD should be delivered with a focus on achieving quality improvement in optometry practice, which will lead to improved health outcomes for the community.

“This purpose is reflected in the CPD standard set by the Optometry Board of Australia which says, ‘Continuing professional development (CPD) is a means by which optometrists maintain, improve and broaden their knowledge, expertise and competence, and develop the personal and professional qualities required throughout their professional lives’.

“Unfortunately, not all of the CPD currently on offer for the optometry profession is of an appropriate standard to achieve improvements in the quality of optometry practice. CPD programs and activities should address practitioner education and training needs, actively engage practitioners in life-long learning, be relevant and useful to daily practice, and integrated with the needs of patients,” said Ms. O’Keefe.

FACE-TO-FACE STILL CRITICAL

Ms. Harris said despite the proliferation of CPD online and in print, face-to-face education sessions at conferences will always be an important component of the profession’s CPD. “Optometry Australia state-run conferences provide the opportunity for optometrists to gather and that’s critical for directing the future of our profession – private practice can be quite isolating, and getting together provides an opportunity to discuss issues which face the profession; to understand different perspectives.”

Ultimately, Mr. Waldron said, CPD is not just about fact finding. “The Board is still of the opinion that ongoing professional development is not just about learning facts but forming opinions and listening and questioning others that should be a part of a professional approach. This process still requires a ‘face-to-face’ interaction component, and newer technologies are making this possible in different ways.

Meeting Registration Requirements

The Optometry Board of Australia states that optometrists must complete a minimum of 80 points of CPD activities over two registration periods. This can be met by undertaking accredited, non-accredited activities or a combination of both. Additionally,

“Of the 80 points over the two registration periods: no more than 20 of the 80 points over two registration periods may be obtained by completing activities relating to optical goods and equipment provided by suppliers or manufacturers; and “40 of the 80 points over two registration periods must be in education related to endorsement for scheduled medicines for those optometrists endorsed under section 94 of the National Law… In addition to a minimum of 80 points over two registration periods, all registered optometrists must have completed, within the previous three registration periods, training in cardiopulmonary resuscitation (CPR) provided by or through an approved training provider.”

Accredited CPD activities are CPD activities that have been accredited by the Optometry Board of Australia (OBA) in accordance its guidelines.

Non-accredited CPD activities are CPD activities that have not been accredited by the Board. Optometrists are able to meet the requirements of this standard by completing non-accredited activities; however, the record keeping requirements are different and in the event of an audit, the activity will be reviewed against the same Board criteria applied to accredited CPD.

For non-accredited CPD there are additional reporting requirements over accredited CPD, which are the responsibility of the optometrist.

In their CPD portfolio they must list:

• the learning objectives of the activity
• how it relates to the individual personal CPD needs, and
• an evaluation of the activities to determine whether the desired outcomes have been achieved.

Supporting documentation must also be provided in the form of:

• receipts or other proof of attendance
• diary entries, and
• activity programs/brochures that describe the content and learning objectives of the activity.

Full information on CPD requirements for registration can be found at optometryboard.gov.au

Conference Points

Last month (April) Optometry Queensland hosted the Australian Vision Conference, two-and-a-half days of educational sessions with a trade show at the Gold Coast Exhibition and Convention Centre.
On offer were 50+ CPD points.

This month, on Sunday 24 May, Optometry NSW will host Super Sunday with 48 CPD points on offer, including 42 therapeutic points. In July the Australian College of Behavioural Optometrists will host its national conference in Brisbane with 24 CPD points attached. Other two-day ACBO conferences throughout the year also offer 24 points.

From 8–9 August optometrists are invited to earn CPD points at WAVE in Perth (for around 43 points) then from 28–30 August more points are on offer at the Tasmanian Lifestyle Conference. In October, Optometry Queensland will host the North Queensland Vision, with 40 CPD points on offer and finally, from 21–23 November, Blue Sky takes place in South Australia.

Every second year, ODMA weighs into the mix with its own educational programs. This August ODMA will offer optometrists up to 30 therapeutic CPD points for attending clinical lectures on Fabulous Friday as well as a masterclass program spread over the three day conference for practitioners and staff. ODMA CEO Finola Carey said while the objectives for the education program have remained the same, the format has changed. “We offered a 40 point CPD program over a day and a half in 2013 but have changed that to our Fabulous Friday 10 hour intensive in 2015… Our event is differentiated quite simply because we are an exhibition with a conference not a conference with an expo.”