William Holmes¹
Jyoti Paul¹, Claire Mallon¹, Fiona Cruickshank¹ and Catherine Porter¹
1 The University of Manchester

Optometrists are healthcare professionals specialised in eye care. The current UK route to becoming an optometrist involves completing a BSc programme followed by a 1-year full-time clinical placement. During this placement, work-based assessments and OSCEs are conducted by the the College of Optometrists. The regulatory body overseeing optometry in the UK, introduced new standards and outcomes for programmes in 2021. These provide an opportunity to re-think how we assess clinical competence at the University of Manchester. 

We plan to use Entrustable Professional Activities (EPAs) to assure the appropriate level of competence for progressing between years of study and for the terminal decision regarding registration for independent practice. To our knowledge this would be the first time EPAs have been used in optometry. Our research questions are as follows 1) What are the EPAs for UK optometric practice? 2) What level of entrustment should be gained for progression and registration? 3) Should a different set of smaller EPAs be used in early year studies 4) What type and volume of data will the competence committee need in order to make progression and registration decisions. 

For questions 1 to 3 our plan is to use a small team of academics and clinicians to draft EPAs and suggested levels according to AMEE guide 140 (Ten Cate and Taylor, 2021) and then refine these with a wider group using the Delphi method according to AMEE guide 111 (Humphrey-Murto et al., 2016). As of August 2023 we have started the process of drafting the terminal EPAs (n=13). In the next 6 months we hope to have completed the drafting and have the Delphi stage under way. We would welcome the opportunity to discuss our overall approach, alternative suggestions for verifying the draft EPAs, how to operationalise them and methods for addressing research question 4. 

References (maximum three) 

Ten Cate, O., & Taylor, D. R. (2021). The recommended description of an entrustable professional activity: AMEE Guide No. 140. Medical teacher, 43(10), 1106–1114. https://doi.org/10.1080/0142159X.2020.1838465 

Humphrey-Murto, S, Varpio, L., Gonsalves, C. & Wood, T.J. (2017) Using consensus group methods such as Delphi and Nominal Group in medical education research, Medical Teacher, 39:1, 14-19, DOI: 10.1080/0142159X.2017.1245856