Marian Elder is a clinical associate at the Centre for Ocular Research & Education, in the School of Optometry & Vision Science, University of Waterloo, Canada.
Interprofessional collaboration between healthcare professionals is a necessary and ongoing process that can improve patient outcomes.1 While optometry has long had a strong collaborative relationship with ophthalmology,2, 3 it has not always been incorporated into teams that include other primary care providers, like family physicians, nurses, pharmacists, nutritionists and social workers.4 Advancing the role of optometry within the interprofessional primary care team requires a better understanding of current perceptions. Christian et al. (2015) explored the potential role optometry can play within a Canadian interprofessional healthcare setting.
Christian L, MacIver S, Alfieri M. Evaluation of interprofessional education and collaboration in optometry. Optom Ed. 2015;40(3): 1-12.
Methods
Between January 2011 and June 2012, fourth-year optometry students at the University of Waterloo School of Optometry & Vision Science were offered the opportunity to participate in a one-day placement with the diabetes clinic of a local family health team, comprising physicians, physician assistants, dietitians, pharmacists and nurses, as well as students within each profession. Fifty placements were available for optometry students, and these placements were awarded on a first-come, first-served basis. The role of the optometrists on the team was to review the date of each patient’s last eye examination, provide input on patient management where applicable, and educate diabetic patients about the importance of annual eye examinations. Before attending the clinic, all students attended a lecture on interprofessional collaboration and the role optometry plays within the diabetes health team.
The optometry students completed two surveys. The first survey was administered following the lecture, and focused on their knowledge and attitudes toward interprofessional collaboration, and the skills that would allow them to practice on an interprofessional team. The second (online) questionnaire was administered after the clinic, and focused on evaluating the collaboration after-the-fact. This online questionnaire was also offered to all the health professionals and learners who also participated in the clinic.
Results
Pre-clinic survey responses (optometry students only)
Prior to participation in the clinic, student respondents strongly agreed that
- there is a need for health professionals to participate in interprofessional collaboration, and
- that doing so would provide enhanced patient care as well as collaborative management.
Most students felt that a better understanding of interprofessional collaboration was needed, and only half of the students surveyed were comfortable in their knowledge of which patients and situations would benefit from it.
Only half of the students were clear about which patients and situations would benefit from interprofessional collaboration.
Students’ attitudes about their ability to practice interprofessional collaboration and optometry’s role within an interprofessional team were variable. Many felt that:
- additional training in interprofessional collaboration was required for them to feel confident collaborating with other professions,
- having more expertise outside of optometry would help them to be more comfortable on a health team (79% and 85%, respectively), and
- they are more comfortable working within optometry than collaborating with other professionals (64%).
Although about half (55%) agreed that other health professionals are highly motivated to work with them in patient care, approximately the same number disagreed that physicians and other health professionals fully understand the role of the optometrist (57% and 48%, respectively).
The majority of students recognized the need to consider a comprehensive patient history within the framework of clinical decisions, though only a third admitted to consistently consulting other health professionals. Despite the lack of regular communication with other health practitioners, 78% felt that optometrists took the opinions of other health professionals into consideration when making clinical decisions.
Post-clinic survey responses (optometry students, other health professionals and students)
Although the post-clinic survey had a low number of respondents overall, trends seemed to indicate conflicting perspectives:
- Members of the family health team felt that collaboration with optometry was active, whereas most of the optometry students who responded felt that this collaboration was still in development and not yet at an active level.
Within the interprofessional team that participated in the diabetes clinic,
- the members of the family health team felt that there were equal contributions from all participating members, while the optometry students did not feel that they were always included as a part of the interprofessional team.
Conclusion
Optometry is one of the only health professions that does not have a dedicated interprofessional education component within its curriculum. This study highlighted hurdles restricting optometry’s participation within interprofessional teams. There is also a need to enhance the connection between optometry and other health professionals, both in terms of working together and communicating with each other. This change will come from incorporating interprofessional education into the current optometry curriculum.
Interprofessional collaboration is an area within which optometry continues to strengthen its role. By incorporating interprofessional education into the curriculum, graduating optometrists will have more confidence and understanding about how they fit into the framework of the primary care team. By enhancing communication and collaboration between all members of the interprofessional team, patient care and patient outcomes will only improve.
REFERENCES
- Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2009(3): CD000072.
- Budning A. Model of interprofessional collaboration in the care of patients with glaucoma and those suspected of having glaucoma. Can J Ophthalmol. 2011;46(6): 460-1.
- Canadian Glaucoma Society Committee on Interprofessional Collaboration in Glaucoma. Model of interprofessional collaboration in the care of glaucoma patients and glaucoma suspects. Can J Ophthalmol. 2011;46(6 Suppl): S1-21.
- Goldman J, et al. Interprofessional collaboration in family health teams: An Ontario-based study. Can Fam Physician. 2010;56(10): e368-74.
