|
The
American Optician
Where Do We Go From Here? Part
VII |
Well, this is the final
chapter in this series. It is important to me that my
profession is better when I am gone than when I began, and
this effort is my way of giving back.
Questionnaire Results
This study was based on the theory that
there is a positive relationship between the level of
education and training among professional Opticians.
Furthermore, it was theorized that licensure and education
is important to the growth and development of Opticians,
particularly in the area of advanced technologies in eye
care.
Specifically, it was hypothesized that
there would be a significant difference in income for
licensed Opticians when compared to those Opticians without
licensure. This study found that licensed Opticians did earn
higher incomes than non-licensed Opticians; however, the
difference was not significant although it was nearing
significance. More importantly, it was hypothesized that if
the practice of Opticianry was well grounded in education
then income would be higher among those Opticians with a
higher level of education.
Although the statistical tests between
the levels of education and licensure among Opticians and
areas of practice in the advanced technologies were
insignificant and not perceived to be very meaningful among
Opticians, this study found that when Opticians were
questioned specifically about the future needs of education,
it was found that it is actually quite important. Opticians
consider education as being extremely important or important
(85.9%), and 89% strongly agree or agree that an increase in
education should be required prior to attempting an
expansion of their scope of practice. This finding
apparently contradicts the importance of education to
practicing Opticians where it was found that the level of
education was not a significant factor in income or the use
of advanced technologies in practice. In reality, only 12%
of Opticians actually did refractions, although it is one of
the key advanced technologies that is considered to be
important to the professional Optician.
These contradictions between the
requirements for education, licensure and the use of
advanced technologies among Opticians can also be explained
by the Theories in Action Model. Opticians perceive their
immediate position as being in "an acceptable
range" whereas, they perceive the governing variables
in the future as being "out of an acceptable
range" and that an Action Strategy has to be pursued by
the profession. Of course, the action strategy consists of
increasing the educational requirements for practice as an
Optician and licensure for all Opticians. Actually, the
professional Optician has reached a consensus on this course
of action; however, there lacks a professional organization
with the leadership to direct Opticians to turn their action
strategy into an action to bring the governing variables of
the profession into "an acceptable range" once
again.
Delphi Panel
While consensus was not completely
achieved on all issues presented to the panel, there were
some important inferences for Opticians. First, the members
of the panel held much the same opinions, and were fixed in
their responses, no matter what degree or licensure they
held. Initially, it was believed that there would be
differences based on academic and professional backgrounds
of the panelists. That was not the case, and it became
evident throughout the process that the panel had similar
feelings about the issues presented regardless of
professional affiliation.
The opinions of the panel presented in
the first iteration remained constant throughout the
process, which consisted of two complete iterations and one
phone review to seek any additional changes. From the
process, several things were evident. It was clear that all
members of the panel indicated they believed that Opticians
in the future would be more involved in refraction, contact
lenses and low vision practice. This is indicated by the
positive response to the questions relating to scope of
practice issues. Each panel member indicated that an
increase in education and training is required for more
advanced practice, even with technology.
The panel indicated that at least an
Associate Degree is necessary to safely and effectively
utilize new technology in practice. This means that
approximately 38.5% of practicing Opticians are ill prepared
to safely and effectively utilize new technologies in
practice. Technology like computerized refraction systems
and advanced contact lens designs require significantly more
preparation than the traditional apprenticeship. The panel
did indicate that apprenticeship is adequate to maintain
current levels of service, including basic optical
dispensing, laboratory work and some basic contact lens
dispensing, but that a formal education component should be
required to provide safe and effective dispensing services
even at the current practice level.
The Delphi panel's strong consensus (100%
of the panel agreed completely on this question) that every
state should require a license for Opticians to provide
assurances that those dispensing eyewear to the public have
passed some minimal competency is important because it
raised the public safety issue. However, no empirical data
was presented that the lack of licensure for Opticians among
some of the states poses a risk to public health and safety.
The panel members also considered certification as not as
important as a licensure, which is issued by the state.
The final question on the Delphi Panel
considered asked the panel if Opticians should seek to
expand their scope of practice. All but one of the thirteen
panelists indicated that Opticians should expand their scope
into refraction, advanced contact lenses and low vision.
Each indicated, however, that an increase in education
should accompany that increase. The lone negative response
to this question felt in the response section that Opticians
could do many advanced level tasks, but only under the
supervision of a doctor.
Recommendations for the Future
It is clear from the research that
Opticians need to change the way they are educated and
trained to be able to utilize new technology and expand into
new areas of practice. If not, they will soon cease to exist
as a viable profession. Technicians in doctor's office now
do a great deal of what Opticians do and the data here
strongly suggests that licensure, certification, technology
or any of the variables described in the study data can be
utilized with little or not training. Both the questionnaire
participants, who were randomly selected and provide a broad
cross-section of the Opticians in the United States, and the
Delphi panel agree that this change is necessary for the
profession to advance. These two groups agree that Opticians
will be playing an advanced role in the future, particularly
as Optometry moves to a more medical model. In many
jurisdictions, Opticians have no requirements for education
and training, or licensure, and that must change for the
profession to meet the demands of practice in the future,
particularly if they want to increase scope of practice.
Based on technological developments, Opticians can assume
more professional responsibility, but cannot do it
maintaining current levels of education and training. The
Optician of today is different from state to state and
similarity of training should be a goal for the profession
and its leaders.
According to the questionnaire and the
Delphi Panel responses data, Opticians need to begin
planning now for more advanced levels of service to the
public, including refraction, more advanced contact lens
practice and low vision. Additionally the questionnaire
participants felt that management can be a role for the
future if Opticians are prepared adequately, and that
courses in business and management should be a part the
Opticians education.
Interestingly, the Opticians Association
of America, over a decade ago, decided in a resolution that
the Associate Degree was to be the entry-level requirement.
Nothing was done to carry that resolution to fruition. The
final question on the questionnaire indicates that a strong
political voice is necessary for Opticianry to move forward.
Unfortunately in the past, this has not been the case.
Political infighting and lack of leaders with a vision have
kept Opticians from advancement. Members of the profession
must elect leaders who can help the profession make the
transition from the current level to the future; leaders who
place the profession above self and individuals who value
the issues made clear in this research. Leadership and a
strong national voice is needed to move Opticians to the
next level, and modeling some of the other professions
mentioned in the research will provide a framework for their
efforts; particularly Optometry.
Where to go from here? Opticians can
choose their own path. But it is clear that change must
occur if they are to continue to exist as a viable
profession. Only 22 states license Opticians, and in the
jurisdictions where certification or licensure is not
required, there is little to no benefit to seeking higher
levels of education or achieving certification. Anyone can
work high levels of technology in doctor's offices and
seemingly be successful as a well-trained and educated
Optician if income is considered a viable measure of
success. This must change for Opticians to become recognized
as true professionals and it is entirely in their hands.
The author wished to extend his deep
appreciation to Mr. Jeff Smith, Publisher, Eye Care
Professional Magazine for allowing this series to be
published and recognizing the value of the professional
Optician. |
