This series of articles is based on the question above, and this is the final article on the subject. 
Are opticians ready for change? 

The author has taken a great deal of time to describe changes happening all around us, and unfortunately we are simply letting them take place with little voice in the matter. Let us look at change itself for a moment. Much of this comes from a research project conducted earlier, and offers the following:

Supporting Theory of Change

This research is based on two supporting theories and a construct from another to study the problems facing opticians. The theories of action were developed from earlier research by Chris Argyris and refined by Argyris and Schön in 1974. It’s actually two theories, theory-in-use and espoused theory. This study will apply the theory-in-use version. The theories of action (theory-in-use and espoused theory) developed by Argyris and Schön in 1974 and the Decisional Balance construct from the Transtheoretical Model support some of the important constructs in this study. Understanding these theories is important to grasp the study’s complexities which underlie the nature of the problem being studied.

Argyris and Schön considered three elements in their model: Governing variables, Action strategies, and Consequences. Governing variables are described by Smith (2001) as values that people strive to keep within an acceptable range. This in turn has an effect on a person’s action strategy, the second element in the model. Action strategies involve a person’s actions to keep their governing variables within an acceptable range (Figure 1). This is a critical element in the model, particularly when there are conflicts between different governing variables. For instance, in this study it may be found that there is a conflict between the governing variable “income” and “education” where an optician may be satisfied with their current income and disregards the need for more education although the consequences may be a loss of income. In this case the optician will probably believe that the result of their inaction not to increase their education will not affect their income. Additionally, trade-offs between governing variables are usually made when the action strategy is developed.

The third element in the theory-in-use model is the consequences of the action strategy used by the person. When there is congruence between the governing variables as the action strategy is implemented, the consequence of the strategy is confirmed. In other words, the theory-in-use is confirmed. However, if the consequences are unintended, that is the action strategy worked against the governing values (variables) then the person must reflect on or “learn” how they can make the action strategy more effective. This is called single-loop learning.

Double-looped learning occurs when the correction of the unintended consequences result in the modification of a person’s or an organization’s values, goals, or underlying philosophy. In this case the person or organization questions the governing values and they must learn to develop a new action strategy.

Argyris and Schon's theory on congruence and learning directly applies to the problem confronting opticians in the United States. It is a group with varied educational, training, and licensure differences. Their governing variables differ significantly from person to person and the consequences confronting opticians if they make the wrong decisions are significant.

The Decisional Balance construct of the Transtheoretical Model, as described by Velcier et al. (1998), is utilized in this study to explain the change that the study’s key constructs may be subjected to as opticians go through a process of change. The Decisional Balance construct shows how an individual considers the importance of pros and cons of various decisions and how they change as they progress through the five stages of change (http://www.uri.edu/research/cprc/TTM/detailedoverview.htm). Although the Transtheoretical Model and the Decision Balance construct is intended to explain individual behaviors, it is applied to organizational behaviors in this study. It is further theorized that the behaviors of opticians as a group is actually the sum of the individual behaviors.

The five stages of the process of change are as follows:

Precontemplation - In this stage people do not have the intention to change or take action. They are characterized as being uninformed as to the consequences of their present condition.

Contemplation - People in this stage intend to change as they become more aware of the pros and cons of changing. They may still be ambivalent to the situation.

Preparation - People in this stage intend to take action in the near future. They have an action strategy but it has yet to be implemented.

Action - In this stage people have implemented their action strategy.

Maintenance - In this stage Velcier et al. (1998) describe it as a stage where people are “working to prevent relapse but they do not apply change processes as frequently as do people in action” (Smith, 2001). This is where the construct as presented by Velcier, et al, is redefined for this study. For this study, the Maintenance Stage represents the stage where the person or organization is confronted with the consequences of their actions or action strategy. If the consequences are positive then efforts are made to maintain the positive consequences; however, if the consequences are not positive and go against the interests of the organization then “learning occurs” and a reconsideration of the actions previously taken have to be made in order to move forward. The modified Decisional Balance construct for this study is shown in Figure 2.

The Transtheoretical Model’s Decision Balance construct describes the stages of change from the early contemplation of the need for the intervention, to the recognition and discussion of the pros and cons, to the preparation to change, to implementation of the intervention, to measurement of outcomes. This theory aptly describes the process opticians are currently undergoing. The profession is at a place in time where there is recognition of the need to change and discuss the direction it needs to take in the future. (Opticians Association of America, 2002) This research will be a step towards helping to decide proper change strategies by providing some direction as to the education and training required of future practitioners.

Discussion and Conclusion

I often wish I had a much greater amount of time to write on these issues, and will eventually turn my thoughts into a book on the subject. Unfortunately opticianry is a different kind of animal, as any talk of moving to a formal education system is met with great disdain from many, because it was the way they were trained. As I have shown, it is the Achilles heel many do not want to talk about. I have shown that we are far behind our international peers, and that the general public has much higher expectations of us than we can currently meet. Technology and changing demographics require we change, and the general lack of licensure requirements validates that we are not really recognized as a profession in most states in the United States.

We must improve and not only accept, but embrace new concepts to advance this field beyond where it now resides, or I, for one, feel it will be too late. My comments are not meant to offend anyone who trained as an apprentice. Far from it, I want the entire field to improve, and that will not only help the future optician, but will lift all boats! Think about it, and join me in the effort to advance opticianry through education. We need your help, the profession needs your help, and at the very least, I hope I have stimulated some thought and discussion on the matter.