Could entrustable professional activities support assessment in optometric clinical education in Australia and New Zealand?

Entrustable professional activities (EPAs) are increasingly being adopted as an assessment tool by medicine and other health professions in a bid to enhance competency-based health professional education. EPAs are well-defined professional activities that can be entrusted to students to perform with varying levels of supervision. They were introduced to overcome some of the limitations of traditional assessment methods of competency such as individual skills assessment or Direct Observation of Procedures and Objective Structured Clinical Examinations.

'Whatever the GP says, is what I'll do'-A qualitative study of patient perspectives in accessing primary eye care for type 2 diabetes.

Introduction: To investigate the perspectives of people accessing a general medical practitioner (GP)-optometry model of collaborative care that was established to increase access to diabetes eye care.

Methods: Qualitative study of patient barriers and facilitators to accessing primary diabetes eye care located in a metropolitan area in Australia. One-on-one interviews were recorded, transcribed and thematically analysed using a determinant framework on patient-centred access to health care.

Antimicrobial stewardship and education in optometry.

Clinical Relevance: Antimicrobial stewardship aims to improve how antibiotics are prescribed by clinicians and used by patients, to ensure safe appropriate use, and to prevent and contain antimicrobial resistance.

Background: Australian optometrists can prescribe a range of antimicrobial agents, but to what extent they consider antimicrobial stewardship is not known. This study evaluated what final-year optometry students and optometrists understood about antimicrobial stewardship in eye care and considered relevance to oral prescribing and education.

Strategies to address inequity of uncorrected refractive error in the Western Pacific: A modified Delphi process.

Purpose: Uncorrected refractive error is the leading cause of vision impairment globally; however, little attention has been given to equity and access to services. This study aimed to identify and prioritise: (1) strategies to address inequity of access to refractive error services and (2) population groups to target with these strategies in five sub-regions within the Western Pacific.

Methods: We invited eye care professionals to complete a two-round online prioritisation process.

Developing realistic benchmarks for glaucoma care delivery.

Clinical Relevance: Realistic benchmarks can serve as comparators for optometrists wishing to engage in clinical practice audits of their glaucoma care.

Background: The iCareTrack study established the appropriateness of glaucoma care delivery through clinical record audits of Australian optometry practices. Benchmarks required for monitoring and improving glaucoma care delivery do not exist.

Dendritic Cell Density and Morphology Can Be Used to Differentiate Vernal Keratoconjunctivitis from Allergic Conjunctivitis.

The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic conjunctivitis (AC), and non-allergic controls to examine if the allergy type causes differences in immune cell activation. The prospective study included 60 participants: 20 with VKC, 20 with AC, and 20 non-allergic controls. In vivo confocal microscopy was performed on the right eye.

Clinical indicators for diabetic eyecare delivered by optometrists in Australia: a Delphi study.

Clinical Relevance: Valid and updated clinical indicators can serve as important tools in assessing and improving eyecare delivery.

Background: Indicators for diabetic eyecare in Australia were previously developed from guidelines published before 2013 and then used to assess the appropriateness of care delivery through a nationwide patient record card audit (the iCareTrack study). To reflect emerging evidence and contemporary practice, this study aimed to update clinical indicators for optometric care for people with type 2 diabetes in Australia.

TFOS Lifestyle - Evidence quality report: Advancing the evaluation and synthesis of research evidence.

Evidence-based practice is a dominant paradigm in healthcare that emphasizes the importance of ensuring the translation of the best available, relevant research evidence into practice. An Evidence Quality Subcommittee was established to provide specialized methodological support and expertise to promote rigorous and evidence-based approaches for the Tear Film and Ocular Surface Society (TFOS) Lifestyle Epidemic reports. The present report describes the purpose, scope, and activity of the Evidence Quality Subcommittee in the undertaking of high-quality narrative-style literature reviews, and leading prospectively registered, reliable systematic reviews of high priority research questions, using standardized methods for each topic area report.

Enhancing the appropriateness of eyecare delivery: the iCaretrack approach.

Optometrists play an integral role in primary eyecare services, including prevention, diagnosis, and management of acute and chronic eye conditions. Therefore, it remains essential that the care they provide be timely and appropriate to ensure the best patient outcomes and optimal utilisation of resources. However, optometrists continuously face many challenges that can affect their ability to provide appropriate care (i.

Blink Rate Measured In Situ Decreases While Reading From Printed Text or Digital Devices, Regardless of Task Duration, Difficulty, or Viewing Distance.

Purpose: To compare blinking measured in situ during various tasks and examine relationships with ocular surface symptoms. The day-to-day repeatability of the blink rate and interblink interval was assessed.

Methods: Twenty-four students (28.

Increased dendritic cell density and altered morphology in allergic conjunctivitis.

Background: Corneal and conjunctival epithelial dendritic cells (DC) have an established role in vernal keratoconjunctivitis, however, their role in more prevalent forms of allergic eye disease remains unclear. This study evaluated corneal and conjunctival epithelial DC density, morphology, and distribution observed using in vivo confocal microscopy (IVCM) in allergic conjunctivitis.

Methods: In this prospective, observational study, 66 participants (mean age 36.

Dendritiform immune cells with reduced antigen-capture capacity persist in the cornea during the asymptomatic phase of allergic conjunctivitis.

Background: Increased density and altered morphology of dendritic cells (DC) in the cornea and conjunctiva occur during active allergic conjunctivitis. This study investigated whether inflammation (characterised by altered DC density and morphology) persists during the symptom-free phase of allergic conjunctivitis.

Methods: Twenty participants (age 43.

Diurnal changes and topographical distribution of ocular surface epithelial dendritic cells in humans, and repeatability of density and morphology assessment.

Purpose: Dendritic cells (DC) play a crucial role in ocular surface defence. DC can be visualised in vivo by confocal microscopy but have not yet been fully characterised in humans. This study investigated the diurnal variation, topographical distribution and repeatability of DC density and morphology measurements.

Corneal epithelial dendritic cells, tear neuropeptides and corneal nerves continue to be affected more than 12 months after LASIK.

Purpose: LASIK causes corneal nerve damage and may affect the neuro-immune crosstalk. This study examined the effects of LASIK on corneal epithelial dendritic cells (CEDC) density and morphology and explored their relationships with corneal nerves and tear neuropeptides. A grading system was developed to assess CEDC morphology.

Blinking and normal ocular surface in school-aged children and the effects of age and screen time.

Purpose: Baseline ocular surface characteristics in children require investigation. This study characterised blinking and relationships with ocular symptoms, tear film and digital device use.

Methods: 45 children aged 6-15 years (56% female) participated in a cross-sectional study.

Smoke and the eyes: A review of the harmful effects of wildfire smoke and air pollution on the ocular surface.

Wildfires are occurring worldwide with greater frequency and intensity. Wildfires, as well as other sources of air pollution including environmental tobacco smoke, household biomass combustion, agricultural burning, and vehicular emissions, release large amounts of toxic substances into the atmosphere. The ocular surface is constantly exposed to the ambient air and is hence vulnerable to damage from air pollutants.

Smartphone gaming induces dry eye symptoms and reduces blinking in school-aged children.

Purpose: Smartphone use by children is rising rapidly, but its ocular surface impact is unknown. This study examined the effect of smartphone use on blinking, symptoms, and tear function in children.

Methods: Prospective intervention study where 36 children aged 6-15years (14 M:22 F) played games on a smartphone continuously for one hour.

Level of appropriate primary diabetic eyecare delivered and achievable in optometry practices in Australia.

Clinical Relevance: Current levels of appropriateness for primary diabetic eyecare delivered by Australian optometrists are presented along with realistic targets (benchmarks) for quality improvement. The demonstrated methods can be used in practice evaluation and benchmarking of other clinical practice areas and settings.

Background: To examine the appropriateness of diabetic eye-care delivery and establish achievable benchmarks of care (ABCs) for optometry practices in Australia.

The appropriateness of and barriers to glaucoma care delivery by Australian optometrists.

Clinical Relevance: Establishing the level of appropriateness and barriers to glaucoma care delivery by Australian optometrists are important first steps in developing tailored interventions aimed at improving glaucoma care delivery.

Background: To determine the appropriateness of and barriers to glaucoma care by optometrists.

Methods: A mixed method study was conducted.

Multiple things going on at the same time: determinants of appropriate primary diabetic eyecare delivery.

Purpose: A recent nationwide medical record audit of optometry practices has identified an evidence-to-practice gap in primary diabetic eyecare delivery. This study aimed to explore the determinants (barriers and enablers) to appropriate diabetic eyecare delivery in Australia.

Methods: A qualitative study involving focus-group discussions and interviews of a purposeful sample of Australian optometrists was conducted.

Systematic review of diabetic eye disease practice guidelines: more applicability, transparency and development rigor are needed.

Objectives: To assess the quality of diabetic eye disease clinical practice guidelines.

Study Design And Setting: A systematic search of diabetic eye disease guidelines was conducted on six online databases and guideline repositories. Four reviewers independently rated quality using the Appraisal of Guidelines, Research, and Evaluation (AGREE II) instrument.