The needs and opportunities for post-graduate education and training programmes for the optometry profession in post-apartheid South Africa

[摘要] English: This research study was undertaken to determine the needs andopportunities for post-graduate education and training programmes inoptometry in post-apartheid South Africa. The rationale for this study canbe found in the stimuli which contributed to the commencement of thestudy, namely the Vision 2020 - The Right to Sight Campaign of the WorldHealth Organisation that resulted in the resolution of the World Council ofOptometry, entitled the Global Vision Care Campaign. That the abovementionedare fully endorsed by the South African government, issubstantiated by policy documents such as the White Paper for theTransformation of the Health System (RSA DoH 1997) and the NationalPrevention of Blindness Programme (RSA DoH 2000). These aspectsresulted in, inter alia, the identification of issues like preventable blindness;the importance of public health; public needs; the lack of human resourcedevelopment; demographic representation; and the lack of clear clinicalcompetency guidelines.The problem statement pertains to the career ladder for optometry, alreadyaccepted in South Africa. It opened the door for magister programmes,allowing practitioners to develop clinical and speciality skills within thescope and parameters set forth and regulated by the Professional Boardfor Optometry and Dispensing Opticians. Despite this career ladder, there.is a need for a programme aimed at providing education and training tolearners in order to become competent to render a professional specialistservice in optometry and to contribute to the enhancement of the disciplinethrough research. Such a programme must afford professionaloptometrists the opportunity to further their education and training in termsof the optometry career ladder, in addition to gaining certain therapeuticprivileges and speciality skills.The research took the form of a descriptive and an exploratory survey,comprising a literature review and an empirical investigation. Theliterature study covered two aspects, namely in the first place factors. influencing the design of optometry education and training programmes.Features like the changing health scene; the history of the development ofthe optometry profession; the transformation of the health care system inSouth Africa and the eye care needs of the South African population; aswell as the transformation of education and training in South Africa weredealt with. The second aspect covered by the literature review was aselective review of optometry training, which dealt with optometriceducation and training in South Africa; its history and the current state ofaffairs; as well as legislation in South Africa. Subsequently optometrictraining in the rest of Africa and the developed world was discussed inbroad terms. The empirical study entailed a questionnaire survey carriedout among South African optometry practitioners. A quantitative designwas employed, but - because the questionnaire also contained someopen-ended questions - the study had a qualitative dimension as well.The overall goal and objectives were to make a contribution to eye careand the prevention of blindness, as well as to make a meaningfulcontribution to education and training in optometry. The aim was todetermine the needs of optometrists with regard to optometric educationand training and the opportunities existing in South Africa, measuredagainst the background of the needs of society (from the optometrists'perspective). The objectives were in the first place to enhancecompetence beyond graduate level, thereby better serving the eye careneeds of the population of South Africa in particular and, in an indirectway, of neighbouring countries. In the second place the objective was tomake recommendations concerning the delivery of relevant and applicablepost-graduate studies at Optometry Schools/Departments. All of theseaspects were achieved by conducting the above-mentioned literaturestudy and by using the findings from the questionnaire.The research design consisted of a needs analysis in the form of thequestionnaire survey used as the method to determine the needs ofoptometrists in respect of post-graduate studies, as well as to obtain theirviews regarding existing opportunities in this regard. The questionnaireconsisted of six categories, each containing five different types of items(cf. 5.4.1; Appendix C).Four rounds of questionnaires were sent out over a period of 16 weeksand the response rate was 70.2% (cf. 5.5). After the returnedquestionnaires had been analysed by the Department of Biostatistics atthe University of the Free State, it became possible for the researcher todraw conclusions; discuss the findings; make recommendations; andidentify the limitations of the study. Each of the six categories wasfollowed by a summative conclusion as well as by the main findings of thecontent of that specific category. The main findings as well as thoseobtained via the literature study, enabled the researcher to makerecommendations on post-graduate optometric education in South Africa.Different factors, which are listed under the following headings andsubheadings, influenced these recommendations:- Points of departure: These include accessibility; affordability; personaldevelopment; professional development; addressing public need;addressing higher education and health policies; addressing research;addressing management skills; and addressing HPCSA Regulations.- Role-players: The role-players include, infer alia, students; providers;the Professional Board; individual optometrists and associations;industry; the public; the State; professional stakeholders; SAQA; andthe CHE.- Post-graduate optometric education and training itself was divided intothree aspects, namely:-Recommendations concerning the programme.-Recommendations with regard to CPO.-Recommendations on clinical competence based on publicneeds.The recommendations on clinical competencies were extensively detailed,since they may serve as a basis for the SGB of Optometry and Opticianry.As this study also focused on the public need, the detail in therecommendations regarding competency will help to ensure that the carewhich the public receive, is optimised. In order not to confuse theprofessional competencies with the categories of the questionnaire, theywere divided into six sections, namely Sections A to F. Each of thesesections was divided under the headings Outcomes; Performancecriteria; and Indicators. Hereafter a framework as a starting point forpost-graduate education and training programmes was proposed.In summation, the researcher is of the opinion that the overall goal andobjectives of the study were addressed and realised and that meaningfulrecommendations were made. The latter are in line with legislation andwith the policy documents referred to earlier. In addition, recommendationson clinical competencies are in line with international norms.Conclusions are, infer alia, as follows:- Based on current undergraduate programmes, there is a need for apost-graduate programme aimed at providing education and training tolearners.- The articulation between the under- and post-graduate programmeswill result in an overview of the undergraduate programme.- The role and functions of the Professional Board are pivotal to thesuccess of education at both under-and post-graduate level.- As the current optometry educational model fails to address theimmediate public need, this study provides at least some of theguidelines in the design of a new model.- It is clear that CPO (Optometry) is in its infancy in South Africa and itssuccess depends on whether it can influence the delivery of servicespositively. It is of the utmost importance, however, that - for CPO to beeffective - it will need to articulate with formal qualifications.The researcher realises the limitations of the study, namely in the firstplace that the opinion on the public need was limited, as it wasoptometrists who were the respondents to this category of thequestionnaire. In the second place, literature and statistical sources of theSouth African situation were limited in that epidemiological data areincomplete and fragmented. In addition, clinical training in optometry hadstagnated during the apartheid years.It is recommended that this study be followed by the compilation of amodel for post-graduate education and the development of a detailedcurriculum plan, as that is essential in order for these recommendations tobe successfully implemented.The researcher is of the opinion that the profession as a whole needs aleadership and management model that would ensure cohesion betweenall the facets of the eye care field. These facets must include, but not belimited to, elements like the providers of education; the quality assurer;professional associations; the State; clinical training networks; servicedelivery structures; programme development at all levels; as well as CPOarticulation with all education and training structures and neighbouringcountries. Such a model will provide direction and momentum toeducation- and needs-driven eye care services in South Africa and willopen the way for the profession to develop to its full potential.

[发布机构] University of the Free State