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The relationship between unwarranted variation in optometric referrals and time since qualification
David J Parkins1,2, Martin J Benwell1, David F Edgar3
1School of Health and Social Care, London South Bank University, London, UK.
Summary
Continuing education and training (CET) alone does not significantly improve optometric referral decisions. Targeted support and mentoring for optometrists within two years of qualification are recommended for better clinical judgment.
Area of Science:
- Optometry
- Ophthalmology
- Healthcare professional development
Background:
- Optometric referral decision-making exhibits unwarranted variation.
- Experience and continuing education and training (CET) may influence these decisions.
Purpose of the Study:
- To investigate variations in optometric referral decision-making.
- To assess the impact of experience and CET on referral practices.
Main Methods:
- Audit of optometric referral data in the UK.
- Online vignette system to assess optometrists' decisions before and after CET.
- Comparison of newly-qualified, pre-registered, and experienced optometrists.
Main Results:
- CET intervention showed no significant impact on referral decisions (p=0.37).
- Referral numbers negatively correlated with time since qualification (p=0.005).
- Newly-qualified optometrists (up to 2 years) made more referrals, with pre-registered optometrists referring more appropriately.
Conclusions:
- CET alone is insufficient to improve optometric referral decision-making.
- Mentoring and targeted CET for early-career optometrists are crucial.
- Ophthalmology feedback is vital for moderating referrals and building confidence in new optometrists.
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