Don't Forget the Why

BY MARY JAMESON, OPT. T., R.
NOV. 1997

Help wanted: Vision assistant. No experience necessary -- will train!

There's an increasing demand for additional staff in most practices, and the supply of trained eyecare personnel is low, so many practices are displaying help wanted ads like this. In fact, most assistants in practice are trained on the job. Knowledgeable staff members can enhance the efficiency of any practice, especially when they understand the rationale behind the procedures they perform.

TEACHING THE HOW

Begin by teaching the technical aspects of the procedures in a step-by-step method, first by demonstrating, then by allowing the new staff member to perform the test on a co-worker under supervision. Be sure to give feedback.

Once the new staff member performs the procedure satisfactorily, encourage him to practice, either with fellow staff members or at home. When the assistant first works with a patient, observe him and check the findings for accuracy.

TEACHING THE WHY

But technique is only the beginning of the learning curve. There are assistants in practice who are performing contact lens procedures without knowing why. The technical skills are there, but the cognitive aspect of the procedures is overlooked. How can patients be convinced of proper contact lens care and handling, for example, when the assistant is not aware of the problems that can occur if the directions are not followed?

Once your assistant is comfortable with the techniques you've taught him, teach him the reasons for that procedure, the normal and abnormal findings and the probable causes and solutions. Reinforce your instructions by opening your reference library for all your assistants to use. Point out sources for information on general ocular anatomy, basic ocular disease, refractive status and other topics. Mark the appropriate pages and be prepared to discuss the topics.

Purchasing a self-study course for the office or a text written and edited for assistants and technicians can enhance the general education of your staff, as well as provide a testing format with multiple choice questions that can be used to assist in the training process. Have journal articles available for them to read, and arrange for them to attend continuing education at a local, state, regional or national meeting.

Invite the new assistant into the examination room to observe a patient with interesting pathology and conditions. Allow him to listen while you discuss information with the patient, and encourage him to ask questions at a later time.

Assistants who understand why they're performing specific procedures are integral partners in the eyecare team. They can help ward off lens problems by explaining to patients how poor rinsing techniques can result in a burning sensation, redness, tearing and blurred vision. With this knowledge, the assistant can help provide the patient with more thorough and efficient care by retraining him as needed in lens care and handling to assure that he has a more complete understanding of the procedures.

Scare tactics such as color photographs of corneal ulcers, acanthamoeba and pseudomonas may be effective with some patients, but there's no substitute for a trained assistant who is able to instruct patients in proper lens care and handling while communicating to them why it's important. CLS

Mary Jameson is the laboratory supervisor for clinical diagnostic procedures/contact lens laboratories in the Department of Clinical Science at the Pennsylvania College of Optometry.