PUBLIC C34(18) COUNCIL Education Strategic Review (ESR): Draft Standards and Learning Outcomes Meeting: 12 September 2018 Status: For decision Project Sponsor: Alistair Bridge (Director of Strategy) Project Board: SMT Paper Author: Alistair Bridge Project team: Ben Pearson, Philippa Mann, Marcus Dye, Roz Platt, Manori Izni- Muneer, Ross Price Council Champions: Clare Minchington, David Parkins and Selina Ullah Project Board: SMT Purpose 1. The purpose of the paper is to seek Council’s views on proposed new standards for education providers and proposed new learning outcomes, and to seek Council’s approval for us to consult publicly on the proposed standards and learning outcomes. Recommendations 2. Council are asked to: 2.1. provide views on the: 2.1.1. proposed new standards for education providers (annex one); 2.1.2. proposed new learning outcomes for optometrists (annex two), dispensing opticians (annex three); and contact lens opticians (annex four); 2.1.3. proposal that rather than develop our own learning outcomes for independent prescribers, we should adopt the Royal Pharmaceutical Council’s Competency Framework for all Prescribers (annex five); and 2.1.4. proposed new learning outcomes for fully-qualified practitioners undertaking Continuing Education and Training (CET) (annex six); 2.2. approve a public consultation on the proposed new standards and learning outcomes, subject to taking into account Council’s views and the further views of our Expert Advisory Group provided at the meeting on 10 September 2018; and 2.3. delegate authority to the Chair and Interim Chief Executive and Registrar to sign-off the revised versions of the standards and learning outcomes for consultation, together with an accompanying consultation document and draft impact assessment. 07 September 2018 Page 1 of 33 PUBLIC C34(18) Strategic objective 3. One of our three strategic objectives is to support the learning and development of optical professionals. Through our Education Strategic Review (ESR), we will ensure that future optical professionals are equipped for the roles they will be expected to perform. In parallel, we are reviewing our CET system to ensure that current optical professionals are fit for the future. Risks 4. The changing needs of patients, changing roles of optical professionals and wider changes in the delivery of healthcare mean that the current system of optical education and training could cease to be fit for purpose. To address this risk, we need to carry out the ESR in a timely way, ensure that changes are based on sound evidence and gain buy-in from stakeholders. 5. To implement the new system of education and training, we will need an effective and efficient approach to the accreditation and quality assurance of education providers. We are currently delivering improvements to our current approach that will pave the way for the implementation of the ESR and ensure consistent standards of education provision. 6. Effective delivery and implementation of the project will require it to be properly resourced. Following the departure of the project director in July, we are recruiting an Interim Director of Education to oversee the ESR, as well as the CET review and the ongoing performance of our functions relating to education and CET. We expect to have someone in post to fulfil this role by the end of September. Background 7. The proposed new education standards and learning outcomes reflect and build on the evidence and feedback we have obtained so far through the ESR and the CET Review. We commenced the review with a call for evidence and published a report summarising the feedback (June 2017). We commissioned research into patterns and trends in health professional education in the UK and internationally (November 2017) and carried out research exploring the perceptions of newly qualified practitioners and employers in relation to current education and training requirements (June 2018). We consulted on the concepts and principles that should inform the new system of education and training and published an independent report summarising the findings (April 2018).1 1 We have published all the documents referred to in this paragraph on our website: https://www.optical.org/en/Education/education-strategic-review-esr/ 07 September 2018 Page 2 of 33 PUBLIC C34(18) 8. We also carried out extensive engagement with stakeholders, including education providers, and gained input from our ESR Expert Advisory Group, CET Reference Group and from our advisory committees. Concepts and principles consultation 9. In developing the draft education standards and learning outcomes, we have built on the findings from our consultation on the concepts and principles that should underpin the new system of education and training. During the consultation period, we held a series of bilateral engagement meetings with education providers; met collectively with providers of optometry programmes through the Optometry Schools Council; met ophthalmic dispensing programme leads; and held a series of student discussion groups, with approximately 85 students in total from seven academic institutions. We also held an open invitation event where around 60-70 delegates participated, including professional associations, patient organisations, education providers, employer organisations. 10. The key findings from the consultation were that: 10.1. the majority of responses to the consultation were supportive of the concepts that we were exploring. In particular, there was a strong endorsement of our intention to take an outcomes-based approach to the regulation of education provision; 10.2. all but one of the stakeholders who responded agreed with the concept of introducing new outcomes-focused standards for education. It was expected that such standards would be less prescriptive and thereby enable greater agility and innovation from providers; 10.3. there was also strong agreement with the concept of ensuring that our education requirements are informed by our standards of practice. Respondents felt that it is important for students to learn what will be expected from them in practice from an early stage in their education; 10.4. most respondents supported the development of new education learning outcomes which all optometry and dispensing optician education providers would be required to deliver, albeit with some caveats. A number of stakeholders could see a case for change because of what they perceived to be deficiencies in the current, competency-based framework. In addition, some stakeholders identified an opportunity for broader learning outcomes to afford education providers more flexibility over how they deliver their programmes. However, the potential for learning outcomes to lead to greater variability in, or a lowering of, standards was identified as a risk that would need to be carefully managed through effective quality assurance; 10.5. the importance and value of including a high quality and varied clinical experience within education programmes was uncontested and a number felt that there is scope to increase this. However, some considerable 07 September 2018 Page 3 of 33 PUBLIC C34(18) implementation challenges and risks were foreseen with respect to providing a greater number of external clinical placements in particular; 10.6. multi-disciplinary learning was perceived to have significant value in preparing students for multidisciplinary health delivery, and a number of education providers reported that it already forms part of their programmes. However, it was regarded as important that multi- disciplinary learning approaches are designed in such a way as to demonstrably enhance learning rather than being treated as a tick box exercise. In addition, a number of implementation challenges were identified, leading some to caution against the GOC taking a prescriptive approach in this area, given the different circumstances of education providers; and 10.7. stakeholders would also like to see the GOC develop a risk-based, evidence-led and proportionate approach to quality assurance in order to ensure compliance with the education standards. 11. Through the consultation we also explored the concept of a national registration exam. This would be an exam set by the GOC and would be in addition to any agreement reached by an education provider with a third party, such as the College of Optometrists (the College) or the Association of British Dispensing Opticians (ABDO), to provide an assessment and/or clinical placements as part of the education programme which they offered to students. However, many respondents viewed the current assessments provided by the College and ABDO as being national registration exams and, therefore, the support for a national registration exam has to be read in this light. While a national registration exam would provide the GOC with extra assurance of consistency, it would involve additional cost for both students and the GOC and would have the potential to undermine our objective of enabling greater flexibility and innovation. At this stage, therefore, we are intending to focus on developing a robust approach to accreditation and quality assurance in order to provide us with assurance of consistent education provision in line with our education standards. Development of Education Standards and Learning Outcomes 12. At the Council meeting in May 2018 we reported that we had developed draft education standards and learning outcomes, taking into account the findings of the consultation, and we committed to sharing