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1. A certified technician supervises the training of new ophthalmic assistants, but the entire technical staff is involved in the instruction. 2. The program lasts for 10 weeks: 8 weeks of training with ophthalmic procedures and 2 weeks of observation. 3. The essential elements of a well-rounded training program include knowledgeable trainers, role playing, and hand-on experience.
We compared the accuracy with which general ophthalmologists, pharmacy personnel, and ophthalmic assistants diluted intravitreal antibiotics, using a method of their own devising, a new protocol using an insulin syringe, and Duane's protocol. The insulin syringe method proved less accurate and more complex than Duane's protocol, but was better than not using a standardized protocol at all. With all methods, the pharmacy personnel produced the most accurate dilutions, with the least variability. The ophthalmologists' dilutions were much more variable both without a protocol and with the insulin syringe method, but they were acceptable with the Duane's protocol. The ophthalmic assistants produced unacceptable results with all methods. Since the decision to inject antibiotics is usually made under emergency conditions, when errors of dilution are more likely, whenever possible, pharmacy personnel should be entrusted with providing the dosage of medications to be injected intraocularly. If pharmacists are unavailable, ophthalmologists may reconstitute medications using a reliable and simple protocol such as Duane's.
This paper describes a refresher training and continuing education programme in clinical and community ophthalmology for para-medical ophthalmic assistants (PMOAs) conducted by the Lions Aravind Institute of Community Ophthalmology. The course participants included 60 PMOAs working either in district hospitals, primary health centres or mobile units from the districts in Maharashtra. Each training programme was spread over 43 hours in 4 days and included lectures, practical demonstrations, and hands-on training in the outpatient, inpatient, and operation theatre of the training institution. Participants were given exposure to outreach activities in an eye camp and a satellite eye centre resembling a district hospital. The PMOAs found the training to be useful and it was seen that areas like patient counselling, instrument and equipment maintenance, and assistance in the operation theatre for newer surgical procedures which were lacking in the basic training were fulfilled in this training programme. Regional Institutes of Ophthalmology, upgraded medical colleges, and other eye-care institutions which have facilities and manpower could organise similar refresher and continuing education programmes for PMOAs so that they could be utilised more efficiently in the blindness-control activities in the country.
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1. Metropolitan areas with a diverse population require reevaluation of training techniques. 2. Communication skills have to be reinforced by a multicultural approach followed by a hospital-based apprenticeship program. 3. Competence level is constantly being reassessed in workshops, student-mentor supervision, and frequent evaluations.
At the present rate of training, physician extenders will shortly make up a substantial fraction of eye care providers. However, there have not yet been any published studies on the impact of this group on the delivery of services. It is the purpose of this article to outline the training categories and requirements now available for physician extenders in ophthalmology and to obtain direct feedback from ophthalmologists regarding current utilization and potential need for such personnel. Readers are asked to complete a questionnaire, which will serve as the basis for a future report on this subject.
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