Orientation Webinar for
WUCO Clerkship Preceptors
Patient Care Services III and IV
Dr. Ida Chung, Instructor of Record
Mrs. Kelee Visconti, Manager of Clinical Education Programs
Ms. Krystle Golly, Administrative Assistant
August 6, 2015
Patient Care Services II through IV
(Clerkship Program)
• Western University of Health Sciences College of Optometry’s
progressive approach to education affords our students with an
exciting and challenging clinical curriculum. The Clerkship program
is a distinctive clinical educational experience that creates
opportunity for early entry into patient care. First and second year
optometry students are placed in select local optometric and
ophthalmologic practices for six, eight-week rotations, where they
learn from some of the premier preceptors in our community. Each
rotation is designed to maximize hands-on participation and allows
the student to practice and observe compassionate and
comprehensive patient care in a real life situation. Students select
from diverse sites, whose practices provide primary care optometry
and rehabilitation, including vision therapy, neuro-optometric
rehabilitation, and low vision rehabilitation.
Student’s Patient Involvement
• Student will perform a variety of activities
including:
– technician and paraoptometric testing
– initial portions of the patient eye exam up to their
training level.
• Students should receive as much hands-on direct
patient care as possible and when appropriate
• Office work should be more minimal but is also
acceptable for the Clerkship Program
• Observation of higher level skills is also
acceptable
Skills Learned by January First Year
STUDENTS PASSED A PROFICIENCY EXAM ON THE FOLLOWING TESTS AND PROCEDURES:
• Taking a Limited Case History (professional in nonverbal/verbal techniques; know to ask Frequency,
Onset, Duration, Location, Associations, Remediation: FODLAR)
• Visual Acuity testing (OD,OS,OU; Distance and Near; with and without Rx; pinhole testing)
• Blood Pressure (w/ JNC-7 Classification)
• Extra Ocular Muscles (H,O patterns)
• Cover Test at Distance and Near (w/ prism neutralization as needed)
• Near Point of Accommodation (blur)
• Near Point of Convergence (break/recovery)
• Confrontation Visual Fields
• Amsler Grid (standard chart)
• Worth4Dot (RG glasses)
• Randot Stereo (plates/book)
• Color Vision
• Hirschberg (penlight)
• Pupil Testing (PERRL-APD)
• Interpupillary Distance Measurement (PD)
Skills Learned by August Second Year
STUDENTS PASSED A PROFICIENCY EXAM ON THE FOLLOWING TESTS AND PROCEDURES:
• Streak Retinoscopy
• Monocular Subjective Refraction (Most Plus for Max VA; JCC:)
• Prism Dissociated Balance
• Horizontal and Vertical Phorias and Vergences
• Binocular Crossed Cylinder
• Negative and Positive Relative Accommodation
• Lensometry of Single Vision and Bifocal Lenses, to include progressive addition lenses
• Lens Optical Center Determination; induced prism calculations
• Bifocal Segment Measurement (height, style and width, PAL brand)
• Identification of Frame and Lens Materials
• Frame Alignment and Adjustment (standard alignment, nose pads, temples)
• Pupilometer Usage
• Measurement of Lens Warpage, Slab Off, Base Curve
• Measurement of Lens Thickness (spectacle and rigid contact lens)
Skills Taught in Lab by August Second Year
STUDENTS PRACTICED THE FOLLOWING TESTS AND PROCEDURES IN LAB WITH
SUPERVISION BUT WERE NOT TESTED WITH A PROFICIENCY EXAM:
• Comprehensive Case History
• Noncontact Tonometry (will learn Goldmann and Tonopen XL by November)
• Eye Drop Instillation
• Slit Lamp Basic Technique (will learn full slit lamp examination by November)
• Accommodative Facility +/-2.00
• Modified Thorington
• Bruckner
• Keystone Visual Skills
• Lifesaver Cards
• Maddox Rod
• Hart Chart
• Brock String
• Sighted Guide Techniques
Clerkship Conditions List by February First Year
Students can be expected to possess a rudimentary knowledge and understanding of the
following common clinical conditions:
• Myopia/ Hyperopia/ Astigmatism
• Presbyopia
• Strabismus (constant/intermittent, unilateral/alternating)
• Amblyopia
• Convergence insufficiency
• Convergence excess
• Divergence excess
• High blood pressure
• Anisocoria (physiological)
• Headache (Migraine, Sinus, Binocularity/Accommodation-related, traction/mass affect type)
• Basics of visual impairment including vision requirements
• Learning-related vision problems
• Mild traumatic brain injury
• Visual field loss
Preceptors will evaluate student performance in the following areas:
Clinical skills: ability to accurately and effectively perform tests involved in patient care. Uses proper
technique and equipment, Records results accurately.
Knowledge base: ability to state pathophysiology, basic mechanisms, and clinical concepts used in
patient care.
Communication skills: ability to effectively interact with patients, preceptor, staff and/or peers to ask
questions, give directions, present case and and/or demonstrate thought processes.
Professionalism: is punctual, respectful, humanistic, ethical, compliant with office protocols
Attitude towards learning: is a self-directed learner, completes assignments, accepts constructive
feedback
Preceptors will evaluate student performance using the following grading scale:
A = Advanced – Behavior is observed at least 90% of the time.
C = Competent – Behavior is observed 80% - 90% of the time.
NI = Needs Improvement – Behavior is observed between 70% - 80% of the time.
U = Unsatisfactory – Behavior is observed less than 70% of the time. Performance is not in the best
interest of the patient.
Student Evaluations
• Student evaluations are submitted in Meditrek
• Students receive an evaluation at the end of
each 8-week rotation
– Preceptors are asked to provide comments on
student performance
– Preceptors are not asked to issue final grades
• Final grades determined by Course Instructor
are:
– Honors, Pass, Remedial, No Pass, Incomplete
Attendance at Patient Care Service Assignments
• Attendance is mandatory at all Patient Care
Service assignments.
• A student needing time off from any clinical
assignment must request the time off from
the Associate Dean of Academic Affairs.
• The Associate Dean of Academic Affairs will
determine if the student’s request to miss a
clinic assignment is excused or unexcused.
Emergency Absence
• Absences including serious illness or other
unforeseeable personal or family emergency
– i.e. trauma requiring medical care, childbirth (by
student or spouse only), death or funeral of a
primary relative, serious illness of a primary
relative when the student is a caregiver, court
appearance that cannot be rescheduled
– Student must contact the Preceptor and Manager
of Clinical Programs, and Associate Dean of
Academic Affairs
Swap Assignment
• Instead of requesting an authorized absence
from the Associate Dean of Academic Affairs
to miss a clinical assignment, a student may
arrange a swap, if allowed, under certain
circumstances, when the swap is at the same
site and substantially similar.
– Swapping assignments are not allowed at
clerkship sites
Unexcused Absence
• An absence is considered unexcused if the
student, even in the event of an emergency, does
not contact the Clerkship Preceptor and Associate
Dean of Academic Affairs.
– It is also considered an unexcused absence if a student
leaves a clinic assignment without the preceptor’s
permission. Students may not leave their assignment
until they have been dismissed for the day by their
preceptor.
– Unexcused absences are considered unprofessional
behavior. If this occurs, Preceptors are asked to
notify the Manager of Clinical Education on the same
day.
Tardiness
• Punctuality is expected at all Patient Care
Services assignments. Students are expected to
be ready to see patients or begin educational
activities at the assigned time. Failure to be at
your clinical assignment on time and ready to
work with patients is considered unprofessional
behavior, as it implies a lack of consideration for
patients, preceptors, peers and staff.
– A student should notify the Preceptor and Manager of
Clinical Education if they are not going to be at their
clinical assignment on time.
– If the student is tardy to a clerkship assignment, the
Preceptor will document the tardiness in Meditrek
under Professionalism.
Preceptor Absence
• Preceptors are responsible for communicating
absences ahead of time directly to the students
affected and to the Manager of Clinical Education
– Students may either be required to make up the
missed clinic time or an alternate learning activity will
be assigned
– Students will ask the Preceptor to sign a clinic makeup form.
– The Preceptor is asked to determine a mutually
agreeable make-up time with the student
Any Questions?
Contact Information
Mrs. Kelee Pleticha-Visconti: kpvisconti@westernu.edu, 909-469-8228
Dr. Ida Chung: ichung@westernu.edu, 909-469-8687
Frequently Asked Questions
• What happens if I notice problems with the
students’ technical skills for their specific level?
• What if my student(s) doesn’t show up on their
designated day?
• What is this “Make-Up” form the student wants
me to sign?
• What if the student is not ready to provide direct
patient care (doesn’t show up ready to work)?
• What if the student asks to switch days?
• What if my office will be closed on one of the
Clerkship days?
…and their answers
• A phone call or email to the Instructor of Record should be made. You
may find this information in the Policy and Procedure Manual.
• If your student(s) does not arrive and you have not received a call or an
email from WUCO, then it is likely that we are not aware and a phone call
or email to the Manager of Clinical Education is in need.
• A “Make-up” form is when a student misses a day and needs to make-up a
day at your practice other than the regular scheduled day.
– For example: There are two holidays in Fall which land on a Monday, Labor Day and
Columbus Day; the student needs to make-up one of the holidays if their designated day
is Monday at your practice
• You may opt to send the student home and ask that they come back when
they are ready to work. This would be considered another make-up and a
call to the University would be necessary for further action on our part.
• If a student asks to switch days only a permanent switch for the entire
rotation should be accommodated and only if it is convenient for you as
the preceptor. Remember, the student chose the day that they are
attending your site.
• If your office will be closed, please notify the student in advance and
coordinate the make-up day at a mutually convenient time for both
preceptor and student.
Questions asked by Preceptors
1 The Previous grading scale was from 1-9 with
a score of “5” being what is minimally
expected. With the new grading scale, is “C”
the new equivalent of what is expected?
• Answer: “C” is defined as “Competent”; therefore,
yes, we consider “C” to be what would be
considered acceptable for passing.
Questions – Continued
2 Are students required to stay until all patient care is
finished at the site?
• Answer: The students are assigned to attend for a 4 hour
session. We do want the student to stay for the minimum
4 hours; however, if you would like them to stay longer,
please just check with the student to make sure that they
do not have any other assignments back on campus.
• Generally speaking, when we have time slots in the Spring
from 8 a.m. – 12 p.m. or 9 a.m. – 12 p.m., the students do
need to be back on campus for didactic courses by 1:00
p.m.
• There are also other occasions where the students have to
return to campus in the evening for course assignments or
scheduled event.
Questions - Continued
3 Are students required to keep a patient log on a
weekly basis and should I request that the student
show me the list? Some students keep a list, others
don’t and when asked, they will say that they
memorize the patient information.
• Answer: Students are supposed to log every patient. They
are not supposed to log/write down any personal
information such as name/address but general information
(age range, race, patient complaint) only. The logs are
supposed to be entered daily but many times they are
entered up to 13 days after the patient encounter.
• Students are encouraged to keep a notepad and pen in
order to write such information in order to log them at a
later time.
Thank you so much!
We appreciate your participation in
our program!