*1.5. Professionals*

This area of the model outlines the 'Ideal Optometrist'. In June 2015, the General Optical Council prepared a report on the public's perception of the optical profession, based on a survey of 2250 adults from across the UK. The sample was designed to reflect a cross-section of the population across various ages and socio-economic grades. Findings suggested that overall confidence in and satisfaction with opticians (both Optometrists and Dispensing Opticians) is high.

In 2018, Irving, et al. [9] suggested that patient's knowledge of eye care had notable gaps with the potential for these gaps to increase risk of vision loss due to late detection of ocular conditions. In recent years, Optometrists have been able to access further additional professional qualifications. In 2007, the Department of Health (UK) granted permission for Optometrists to train as Independent Prescribers. This qualification allows Optometrists to manage a wider range of patients than with the entry-level qualification providing patients with more accessible eye care. In addition to independent prescribing, in the past decade, a range of Professional Certificates have been launched, allowing Optometrists to upskill in a number of areas including glaucoma management, pediatric eye care and low vision. The number of Optometrists currently undertaking these qualifications is increasing and in recent years, employment vacancies have been advertised specifically requiring these additional qualifications as part of the 'essential criteria'.

These additional qualifications allow Optometrists to maintain and update their skills and knowledge in alignment with emerging evidence, allowing for career progression. In the past two decades, there has been a shift towards the majority of Optometrists working for large multiple franchises rather than independent practices. These additional qualifications allow Optometrists to enhance their employability and transferability.

Across the globe, the term 'Optometrist' does not refer to a consistent standard for the profession. In many countries, including the United States and Canada, newly qualified Optometrists hold an OD (Doctorate of Optometry) and have a wider scope of practice than in the UK, o ffering a greater range of therapeutic services to patients and are regarded as highly qualified professionals.

In other countries in Europe, Optometrists have a more limited role, closer aligned with Dispensing Opticians where medical eye related issues are always referred to a hospital Ophthalmologist.

It may be argued that the drive towards higher qualifications is partly motivated by the increasingly litigious nature of health care or the age of self-diagnosis via the internet. Where patients are considered as consumers, Optometrists may feel obliged to maintain their knowledge and skills to a higher level and therefore undertake courses to protect themselves.

However, whatever the motivation, there does seem to be an appetite for further qualifications in Optometry and this increased level of skills and knowledge will benefit both patients and practitioners [10].

#### *1.6. Undergraduate Optometry Students' Perspective of the Place Model*

Due to the limited published data on professional perspectives in Optometry, we conducted a scoping exercise to determine how the Place Model may be applied to the profession.

## **2. Materials and Methods**

The Place Model [1] Survey was originally designed to determine the views of teachers and teacher educators of the Place Model and Freidson's three logics [11]. For the purposes of this study, the Place Model Survey has been adapted to determine the views of undergraduate Optometry students (Appendix A).

Data collection took place during the 2018–2019 academic year and the study was approved by Research Governance at Ulster University which adheres to the tenets of the Declaration of Helsinki.

Participants were undergraduate Optometry students at Ulster University and prior to participation, were provided with an information sheet outlining the study. All undergraduate Optometry students were invited to participate in the study. Consent was assumed when the subject choose to complete the survey as indicated on the survey itself (Appendix A).

Participants were provided with an oral description of the Place Model and were then asked to complete the survey. This comprised; initial demographic questions, Place Model questions where the subject was asked to locate themselves (with an X mark) and their perception of the status and professional learning journey which is typical of optometrists within their own (United Kingdom based) education system (with a 0 mark). In addition, they were asked for a written explanation of these two locations [11].

Following survey completion, statistical analyses were performed using IBM Statistical Package for the Social Sciences (SPSS) (version 25).
