Some thoughts on the next five years of the European Diploma
Developments in European education
Developments are taking place in European education that parallel the developments of ECOO’s European Diploma in Optometry. In 1999 in Bologna, a treaty was signed by 29 European Ministers of Education (Bologna Declaration) agreeing to make European higher education more transparent, comparable and interchangeable by introducing the bachelor-master system of education. The treaty’s objective is internationally comparable educations that can be tested against internationally comparable quality standards. All parties signing the treaty committed themselves to introduce in their country before 2009 the BaMa (bachelor-master) structure of higher education, a two cycle (undergraduate and graduate) model. The undergraduate cycle consists of the Bachelor phase; the graduate cycle is the Master phase. The commitment was freely taken by each signatory country and was not a reform imposed upon national governments or higher education institutions. The Bologna process aims at creating convergence and, thus, is not a path towards the standardization or uniformization of European higher education. The Declaration clearly acknowledges the necessary independence and autonomy of higher education institutions. The fundamental principles of autonomy and diversity are respected. The Declaration reflects a search for a common European answer to common European problems.
In May 2001 higher education ministers from 32 European countries met in Prague and confirmed the key points of creating a European Higher Education Area by 2010:
A new follow-up meeting of the higher education ministers will take place in the second half of 2003 in Berlin to review progress and set directions and priorities for the next stages of the process towards the European Higher Education Area.
It may be necessary for the development of their professional and academic career that students continue their studies in another European country. Students envisaging a study abroad will be looking for:
In a number of countries such as the United Kingdom (1966), Germany (2001) and The Netherlands (2002) the bachelor-master (BaMa) system has now been introduced. Graduate (MSc) and postgraduate (PhD) studies have been available in the UK since 1969. Recently, in October 2002, the German Federal Handwerkskammer (Federal Council of Handicrafts), which controls and regulates 123 handicraft professions including not only traditional professions as Augenoptiker/Optometrists but also the new IT professions, announced the introduction of a Bachelor’s Degree for Handwerksmeister (handicraft masters). Also recently, in October 2002, a treaty was signed by the University of Applied Sciences TFH Berlin (Germany) and the Pennsylvania College of Optometry (United States) for a joint Master of Science Degree in Clinical Optometry at the school in Berlin from 2003. Also The Netherlands are developing a Master’s Degree in optometry.
The international comparison of bachelor and master education will be supported by a system of accreditation based on content and quality. Accreditation means that education meets professional qualifications as laid down in the law. Accreditation is the final result of a system of evaluation and visitation. In 2001 Germany established accreditation agencies (Akkrediterungs Agenturen) which are state controlled or private institutions. In The Netherlands from 2003 the newly established National Accreditation Council will decide, based on standardized quality control, whether schools will get accreditation. Accredited school meet high quality standards according to European directives. Without accreditation, schools will no longer receive government money!
ECOO’s European Diploma in Optometry
The first initiative to establish the Diploma was taken by ECOO in 1988 in Venice, more than 10 years before the Bologna Declaration. The virtues of the diploma are that optometry in Europe now has one uniform standard of practice; that all member states of ECOO are familiar with its syllabus; and that they all take example from the diploma. The most important merit of the diploma is that the standard of optometry in Europe has once and for all been settled and that there is no going back on this decision. ECOO’s European Diploma in Optometry is and must remain the Gold Standard of Optometry in Europe! The imminent expansion of the European Union will not and must not endanger the standard!
Since the Bologna Declaration developments of the diploma need to closely follow developments in European education.
The objectives of ECOO’s European Diploma in Optometry have been threefold:
In many countries health care has become so expensive that governments look for ways to substitute expensive medical specialists and the less expensive general medical practitioners by non medically qualified professionals who can do the job just as well but for less money. The dividing lines between domains and responsibilities are shifting and optometry may profit from these developments! Everywhere health care is getting so expensive that modernization of health care becomes necessary. In this process ECOO and the Diploma should take their role.
ECOO’s European Diploma in Optometry aims to achieve a uniform practice of optometry of the highest and most realistic standards throughout Europe and to increase the scope of practice. The right order is: education, legislation, implementation. Educate, then Legislate!
The Diploma is the combined total of all knowledge, skills and attitudes that the ECOO member countries deem necessary. For example, it combines the strong physical basis and emphasis on the optical aspects of German Augenoptik/Optometry with the biomedical and healthcare approach of optometry in the United Kingdom.
Europe encourages free movement of workers, an optometrist from country A is entitled to work in country B provided he has the proper qualifications required to practice in country B. In the future, students or practitioners who want accredited education in additional fields of optometry which are not taught or accredited at their own school should be able to take their already obtained ECTS credits with them and graduate at another institution. ECOO’s European Diploma in Optometry can therefore be especially useful as a calibration instrument for the member states of ECOO. Each country can use those parts of the syllabus of the European Diploma that are necessary for that country’s requirements. It will enable countries to develop their educational structure at their own pace whilst building accreditation towards the full Diploma.
To make ECOO’s European Diploma in Optometry a success has proven to be a most complicated and cost intensive process. There is a huge variation of standards and a low pass rate. It is even for students and graduates from countries with optometric education at the highest level difficult to pass the European exam.
In view of the present low number of candidates one may conclude that the diploma has not yet become established in the awareness of the European optometric rank and file.
Despite considerable financial contributions from ECOO members, industry, European Community (Leonardo da Vinci funding) and other donations, financing of ECOO’s European Diploma in Optometry remains a serious problem and will in the future require both increased contributions from the members and increased examination fees from the candidates. Funding from outside the profession will have to be considered and when the future format of the Diploma has been decided approaches can be made to the optical industry and Brussels.
The problems during the October 2002 exams have demonstrated that the organization of exams puts too heavy a burden and responsibility on the association that administers the Diploma.
In the long term it seems impractical to continue with one central examination for Europe. The moment has come to consider changes in the present set up of the diploma and switch to examinations at accredited schools throughout Europe and philosophize about competency based standards and examinations.
Competencies and accreditation
There is a world wide movement to competency based standards and examinations. Australia and New Zealand already have introduced competency-based standards for trades and professions to allow for maximum use of skills present in the community, increase labour market efficiencies and equity, offer a fairer method of testing overseas trained professionals, and facilitate the recognition of those who attempt, but fail, to obtain professional qualifications. Competency-based standards are seen to encompass all forms of achievement of competence rather than only formal indicators such as formal qualifications from educational institutions. Competency is the ability to perform the activities within an occupation or function to the standard expected in employment.
The competency standards for optometry of Australia and New Zealand list the minimum standards of knowledge, skills and attitudes which a new graduate needs to meet in order to perform to an appropriate standard in the workplace. Competencies provide optometry with a common language.The Australian overall competency of the profession is segmented into units of competencies that typically represent a major function or role of the profession:
Unit 1: Professional and Clinical Responsibilities
Unit 2: Patient History
Unit 3: Patient Examination
Unit 4: Diagnosis
Unit 5: Patient Management
Unit 6: Recording of Clinical Data
The registration authorities of Australia and New Zealand have set up The Optometry Council of Australia and New Zealand (OCANZ) as the body from the government regulatory authorities across both countries who oversee standards in optometry. The competencies are set through consultation with the schools of optometry and the professional bodies.
Competency-based standards are now the basis of the examination process that has been put in place for overseas optometrists wanting to practice in Australia and New Zealand. This examination is run by OCANZ. The same body, OCANZ, has put in place an accreditation process that each of the four optometry schools in that region have gone through. Their accredited status means that their graduates are exempted from having to sit the OCANZ examinations. The facilities, education processes and examinations are deemed to be sufficient to guarantee that the graduates of the four optometry schools have the entry level competencies to practice in either Australia (all states) or in New Zealand.
Competency based standards provide optometry with a common language. Common competencies and standards mean that proper recognition can be given for knowledge and skills acquired in other countries. This will make the cross border recognition of qualifications and the identification of deficiencies easier. The optometrist will then only have to qualify in the deficient area which saves him re-qualification in order to practice in another country.
The competencies of the European Diploma include the competencies of the optician, which in several countries is a separate profession.
Competency based standards enable development of the Diploma recognizing the standards of education and training in all member countries of ECOO.
Conclusions
Feike Grit, BSc DSc FCOptom FAAO, Netherlands, 3rd November 2002
The author wishes to thank Wolfgang Cagnolati (Germany), Frank Buijs, Gert-Jan Deben, Frans van der Horst, Kees Kortland (Netherlands) and Bob Chappell (United Kingdom) for their input.
The viability of ECOO’s European Diploma in Optometry
A working paper
Developments in European education
Developments are taking place in European education that parallel the developments of ECOO’s European Diploma in Optometry. In 1999 in Bologna, a treaty was signed by 29 European Ministers of Education (Bologna Declaration) agreeing to make European higher education more transparent, comparable and interchangeable by introducing the bachelor-master system of education. The treaty’s objective is internationally comparable educations that can be tested against internationally comparable quality standards. All parties signing the treaty committed themselves to introduce in their country before 2009 the BaMa (bachelor-master) structure of higher education, a two cycle (undergraduate and graduate) model. The undergraduate cycle consists of the Bachelor phase; the graduate cycle is the Master phase. The commitment was freely taken by each signatory country and was not a reform imposed upon national governments or higher education institutions. The Bologna process aims at creating convergence and, thus, is not a path towards the standardization or uniformization of European higher education. The Declaration clearly acknowledges the necessary independence and autonomy of higher education institutions. The fundamental principles of autonomy and diversity are respected. The Declaration reflects a search for a common European answer to common European problems.
In May 2001 higher education ministers from 32 European countries met in Prague and confirmed the key points of creating a European Higher Education Area by 2010:
- to simplify the patchwork of higher education qualifications
- to improve mobility within Europe and attracting students from around the world
- toensure high standards
A new follow-up meeting of the higher education ministers will take place in the second half of 2003 in Berlin to review progress and set directions and priorities for the next stages of the process towards the European Higher Education Area.
It may be necessary for the development of their professional and academic career that students continue their studies in another European country. Students envisaging a study abroad will be looking for:
- study programs which are relevant to their final degree
- full academic recognition which ensures that they will not lose time in completing their degree by studying in another European country
- alternative ways to get their desired degree
In a number of countries such as the United Kingdom (1966), Germany (2001) and The Netherlands (2002) the bachelor-master (BaMa) system has now been introduced. Graduate (MSc) and postgraduate (PhD) studies have been available in the UK since 1969. Recently, in October 2002, the German Federal Handwerkskammer (Federal Council of Handicrafts), which controls and regulates 123 handicraft professions including not only traditional professions as Augenoptiker/Optometrists but also the new IT professions, announced the introduction of a Bachelor’s Degree for Handwerksmeister (handicraft masters). Also recently, in October 2002, a treaty was signed by the University of Applied Sciences TFH Berlin (Germany) and the Pennsylvania College of Optometry (United States) for a joint Master of Science Degree in Clinical Optometry at the school in Berlin from 2003. Also The Netherlands are developing a Master’s Degree in optometry.
The international comparison of bachelor and master education will be supported by a system of accreditation based on content and quality. Accreditation means that education meets professional qualifications as laid down in the law. Accreditation is the final result of a system of evaluation and visitation. In 2001 Germany established accreditation agencies (Akkrediterungs Agenturen) which are state controlled or private institutions. In The Netherlands from 2003 the newly established National Accreditation Council will decide, based on standardized quality control, whether schools will get accreditation. Accredited school meet high quality standards according to European directives. Without accreditation, schools will no longer receive government money!
ECOO’s European Diploma in Optometry
The first initiative to establish the Diploma was taken by ECOO in 1988 in Venice, more than 10 years before the Bologna Declaration. The virtues of the diploma are that optometry in Europe now has one uniform standard of practice; that all member states of ECOO are familiar with its syllabus; and that they all take example from the diploma. The most important merit of the diploma is that the standard of optometry in Europe has once and for all been settled and that there is no going back on this decision. ECOO’s European Diploma in Optometry is and must remain the Gold Standard of Optometry in Europe! The imminent expansion of the European Union will not and must not endanger the standard!
Since the Bologna Declaration developments of the diploma need to closely follow developments in European education.
The objectives of ECOO’s European Diploma in Optometry have been threefold:
- to achieve a uniform high standard of practice of optometry throughout Europe
- to facilitate mobility and employability of optometric practitioners within Europe
- to reinforce representation of the optometric profession in Brussels and with national health care departments and higher education institutions
In many countries health care has become so expensive that governments look for ways to substitute expensive medical specialists and the less expensive general medical practitioners by non medically qualified professionals who can do the job just as well but for less money. The dividing lines between domains and responsibilities are shifting and optometry may profit from these developments! Everywhere health care is getting so expensive that modernization of health care becomes necessary. In this process ECOO and the Diploma should take their role.
ECOO’s European Diploma in Optometry aims to achieve a uniform practice of optometry of the highest and most realistic standards throughout Europe and to increase the scope of practice. The right order is: education, legislation, implementation. Educate, then Legislate!
The Diploma is the combined total of all knowledge, skills and attitudes that the ECOO member countries deem necessary. For example, it combines the strong physical basis and emphasis on the optical aspects of German Augenoptik/Optometry with the biomedical and healthcare approach of optometry in the United Kingdom.
Europe encourages free movement of workers, an optometrist from country A is entitled to work in country B provided he has the proper qualifications required to practice in country B. In the future, students or practitioners who want accredited education in additional fields of optometry which are not taught or accredited at their own school should be able to take their already obtained ECTS credits with them and graduate at another institution. ECOO’s European Diploma in Optometry can therefore be especially useful as a calibration instrument for the member states of ECOO. Each country can use those parts of the syllabus of the European Diploma that are necessary for that country’s requirements. It will enable countries to develop their educational structure at their own pace whilst building accreditation towards the full Diploma.
To make ECOO’s European Diploma in Optometry a success has proven to be a most complicated and cost intensive process. There is a huge variation of standards and a low pass rate. It is even for students and graduates from countries with optometric education at the highest level difficult to pass the European exam.
In view of the present low number of candidates one may conclude that the diploma has not yet become established in the awareness of the European optometric rank and file.
Despite considerable financial contributions from ECOO members, industry, European Community (Leonardo da Vinci funding) and other donations, financing of ECOO’s European Diploma in Optometry remains a serious problem and will in the future require both increased contributions from the members and increased examination fees from the candidates. Funding from outside the profession will have to be considered and when the future format of the Diploma has been decided approaches can be made to the optical industry and Brussels.
The problems during the October 2002 exams have demonstrated that the organization of exams puts too heavy a burden and responsibility on the association that administers the Diploma.
In the long term it seems impractical to continue with one central examination for Europe. The moment has come to consider changes in the present set up of the diploma and switch to examinations at accredited schools throughout Europe and philosophize about competency based standards and examinations.
Competencies and accreditation
There is a world wide movement to competency based standards and examinations. Australia and New Zealand already have introduced competency-based standards for trades and professions to allow for maximum use of skills present in the community, increase labour market efficiencies and equity, offer a fairer method of testing overseas trained professionals, and facilitate the recognition of those who attempt, but fail, to obtain professional qualifications. Competency-based standards are seen to encompass all forms of achievement of competence rather than only formal indicators such as formal qualifications from educational institutions. Competency is the ability to perform the activities within an occupation or function to the standard expected in employment.
The competency standards for optometry of Australia and New Zealand list the minimum standards of knowledge, skills and attitudes which a new graduate needs to meet in order to perform to an appropriate standard in the workplace. Competencies provide optometry with a common language.The Australian overall competency of the profession is segmented into units of competencies that typically represent a major function or role of the profession:
Unit 1: Professional and Clinical Responsibilities
Unit 2: Patient History
Unit 3: Patient Examination
Unit 4: Diagnosis
Unit 5: Patient Management
Unit 6: Recording of Clinical Data
The registration authorities of Australia and New Zealand have set up The Optometry Council of Australia and New Zealand (OCANZ) as the body from the government regulatory authorities across both countries who oversee standards in optometry. The competencies are set through consultation with the schools of optometry and the professional bodies.
Competency-based standards are now the basis of the examination process that has been put in place for overseas optometrists wanting to practice in Australia and New Zealand. This examination is run by OCANZ. The same body, OCANZ, has put in place an accreditation process that each of the four optometry schools in that region have gone through. Their accredited status means that their graduates are exempted from having to sit the OCANZ examinations. The facilities, education processes and examinations are deemed to be sufficient to guarantee that the graduates of the four optometry schools have the entry level competencies to practice in either Australia (all states) or in New Zealand.
Competency based standards provide optometry with a common language. Common competencies and standards mean that proper recognition can be given for knowledge and skills acquired in other countries. This will make the cross border recognition of qualifications and the identification of deficiencies easier. The optometrist will then only have to qualify in the deficient area which saves him re-qualification in order to practice in another country.
The competencies of the European Diploma include the competencies of the optician, which in several countries is a separate profession.
Competency based standards enable development of the Diploma recognizing the standards of education and training in all member countries of ECOO.
Conclusions
- ECOO was ahead of its time when, in 1988, it established the European Diploma in Optometry. It parallels the developments in the European Higher Education Area since the 1999 Bologna Declaration.
- The new European higher education system (establishment and mutual recognition of BaMa structure and ECTS credits) reinforces optometry’s farsighted efforts to streamline the profession in the European Higher Education Area.
- The Diploma is important as a political tool, for educational advance and for increase of scope of practice. It sets a standard for educators, improves national qualifications and encourages professional advance (lifelong learning). Lifelong learning promotes career prospects. The Diploma, competency based standards and exams and a system of accreditation will reinforce the profession’s position in Brussels and at the national health care departments.
- The Diploma is especially useful as a calibration instrument for the member states of ECOO. Each country can use those parts of the syllabus of the European Diploma that are necessary for that country’s requirements. It will enable countries to develop their educational structure at their own pace whilst building accreditation towards the full Diploma.
- The standard of optometry in Europe has been settled once and for all. There is no going back on this decision. ECOO’s European Diploma in Optometry must be the Gold Standard of Optometry in Europe and must remain so also after the imminent expansion of the European community. Therefore no discussion is necessary about the viability of ECOO’s European Diploma in Optometry!
- To make the Diploma a success has proven to be a most complicated and cost intensive process. There is a huge variation of standards and a low pass rate. In the long term it seems impractical to continue with one central examination for Europe.
- Short term
- Mid term
- Long term
Feike Grit, BSc DSc FCOptom FAAO, Netherlands, 3rd November 2002
The author wishes to thank Wolfgang Cagnolati (Germany), Frank Buijs, Gert-Jan Deben, Frans van der Horst, Kees Kortland (Netherlands) and Bob Chappell (United Kingdom) for their input.