July 2024 - Evidence based practice

Evidence based practice has been credited as a way to optimise patient outcomes and should therefore be a priority for optical professionals and learners. It applies research findings and the integration of evidence with clinical knowledge to daily patient care. The General Optical Council's ‘Outcomes for Registration and Approved Qualifications’ stress in Outcome 3 (Clinical practice), that optical professionals must engage in evidence-informed clinical decision-making for all patients, and accept responsibility and accountability for professional decisions and actions. 

Lecturer in ophthalmic dispensing, Maryna Hura observes that “the very first day on an ophthalmic dispensing course mark(s) the beginning of our journey as life-long learners and, to some extent, researchers.”[1] The accumulation of knowledge and experience enables optometry and ophthalmic dispensing professionals to challenge existing traditions, as well as new developments. 

Optical professionals place great emphasis on making decisions based on evidence, but it can be difficult to connect research findings with the patient experience. With this in mind, how can we help learners to navigate the evidence base that underpins clinical learning? This month, Specialist Optometrist and Phd Student, Matt Roney answers key questions on how to develop decision making skills in optometry and ophthalmic dispensing learners.  

How can learners develop skills to make decisions based on evidence and research?

Research based evidence is fundamental to everything that we as optometrists and dispensing opticians do in our day-to-day job, whether this is in a manufacturing, clinical or an academic setting. This evidence-based work is underpinned by a hierarchy as demonstrated in Figure 1. It is imperative that optometrists and dispensing opticians are familiar with this ladder of evidence as this infers the quality and thus the “reliability” of such evidence.

Although it is great to look at a pretty picture, how do you make this pyramid translatable into your daily attributes? These are my anecdotal, tried, and tested methods of developing skills to make evidence-based decisions in my daily practice. 

  • Firstly, fully immerse yourself in your subject area! Starting at a superficial level, followed by delving down into the nitty gritty of the topic. Taking time to reflect and consolidate knowledge whilst applying these to real world scenarios.
  • Consult and explore the free member resources provided by The College of Optometrists, particularly the peer reviewed Clinical Management Guidelines (CMGs) and the “Using Evidence in Practice”. This informs your knowledge basis and provides the most up to date expertise for yourself, colleagues, and the patients we serve. (College of Optometrists, 2023)
  • In addition to the CMGs provided by The College of Optometrists, I myself consult peer reviewed guidance as delivered by the Cochrane Library as well as clinical guidance by the National Institute for Health and Care Excellence (NICE). This a source of the highest quality research and understanding in our field. (Library, 2024) (National Institute for Health and Care Excellence, 2024)
  • Understand the “what, where and why” of evidence-based practice through podcasts, CPD and articles. One resource that I advise all optometrists and dispensing opticians wanting to practice at the top of their licence is to listen to the Docet “Sound Optometry” podcast, episode 38; providing a guided journey through evidence-based practice with guest speakers Paramdeep Bilku and Alan Hawrami, many of whom consider these speakers to be the “goats” of modern day IP optometry! (Docet, 2024)
Figure 1 (Learning, 2020)
  • Collaborate with a mentor, someone who you look at and think, “you know what, I wouldn’t mind taking a leaf from your book!”. They always inspire those wanting to develop and are more than happy to provide guidance alongside a cup of tea when needed!
  • Join a “journal club”. There is a plenitude of journal clubs out there. Although they might not call themselves a “journal club”, the underlying purpose is certainly there! A collective gathering of colleagues from the profession who come together regularly to discuss the latest developments, research and present/discuss anecdotal cases to a cohort of peers. If you can’t find one, form one?!
  • Integrate simulation exercises into your regular training and CPD. This provides an inherent opportunity to integrate evidence-based research into clinical decision making.
  • Another way to develop skills in the area of evidence based practice is to become involved in research itself! I myself have opened a new chapter in my career by undertaking a PhD in the field of Glaucoma at The University of Liverpool. In such a short space of time, my understanding, appreciation and knowledge basis in the field of research has improved dramatically. This in turn has opened the door to a higher level of understanding when reading journals, evidence as well as providing the latest advice and guidance to patients in a clinical setting. Becoming involved in research doesn't have to be this formal or involved, it can be done in your own practice. The College of Optometrists can provide guidance and even financial support to encourage the development of research at not only a University level (Undergraduate, Phd Scholarships, Postdoctoral, as well as Research and Clinical Fellowships) but also at a practice level (practice-based research projects) (https://www.college-optometrists.org/professional-development/research-awards-and-grants/research-grants). Getting into research is something many don't think about, however I would highly recommend at least considering it!
  • And finally, undertake higher qualifications. Whether that is postgraduate qualifications accredited by The College of Optometrists (e.g. Higher Certificate in Glaucoma) or University accredited learning (e.g. Masters of Research – MRes), this is an incredible opportunity to accrue formal teaching and add more arrows to your quiver. (College of Optometrists, 2023)

How do you help prepare learners for the unpredictable future?

Our profession is changing by the year, month, day, minute and second. I have been a part of this profession for 7 years (registering in 2017), in that time I have seen a multitude of changes. So much so, that even just thinking about them is making me tired! 

But nonetheless, how do I myself help learners to be ready for what lurks around the corner? No matter who it is, optometrists, optometry students, ophthalmic dispensing students and allied health colleagues, I think the first step is to go back to question 1 as a starting point. 

Otherwise, I wholeheartedly believe that it is crucial to foster adaptability, open-mindfulness and continuous learning. This can be achieved through teaching problem-solving skills, encouraging interdisciplinary collaboration, whilst promoting a culture lifelong learning. Rather, not learning for learnings sake, but because it is the right thing to do. Ultimately, providing the best possible information and guidance for those we encounter on a daily basis. 

I also genuinely believe, it is fundamental to expose yourself to an array of clinical scenarios and emerging technologies, allowing you to stay agile and ready to face future challenges in the field. Even if it’s something you don’t think is “up your street”, all knowledge is good knowledge!

This is the best advise that only you can do to stay at the forefront of the profession allowing you to stand out from the crowd!

How can we advise course teams on how to guide learners?

Having had a fair few years of continued involvement with higher educational institutions, I strongly believe that course teams should implement the incorporation of active learning strategies. But, what do I mean by this superficial statement? I stand by that some of the best ways to learn and develop is through case based learning and PBL (problem-based learning). This, in my opinion should form the foundations for vocational curriculums at both under and postgraduate level. This goes hand in hand with my utilisation of formative assessments as a periodic opportunity to receive ongoing feedback. 

And finally. I believe that as educators, the best thing that you/we can do for your/our students is to inspire curiosity and inquisition. This opinion provides the foundation for supporting colleagues to go the “extra mile”, taking a genuine interest in their career, become interested in research whilst being the best that they can be for our truly gifted and talented profession! 

And as a parting note, thank you, you as the reader for all you do for our profession. Ta!

Keep updated 

If you would like to be kept up to date with the work of SPOKE, please email spokehub@college-optometrists.org to be added to our Advisory Review Group. Similarly, please email with your views of Topic of the month or any suggested themes you would like to see covered. 

Mr M Roney BSc (Hons) Optometry, Dip Glauc, Dip TP(IP), MCOptom

Matt earned his Optometry degree from the University of Bradford in 2016 and completed his pre-registration training at Moorfields Eye Hospital, London. Since becoming fully qualified Optometrist in 2017, he has worked with the Liverpool Hospital Foundation Trust and Alder Hey Children’s Hospital.

Presently, Matt serves as a Specialist Optometrist at The Royal Liverpool University Hospital, specialising predominantly within the field of Glaucoma and Acute Ophthalmology. He currently holds the Diploma in Glaucoma as well as in Therapeutics and Independent Prescribing (IP). His clinical expertise is further recognised through his role as an Honorary Clinical Fellow in Ophthalmology at the University of Liverpool. In addition, he is a visiting lecturer and examiner at The University of Hertfordshire, focussing on Glaucoma and IP.

In 2019, Matt was elected as a council member representing the North-West of England within The College of Optometrists, also serving as a Trustee for the College.

As of 2023, Matt has transitioned into a new phase of his career, a PhD at the University of Liverpool, funded by Glaucoma UK and St Paul’s Research Foundation. His research focuses on utilising newer generational imaging modalities to improve the success of Glaucoma filtration surgeries. This research underscores his dedication to advancing the field through innovation and enhanced patient care.

Matt's journey is characterised by his relentless pursuit of excellence in clinical practice, education, research, and professional leadership, reflecting his deep commitment to Optometry.

Bibliography and references 

[1] Hura.M (July 2019) Evidence-based practice Part 1, Dispensing Optics

The College of Optometrists. (2023) Higher qualifications (Accessed: 30 May 2024).

The College of Optometrists. (2023b) Independent prescribing (IP) qualification (Accessed: 30 May 2024).

The College of Optometrists. (2023) Using evidence in practice (Accessed: 30 May 2024).

Docet (2024) Sound Optometry: Episode 38 - Evidence-based practice: What, where, why? (Accessed: 30 May 2024).

Hura.M (August 2019) Evidence-based practice Part 2, Dispensing Optics

Learning, R. (2020) Hierarchy of Evidence 

Library, C. (2024) Cochrane reviews | Cochrane Library, Cochrane Library (Accessed: 30 May 2024).

The National Institute for Health and Care Excellence (2024) NICE. (Accessed: 30 May 2024).

Tempany. K (March 2023) ABDO CPD Using evidence-based practice to communicate myopia management 

Wilson.B and Austria. M.J (Feb. 26, 2021) What is Evidence-Based Practice?