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This is the third installment in a 3-Article series covering the genesis and maintenance of the National Board Exam for Optometry (the Exam).  There are three individual parts of the National Board Exam (Part I – Applied Basic Science, Part II – Patient Assessment and Management and Part III – Clinical Skills Exam), but this article series discusses the Exam as a whole. The following information should be helpful in providing a basic understanding of this essential tool for ARBO’s member boards.

This is Article 3 in a 3-Article series covering the genesis of the National Board Exam (the Exam). In Articles 1 and 2 we discussed how the Exam is developed and maintained using a ‘validity centered’ approach. Article 3 will finish the discussion with Standard setting and Maintaining the test.

Conduct standard setting

The primary guiding question for this step is:

• How should we determine the cut-point on the test score scale, i.e., what will be the ‘cut score’?

The most critical outcome of a licensure exam is the pass/fail decision.  The passing score must be defensible and reflect the skills necessary for entry-level practice. The National Board of Examiners in Optometry (NBEO) recommended that the passing score[1] be obtained through a systematic standard setting study.

Standard setting is the process of defining the performance expectations of the minimally qualified candidate and translating that performance expectation into a passing score.  For the most recent study, NBEO used the yes/no variation of the Angoff[2] standard setting method (commonly used to determine passing scores for licensure programs).  The standard setting study was conducted with the input of an independent panel of Subject Matter Experts (SME) and facilitated by an independent third-party testing organization.

Maintaining the test

The primary guiding question for this final step is:

• Once a test is created, what are the test creators’ ongoing responsibilities?

To preserve exam security, NBEO periodically publishes new exam forms.  Although these new forms are based on the same Competency Model, the forms contain new items.  To meet this need, item development meetings, item review meetings, and new form constructions are conducted regularly.  Additionally, to ensure that the test items are performing well statistically, periodic analyses (i.e., health checks) are conducted regularly.

The optometric profession is not static; over time, best practices can change and new technologies emerge. The NBEO constantly monitors to ensure that the content and performance expectations remain current and relevant.  To meet this need, NBEO conducts new job task analysis and standard setting studies.

Table 1. Frequency of Test Development Activities

Activity	Frequency
Item Development; Item Review; Health Check; Form Creation	At least yearly
Job Task Analysis; Standard Setting	Approximately every 5 years

 

Thanks to Dr. Brett Foley of Alpine Testing for the content of this series.

 

[1] Each licensing body is responsible to determine if a candidate has demonstrated sufficient competency to be eligible for license.  Licensing bodies who apply passing scores different from those recommended by NBEO are responsible to justify and defend the decisions made using those passing scores.

[2] For information on the specific methodology, see: Impara, J. C., & Plake, B. S. (1997). An alternative approach to standard setting. Journal of Educational Measurement, 34(4), 355-368.

This is the second installment in a 3-Article series covering the genesis and maintenance of the National Board Exam for Optometry (the Exam).  There are three individual parts of the National Board Exam (Part I – Applied Basic Science, Part II – Patient Assessment and Management and Part III – Clinical Skills Exam), but this article series will discuss the Exam as a whole. The following information should be helpful in providing a basic understanding of this essential tool for ARBO’s member boards.

 

The National Board Exam – Article 2 of the 3-article series

This is Article 2 in a 3-Article series covering the genesis and maintenance of the National Board Exam for Optometry (the Exam).

In Article 1 we began our discussion of how the Exam is developed and maintained using a ‘validity centered’ approach. We will continue the discussion along the flow chart with Developing and Reviewing content and then pre-test, analyze and assemble operational test.

Develop and review content

Guiding questions for these development steps include:

• How will quality items be created?
• Who will create them?
• How many items should be written?
• Which steps are needed to make sure items are not biased against certain subgroups?
• How can we ensure technical accuracy of the items?

Once the Competency Model is finalized, test items must be written targeting the appropriate content areas.  Subject Matter Expert (SME) Committees are trained by testing professionals in the current best practice for writing high-quality items.  Generally, more test items are written than are needed for a single exam form to allow for item attrition during review.  Once items are written, SMEs are guided through a review process in which they help determine the congruence, accuracy, and fairness of the items.  The SMEs make sure the items match the intended content areas, are technically accurate and clear, and do not unfairly disadvantage any group or contain potentially offensive language.

Pretest, analyze, and assemble operational tests

Guiding questions for these development steps include:

• How is pre-test data used to assemble operational tests?
• How do we make sure results from different forms are comparable?

Items that have been written and reviewed are eligible for inclusion on the Exam test form.  Test forms are built to reflect the content representation laid out in the Competency Model and Test Blueprint.  However, items are not used to compute candidate scores until they have been administered to sample real test candidates. The statistical information obtained from this pre-testing process provides additional information about the technical quality of the items.  The empirical data obtained from pre-testing is also important when constructing new test forms. The overall difficulty of the new form is designed to match the old form through a statistical process known as equating.

Article 3 will cover

• Standard setting
• Maintaining the test

Thanks to Dr. Brett Foley of Alpine Testing for the content of this series.

This is the first installment in a 3-article series covering the genesis and maintenance of the National Board Exam for Optometry (the Exam).  There are three individual parts of the National Board Exam (Part I – Applied Basic Science, Part II – Patient Assessment and Management and Part III – Clinical Skills Exam), but this article series will discuss the Exam as a whole. The following information should be helpful in providing a basic understanding of this essential tool for ARBO’s member boards.

The Exam plays an important role for our state and provincial board members. It is an essential tool that allows ARBO member boards to judge entry-to-practice competency for licensure. But more than a tool, the Exam is a living entity that must constantly change and update itself in order to adapt to the ever-shifting optometric environment.

We all know of the Exam. Boards rely on it, candidates sweat over it and a cadre of councils, committees, dedicated optometrists and a leadership organization (NBEO) create it, mold it, organize and constantly update it. The result is a current, comprehensive, relevant and fair exam that stands as a pillar of optometric public protection.

So what exactly goes into the planning required to produce this examination? The National Board of Examiners in Optometry (NBEO) uses a ‘validity-centered’ approach when developing the exam.

Validity is the degree to which theory and evidence supports the intended uses and interpretations of test scores. Every step in the exam process is centered around validity.

Next, we will discuss who is involved in the development of the Exam and discuss the first few elements in Figure 1.

Who is involved in the Exam development?

• 

  NBEO staff are responsible for the day-to-day operation and administration of the program.

• Subject Matter Experts (SME) Committees – Optometric professionals and educators of new professionals provide content expertise necessary for many of the test development steps.
• Independent Assessment Professionals – These are the psychometric professionals that help to train SMEs in test development processes and provide technical consultation and review.

 

Designing the program and the test

Questions that guide these important initial steps include:

• What is the purpose of the test?
• What format should the test be?
• How will the test be administered

The primary purpose of the Exam is to accurately identify candidates with the knowledge, skills and abilities needed for safe and effective entry-level optometry practice. The Exam format is multiple-choice. The administration is computer-based at Pearson VUE testing centers for Part I and Part II. Part III is administered as a clinical exam on-site at the National Center of Clinical Testing in Optometry (NCCTO®) located in Charlotte, North Carolina.

 

Analyze the domain and develop the blueprint

Questions to guide this process include:

• What knowledge/skills/abilities should the test address and at what cognitive complexity level?
• How many test items should be devoted to each content area?

The content of the exam items must match the knowledge/skills/abilities necessary for the safe and effective entry-level practice (i.e., the “job-relatedness” of the exam) to ensure the validity of test score interpretations.  SMEs – Clinical optometric professionals and educators of new professionals – are heavily involved in this process.

Focus groups of SMEs convene to identify important content areas based on their professional experience.  The results of the focus groups are converted into surveys, which are distributed to a large sample of optometric professionals for feedback.   This feedback helps to identify the most important knowledge/skills/abilities necessary for safe and effective entry-level practice.

Survey information is used to create and update the Exam Content Matrix – a document shared with candidates and other constituents that specifies the content areas eligible for inclusion on the exam and the relative weight given to each area. Survey feedback is used to develop and verify that the content of the Exam Content Matrix remains appropriate over time.  The formal process of identifying the relevant exam content and determining the proportional representation of this content on the exam is referred to as a job task analysis.

Article 2 of this article series will discuss

• Developing and reviewing content
• Pretest, analysis and assembling the operational test

Article 3 will cover

• Standard setting
• Maintaining the test

Thanks to Dr. Brett Foley of Alpine Testing solutions for the content of this series.

2019 is a landmark year for ARBO as we commemorate our 100^th anniversary!  ARBO is one of the oldest continuously operating organizations in optometry and our mission of assisting licensing boards hasn’t changed since we began.  For 100 years, we’ve provided our members with programs and services to assist in evolving the effectiveness and competence of the licensing boards.  In this day of high-speed technology, it seems that companies come and go all the time.  One hundred years is not just a milestone birthday, but an indicator that this organization is well-grounded and necessary. 

During these past 100 years, the thousands of people that have been involved with ARBO have provided great insight and leadership for optometry.  ARBO began as the International Association of Boards (IAB) in 1919. The early leaders had a vision—to create a venue to bring boards of optometry together to create uniformity, share knowledge, and advance optometric regulation for the benefit of the public.

Our name was changed to the Association of Regulatory Boards of Optometry (ARBO) in 1999, but our focus remains the same.  Regulatory boards today continue to be presented with many challenges, and experience is a great teacher.  For 100 years, ARBO has served its member boards well by developing programs to help ease the burden on regulatory boards and by being a conduit of information regarding licensure and regulation. 

ARBO can look to its history and view many instances of great wisdom.  In many cases, the issues that were raised by ARBO leaders were ahead of their time, and ahead of the thinking of the majority of the profession. Today, the possibilities for the future of optometry remain as exciting as our early leaders envisioned.  However, efforts at deregulation and ever diminishing resources in governmental budgets and all of health care will continue to have an impact on our future progress.

We will look to the next century as a great challenge for optometry and ARBO must keep advancing as well to protect the public we all serve.  To commemorate ARBO’s past accomplishments and its historical significance to present-day optometry, we invite you to attend our 100^th Annual Meeting, June 16-18, 2019 in St. Louis, Missouri.  Please join us for our centennial meeting as we look back, see ahead, and work together to create a 20/20 vision for the next century of ARBO.  We look forward to seeing you there!

The American Academy of Optometry (Academy), the Association of Regulatory Boards of Optometry (ARBO), and the Association of Schools and Colleges of Optometry (ASCO) are pleased to announce a joint agreement has been reached to restructure the governance of the Council on Optometric Practitioner Education (COPE™). The newly established COPE Governing Committee will be comprised of representatives from ARBO, ASCO, and the Academy to assure collaboration and the ongoing advancement of the quality of optometric continuing education.

“After several years of profession-wide discussions, the Academy is pleased to announce that we signed a Memorandum of Understanding agreement to form a multi-organizational COPE Governing Committee. The collective strengths and unity of our organizations will ensure the highest standards of optometric continuing education and the sustained advancement of the profession,” states Brett G. Bence, OD, FAAO, Academy Past President (2015 & 2016).

COPE accredits optometric continuing education for use by ARBO’s member regulatory boards in assessing and determining eligibility for licensure by optometrists. COPE accreditation serves the public, regulatory boards and the profession by promoting improvement in competence, performance and patient outcomes.

“ARBO is pleased to announce this historic collaboration with the Academy and ASCO. We’re looking forward to enhancing communication and broadening decision-making by adding their expertise to COPE. I’m confident that they will make valuable contributions to the COPE accreditation process to have a positive impact on optometrist learning, performance and patient health outcomes,” states Richard Orgain, OD, ARBO President.

“As optometric educators, the faculties from our 23 institutions set high standards for ourselves and for our students,” says David Damari, OD, FCOVD, FAAO, President of ASCO and Dean of Michigan College of Optometry at Ferris State University. “ASCO is pleased to join our colleagues from ARBO and the Academy on this agreement regarding the governance of and standards set by COPE. This collaborative effort will benefit all optometrists as they continue on the path of life-long learning begun in the schools and colleges of optometry.”

Initial nominations to the COPE Governing Committee are now underway, with the anticipation of completion in January 2019. Duties of the governing committee will include setting standards, policies and procedures for the COPE accreditation program, making accreditation determinations based on compliance with COPE accreditation criteria and policies, and preparing and presenting an annual report to the ARBO House of Delegates and the boards of directors of the participating organizations.

About the American Academy of Optometry

The American Academy of Optometry enhances excellence in optometric practice by fostering research and disseminating knowledge in vision science through its journal, Optometry and Vision Science, and the continuing education presented at its annual meeting. Fellows of the Academy are committed to the premise that learning is a lifelong obligation of a professional, as is the commitment to expand the profession’s knowledge base through ongoing fellowship and exchange. For more information, visit www.aaopt.org or contact Ms. Jenny Brown at jennyb@aaoptom.org.

About the Association of Regulatory Boards of Optometry

The Association of Regulatory Boards of Optometry (ARBO) is a non-profit organization based in Charlotte, North Carolina, and serves 66 Regulatory Boards of Optometry in the United States, Canada, Australia, and New Zealand. ARBO’s mission is to represent and assist member licensing agencies in regulating the practice of optometry for the public welfare. ARBO established the Council on Optometric Practitioner Education (COPE) in 1993 on behalf of optometric licensing boards to accredit continuing education courses, providers and activities for license renewal. For more information on ARBO or COPE, please contact Lisa Fennell, ARBO Executive Director, 200 South College Street, Suite 2030, Charlotte, NC, 28202, ph: (704) 970-2710 or e-mail: lfennell@arbo.org.

About the Association of Schools and Colleges of Optometry

The Association of Schools and Colleges of Optometry (ASCO) is a non-profit association representing the interests of optometric education. Founded in 1941 and headquartered in Rockville, MD, ASCO is committed to achieving excellence in optometric education and to helping its member institutions prepare well-qualified graduates for entrance into the profession of optometry. Its membership encompasses the schools and colleges of optometry in the 50 states and Puerto Rico. A number of optometry schools outside the United States are affiliate and associate members. For more information about ASCO, visit www.optometriceducation.org or contact Ms. Kimberly O’Sullivan, Director of Communications, at kosullivan@opted.org.

We have noted in previous articles that “Advocacy serves to protect the profession of optometry and that regulatory serves to protect the public.” This statement has recently come under criticism, so we’d like to expand on this. Fundamentally, the statement, “Advocacy organizations protect the profession, and Regulatory organizations protect the public” is correct, and with a broad brush helps to clarify the duties and responsibilities of the different professional organizations. This is not to put advocacy or regulatory in a good or bad light. Organizations have different missions and stakeholders – which is completely appropriate. Promotion of the profession and protection of the public are necessary.

Advocacy vs. Regulatory: The Difference

Organizations do serve different purposes. The confusion (whether purposely or naively) occurs in the details of our missions. From an advocacy standpoint, if the profession is well-equipped, well-educated, and solidly established in the healthcare community as a primary care provider, patients will in-fact be better served. However, ensuring that the profession is well established and has an important, necessary and ongoing place in the healthcare arena is the primary mission of any advocacy organization. One can rightly argue that the health and well-being of the patient is a direct benefit of a strong and healthy profession. However, that is not the primary goal of professional advocacy. The primary goal of professional advocacy organizations is (and should be) the health and well-being of the profession. The health of the patient is a side effect benefit. To tie the two together and say advocacy’s mission is the same as a regulator’s (or the patient’s) mission is inaccurate and can be seen as disingenuous. On the flip side, the regulatory side could just as easily claim that we are responsible for a strong and viable profession by ensuring the good health and well-being of the patient. This would be equally misleading. You can’t ride on the coattails of a tangential result and take credit as your primary mission. Politicians do this all the time. It doesn’t mean it’s right.

Let’s look at technology. Computers today are nowhere near as fast as the human brain. However, in 10-15 years, computers will be faster and we are already starting to see the impact. Computer imaging is expanding exponentially, and computer interpretation/diagnosis already in its infancy will grow rapidly. Computers may become better diagnosticians than doctors. Can a computer diagnosis be more accurate and timelier that a human diagnosis? Won’t that be better for the patients? What happens to the provider? Will the advocacy organizations ignore the providers they’ve represented and depend on for their survival, or will they embrace a timelier and more accurate diagnosis? i.e., what’s best for the patient.

A strong profession is better for the patient, and a healthier patient as a result of professional care is better for the profession becomes a circular argument. Our professional organizations need to pick a lane and stick to what they do best as defined by their primary mission. A profession’s advocacy organization advocates for that profession. That’s their job; it doesn’t make them sinister or at odds with everyone else. Quite the contrary, they are an important part of a successful profession, but understanding that there are many important parts to a successful profession is essential for the profession looking to the future.

Our professional organizations need to recognize and understand the differences in our missions rather than try to spin it to try and be all things to all people. Homemade saviors will usually come off as either disingenuous or naive and become a hindrance to a forward moving profession.

OE TRACKER has revolutionized how licensing boards verify and audit their licensees’ and registrants’ CE attendance. OE TRACKER has also transformed how optometrists store and track their CE hours.  With OE TRACKER, CE attendance data is electronically stored and can be accessed 24/7 by licensing boards and optometrists.

OE TRACKER Assists Licensing Boards

OE TRACKER makes CE audits a snap! Due to the time and cost of manual audits, many licensing boards only perform random audits by selecting a small percentage of the optometrists in their jurisdiction. With OE TRACKER, audits can be done electronically, saving time and reducing paperwork. OE TRACKER also increases efficiency, allowing licensing boards to audit up to 100% of their licensees/registrants easily and accurately. It is a great tool for ARBO’s member licensing boards to use to help fulfill their mandate for public protection.

OE TRACKER Benefits Optometrists

OE TRACKER electronically tracks and stores CE attendance data for optometrists. The information can be accessed anytime from anywhere.  Optometrists can also review the CE requirements and their progress towards meeting them in any jurisdiction where they have a license. OE TRACKER can be accessed by an optometrist using either the mobile app or online by going to www.arbo.org.  Using OE TRACKER is as simple as it gets!

OE TRACKER Attendance Data

Data from both COPE and Non-COPE courses can be submitted to OE TRACKER.  Attendance data is submitted to OE TRACKER in several ways.  CE Providers can send the attendance from their courses to ARBO in a spreadsheet or use the OE TRACKER mobile app.  Optometrists can fax or email attendance certificates to ARBO for uploading or use the online upload form on the website. Once the hours are uploaded into OE TRACKER, the optometrist is sent a verification email.

OE TRACKER Fees

There is no charge to CE Providers to submit attendance data to OE TRACKER.  Optometrists receive basic access to their OE TRACKER account at no charge.  For full access, optometrists can pay a $25 annual subscription fee (or $60 for three years) that allows complete access to view and print their CE transcript, to print individual CE certificates, and to fax, email, or upload attendance certificates to ARBO to add into their account.  Many licensing boards and state associations also pay the annual subscription fee for their licensees/registrants or members.

OE TRACKER FAQs for Licensing Boards:

1. What is the cost to my board to use OE TRACKER?

   Utilization of OE TRACKER is included as part of membership in ARBO.  Licensing Boards can acquire a username and password from ARBO to access OE TRACKER and run the standard auditing reports. Custom reports and auditing services are also available at an additional charge.  

2.  How does an optometrist get an OE TRACKER account?

   Most optometrists are assigned an OE TRACKER number in optometry school when they register for the National Board Exams.  Once they graduate and become licensed, they use the same number to track their CE hours.  Optometrists can contact ARBO to set up a username and password to log into their account.

3. How long would it take our board staff to do a CE audit using OE TRACKER?

   It depends on how many optometrists are licensed in your jurisdiction and what your requirements are.  A standard OE TRACKER auditing report can be generated in a few minutes.

4. Can our board use OE TRACKER exclusively and do away with manual CE tracking and having to sort through paper CE certificates?

   Yes. Many licensing boards do exactly that.

5. Is there any reason that an optometrist in my jurisdiction could not use OE TRACKER?

   This would only be the case if they don’t have access to a computer, tablet, or smartphone.

OE TRACKER FAQs for Optometrists:

1. What if I don’t have an OE TRACKER number?

   If you went to optometry school in the US, you were most likely assigned an OE TRACKER number when you took the National Board Exams.  If you don’t know your OE TRACKER number, you can call ARBO at 866-869-6852 to find out what your number is and set up a username and password to access your account.  If you went to optometry school outside of the US, you can call ARBO to get an OE TRACKER number and have your account set up.

2. If there are CE courses I’ve taken that aren’t in my OE TRACKER account, how do I get those credits added to my account?

   If you’ve paid the OE TRACKER subscription fee, you can fax, email, or upload your certificates on our website for ARBO staff to add the credits into your account.

3. How long will it take for credits to show up in my OE TRACKER account after I take a course?

   If the CE provider uses the OE TRACKER mobile app, the credits will show up immediately after you scan the QR code. If you fax or email CE certificates to ARBO, the credits will be entered in your account within 3-5 business days after they are received.

4. If a course is not COPE accredited, can it still be added to my OE TRACKER account?

   Yes. Non-COPE courses can be added to your OE TRACKER account.

5. What will I see in my OE TRACKER account if I don’t pay the subscription fee?

   If you don’t pay the subscription fee, you will only have basic access to your account and will be able to see the date and the number of hours of the courses you took. In order to see the detailed course information, the subscription fee must be paid. Once you pay the fee, you will also be able to submit credits via fax, email, and online uploading and print certificates or a transcript.

6. Can the State/Provincial licensing boards make the OE TRACKER fee part of my license fees, so I can always have access to OE TRACKER?

   Yes. Many licensing boards currently pay the OE TRACKER fee for their licensees/registrants. Please check with your licensing board to see if they offer this benefit.

 

 

NEWS RELEASE

July 2018

The Association of Regulatory Boards of Optometry (ARBO) met for its 99^th annual meeting in Denver, Colorado June 17-19, 2018.  Representatives from 44 regulatory boards attended the meeting, spanning the US, Canada, Australia and New Zealand.  Among the highlights of the meeting were such topics as consumer protection, interstate medical licensure compacts, updates on open meeting rules and regulations, FTC perspectives on promoting competition in regulated occupations, and legal updates regarding the regulatory environment.  Dr. Steven Odekirk from Charleston, West Virginia was elected to the ARBO Board of Directors and Dr. Richard Orgain was re-elected for his second term.

The members of the ARBO Board of Directors for the 2018-2019 term are:

• Richard C. Orgain, OD, Tennessee, President
• James S. Campbell, OD, West Virginia, Vice President
• Patrick W. O’Neill, OD, FAAO, Minnesota, Secretary-Treasurer
• Susy Yu, OD, MBA, FAAO, California, Immediate Past President
• Thomas M. Bobst, OD, FAAO, Ohio
• Steven W. Odekirk, OD, West Virginia
• Coby S. Ramsey, OD, Wyoming
• Jerry A. Richt, OD, Tennessee
• Jeffery B. Yunker, OD, North Dakota

What role does ARBO play with the regulatory boards?

To start, ARBO is a member organization made up of optometric regulatory boards in the United States, Canada, Australia and New Zealand. ARBO’s only interests are those of its member boards and of the regulations that the optometry boards are charged with enforcing. Simply put, ARBO’s mission is to serve its member boards.

ARBO provides services and programs for its members to lessen the burden on state/provincial governments for:

Initial licensure:

• NBERC – National Board Examination Review Committee
  • NBERC is responsible for ensuring that the National Board Exams meet all requirements for testing the entry-level competency of optometrists.
  • ARBO’s member boards rely on the National Board Exams when issuing a license in their jurisdiction. The members, through NBERC, are able to review the exam development process and provide feedback and recommendations.

Maintenance of licensure:

• COPE– The Council on Optometric Practitioner Education, created by ARBO’s member boards, accredits continuing education activities and providers based on the requirements set by the optometric licensing boards.
• OE TRACKER– Captures and stores continuing education attendance data electronically for optometrists and licensing boards. The data can be accessed online by both the optometrist and the licensing board, saving time and paperwork by allowing for up to 100% electronic audit.

Regulatory Training and Research:

• ARBO’s Annual Meeting each year contains sessions for training of regulatory board members and a legal update of regulatory issues.
• ARBO will research regulatory issues for its members and find out how other regulators are dealing with the same issues.

Regulatory Capture

ARBO is aware of attempts at regulatory capture.  This is when a group tries to influence a regulatory board to think more about protection of the profession than protection of the health and welfare of the public. In order for regulatory bodies to be effective and defensible, they must be free of influences that may try to corrupt their mission. In many cases, this influence comes from the professional advocacy groups or any special interest group that may be affected by regulation. That is not to say that advocacy or special interest groups are bad. Quite the contrary; most serve their profession or special interest well. As a regulator, however, it is critical that the differences between advocacy and regulatory are understood.

Advocacy serves to protect the profession of optometry; regulatory serves to protect the public when receiving services from the optometric profession.  That does not mean that we work against professional advocacy organizations. Optometry is a proud profession and our professional organizations understand the importance of excellence in patient care and protection. In many ways, we fight the same battles for providing quality care for patients, but our roles are distinctly different.

Risks of Allowing Advocacy to Influence Regulatory

Most regulatory boards contain both optometrists and non-optometrist members. Optometrists have a significant role in regulation in that they are experts in the profession and are uniquely qualified to judge whether the services provided are competent, ethical, and meet the standards outlined in in law. However, if an advocacy group were to influence the judgment of an optometric board member that would constitute a significant conflict of interest and could jeopardize optometric representation on the board. Loss of optometric representation on regulatory boards would leave the boards without competent optometric expertise which could put the public at even greater risk.

One could rightly say that having any optometrist on a state or provincial licensing board creates a conflict of interest. Conflicts of interest often cannot be avoided, but they can be identified and managed to a satisfactory degree. Part of that management is to understand that all actions and judgments must be as government agents representing the best interest of the public we serve. We manage the conflict of interest by understanding our role as regulators and professional experts and not allowing our board position to be influenced (or seen as being influenced).