A survey of UK optometry trainees’ smoking cessation training

Abstract

Background: Smoking is a risk factor for a number of eye conditions, including age-related macular degeneration, cataracts and thyroid eye disease. Smoking cessation interventions have been shown to be highly cost-effective when delivered by a range of healthcare professionals. Optometrists are well placed to deliver smoking cessation advice to a wide population of otherwise healthy smokers. Yet optometrists remain a relatively neglected healthcare professional group in smoking cessation research and policy. Surveys of UK medical/nursing schools and of optometrists' training internationally demonstrate significant deficits in current curricular coverage regarding smoking cessation. This study aimed to identify the extent of smoking cessation training in UK optometry trainees' undergraduate and pre-registration training. Methods: All undergraduate optometry schools in the UK (n = 9) were invited to participate in a web-based survey of their curricular coverage and assessment related to smoking cessation, and of perceived barriers to delivering smoking cessation training. A content analysis of the College of Optometrists Scheme for Registration Trainee Handbook 2014 was conducted to identify competence indicators related to smoking cessation. Results: Nine undergraduate optometry schools (100%) responded to the survey. The majority reported dedicating limited hours (0-3) to teaching smoking cessation, and predominantly focused on teaching the harmful effects of smoking (89%). Only one school provides practical skills training for delivering evidencebased smoking cessation interventions, including very brief advice. The majority of schools (78%) reported that they did not formally examine students on their knowledge or skills for supporting smoking cessation, and rated confidence in their graduates' abilities to deliver smoking cessation interventions as 'poor' (78%). Lack of knowledge amongst staff was identified as the key barrier to teaching about smoking cessation support. The pre-registration competency framework does not include any competence indicators related to providing support for quitting smoking. Conclusions: There are substantial gaps in the current curricula of UK optometry training, particularly regarding practical skills for supporting smoking cessation. Increased curricular coverage of these issues is essential to ensure trainee optometrists are adequately trained and competent in supporting patients to quit smoking.

What do patients think about the role of optometrists in providing advice about smoking and nutrition?

“…A recent review of undergraduate optometry schools in the United Kingdom (UK) concluded that there was a need to enhance practical training to support smoking cessation in the curricula of optometry training, to ensure optometrists are competent in supporting patients to quit smoking. 36 This finding parallels research that reviewed the coverage of tobacco addiction in UK medical school curricula and confirmed similar deficiencies in physician training in this area. 37 At present, whether similar scope for improved training in this area exists in the Australian optometric curricula is unclear.…”

“…There is therefore a need to ensure that eye care professionals are adequately equipped, in terms of training and competence, to discuss smoking behaviours with their patients. A recent review of undergraduate optometry schools in the United Kingdom (UK) concluded that there was a need to enhance practical training to support smoking cessation in the curricula of optometry training, to ensure optometrists are competent in supporting patients to quit smoking . This finding parallels research that reviewed the coverage of tobacco addiction in UK medical school curricula and confirmed similar deficiencies in physician training in this area .…”

Seeing New Opportunities to Help Smokers Quit: A UK National Survey of Optometrist-Delivered Smoking Cessation Behavioral Support Interventions

“…< 1 hour) to teaching on smoking cessation (35). This time is spent primarily teaching the negative health consequences of smoking, rather than practical skills for delivering smoking cessation interventions in practice (35). Similar gaps have been identified in surveys of optometry training curricula in other countries (e.g.…”

“…A recent national survey of the curricula of all optometry undergraduate and pre-registration training programmes in the UK identified that optometry schools typically dedicate limited time (i.e. < 1 hour) to teaching on smoking cessation (35). This time is spent primarily teaching the negative health consequences of smoking, rather than practical skills for delivering smoking cessation interventions in practice (35).…”

“…In the UK, the College of Optometrists Scheme for Registration Trainee Handbook specifies the core competences that trainee optometrists are expected to acquire and demonstrate as part of their pre-registration training and assessment. However, a content analysis of the most recent edition of the competence framework identified no competence indicators related to smoking cessation service provision(35). There is scope to incorporate smoking cessation under existing competence indicators in the framework, such as 'assessing patient history related to general health and lifestyle,' and 'making appropriate referrals'(35).…”