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Some offices may have seen a drop
in the amount of business, and some difficult decisions are going to have to be
made in response. It makes sense to assess costs and look for efficiency in the
office during times of economic certainty, so it is no surprise that employers
will take a long look at their expenses to make the most of any financial
investment.
What might come as a surprise,
however, is that the employer’s best investment is one that can be grown and
developed inexpensively, often at little or no cost. That investment? Employees.
The training of your employees and the values imparted to them by that training
should be considered in any discussion of staff efficacy or performance.
Develop Your Investment
If you
provide your employees with support and direction, you can expect to receive
greater responsibility, loyalty and expertise in return. A serious commitment
to your employees’ development underscores their role as representatives of the
office—professionals who are accountable for carrying out the intentions of the
employer, whether the employer is present or not.
Employees
are entrusted to unlock the doors each morning and do the work each day. Every
time an employee interacts with a patient, a particular image of the office is
painted. What kind of image do you want it to be? Probably a professional,
inclusive, medical environment, in which patients will feel both comfortable
and confident in your care, right?
Foundations of Learning
Big
(and basic) nuggets of information constitute a solid foundation for further learning.
For instance, when explaining prism
shape and lens mechanics, you might break it down like this:
• Light is bent toward the base of
a prism, and the image is displaced
toward the apex.
• Diopter: A 1.00D lens displaces the
image 1cm at a distance of 1m.
• Focal length is a reciprocal of
lens power, f = 1/D
Cylinder
power.
• Lens cylinder has no power along its axis and full power 90º away.
• Visible
light occupies a very small area on the electromagnetic scale.
• Lens
clock.
• Index of
refraction = the speed of light in a vacuum / the speed of
light in the material.
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But, how is this intention supposed to
manifest itself? How does such a specific and complex vision materialize?
You’ll
have to build up to that vision by building up your employees—by educating
them, defining their responsibilities and maintaining a high standard of
performance. In order to perform at their highest (especially now), employees
will require guidance, a clear sense of where their responsibility begins and
ends, a climate of teamwork, and behavior to model.
But, at
times, difficult choices may have to be made. People may even have to be let
go. The office needs to function at an efficient level. Just remember that both
overstaffing and letting staff
underperform are inefficient.
All facets
of your managerial role in the office are not necessarily obvious. As the
doctor, you occupy a position of influence. But, as a doctor, your time is most
likely best spent caring for patients. So, the office needs someone in place
who is accessible to handle decision-making. And, the staff needs to know where
to go to get any questions answered, particularly any question about policy or
procedure, when you are inaccessible.
From
there, employees should be free to operate while being held to a high
performance standard. There should be no hesitation on their part to recommend
the best lens, treatment or frame options. After all, we’re talking about
improving the patient’s vision.
While
experience is the best teacher, the education and training of your employees
must not be left to chance. Clarification of each role and an adherence to a
planned schedule of development will produce a more satisfactory experience for
both trainer and trainee.
The Value of Structure
Structure
the employee development process by maintaining a file that can be referred to
by both trainer and trainee when it comes to measuring successes and to
determining any retraining needs. Knowledge grows from a combination of
information and experience. The philosophy "learn as you go,” is a vague one at
best. A training plan makes the experience more objective and less about the
personalities of the parties involved.
Sometimes
training will require a real effort, a vigilance to stay on track.
Other times,
examples of the concepts seem to come into the office at exactly the right
time–– when an employee is ready to build on an optical concept. Be flexible.
You’ll need to allow for occasional deviation from the lesson plan. Use your
syllabus as a template, but remember that each person’s experience teaching or
learning will color the actual result. Show flexibility when areas require less
or more than the planned amount of study.
While no
two experiences are ever the same, there are patterns in training. Make the
most of each individual’s strengths. Working with a trainee has something in
common with speaking with patients: How well you are understood often depends
on how well you adjust your message to the level of knowledge of your audience.
Familiarize
your trainee with a few major concepts early on, and you can come back to these
fundamental concepts as building blocks for development.
The Saturation Point
After time, the new employee will
often begin to slow down under the weight of all this new, specialized
information. Avoid the mistake of covering information of a more and more
complex nature—such a steady stream of increasingly complex input is bound to
overwhelm the trainee. Instead, the best trainers deliberately teach meaningful
building blocks first. Then, as the trainee reaches a saturation point in their
level of knowledge, it is time to teach simpler
points, or even rote tasks, which are easier to learn.
This model of pacing—bigger things
first, and simpler information later—can be applied to a few areas of the
office:
• Dispensing and lens selection.
• Lens fundamentals first. Prism shapes meet at base to make a plus
lens, and prism shapes meet at apex to make a minus lens. Later, lens thickness
and lens de-centration of lenses is better understood, because trainee
has a better handle on overall lens shape.
• In-house surfacing. The trainee can learn to enter computation, tape
lens blanks, rough and fine lenses, pull and file lens blanks. Then, later, he or she can learn simpler
data entry—and then, develop the finer points of each technique.
•
In-house finishing lab. Start
with fundamentals, such as base curve, the lens clock, diopter, prism and
cylinder, for a frame of reference. The lens
clock gives understandable, approximate power readings. Then,
develop the trainee’s lensmeter skills. Teach him or her to edge, de-center
and block in small quantities at
first. By sharing concrete, basic optical principles early on, the
trainer ensures a firmer grasp on abstract concepts when they present
themselves to the trainee.
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There Are No Guarantees
While
you’ll want to do all you can to make sure the training process goes as well as
possible, several factors will remain beyond your control, including the
trainee’s aptitude, the amount of time spent with the trainee, the schedule of
the trainee and, of course, the pace of the office.
With
several factors beyond your control, it makes sense to do all you can to
influence those within it.
The worlds of opticianry and
para-optometry involve specialized knowledge and a very low margin of error.
It’s important to screen your applicants to get the best fit. Offices are
generally staffed with supportive people, making coping much easier. And, a
sense of humor seems essential enough to be considered a prerequisite for the
job.
Such a goal as passing the certification and licensing exam or state exam
may be very satisfying for the employee when completed, as well as a great
investment in that employee, and an empowering measure toward employee
retention.
Generally,
the rewards of passing the exams are usually financial and morale-based.
Employees can usually expect better pay, and employers can expect the employee
to demonstrate a particular standard of knowledge, making that employee’s time
more valuable to the employer—and better spent in the office. For example,
knowledgeable dispensers will recommend premium lenses with confidence.
Strategy and a Syllabus
While
there is no absolute guide, a solid training plan puts forward principles to be
revisited at a later date, as the employee’s experience and knowledge grows. It
is a very rewarding transformation to witness—especially when new employees
begin to actively support the existing staff.
This
example of a training strategy and syllabus is divided into five phases. The
first three phases of the syllabus require one week each, and phases 4 and 5
each require two weeks. But, remember to be flexible. As discussed earlier,
various factors may intrude upon the training schedule and force it to be
modified.
By the
two-month mark, provided the employee continues to grow, an extended training
schedule can be maintained on a bi-weekly or monthly basis. At this point, a
change of approach is likely in order. Rather than shadowing or active
training, have the trainee update the trainer on his or her progress. This way,
both you and the trainer have a much better idea of what the new employee is
learning and retaining.
Consider
the following training strategy and syllabus as an example. Your particular experience is bound to differ from it,
but what is important is to foster learning at various levels, and to keep coming
back to those same basics, so that your trainee may grow while not forgetting
the foundation of his or her knowledge.
Alphabet Soup
As an
employer, you can “get the most” from your investment in staffers by continuing
their professional development. While this article primarily deals with the
laboratory and dispensing optician, there are many certifications possible,
including American Board of Opticianry Certified (A.B.O.C.), National Contact
Lens Examiner Certified (N.C.L.E.).
The
A.B.O.C.-N.C.L.E. offers advanced certifications, such as A.B.O.C.-A.C. and
N.C.L.E.-A.C. At the highest level, there is A.B.O.M., or master optician.
The para-optometric
section of the American Optometric Association offers Certified Para-Optometric
(C.P.O.), Certified Para-Optometric Assistant (C.P.O.A.) and Certified
Para-Optometric Tech (C.P.O.T).
There are
also state licensing exams and state optician societies.
Also,
there are avenues of education outside of traditional certification. Lens sales
consultants can provide education on the best use of various products. Optician
education can also be found online through independent educators, training companies
and trade magazines.
Lastly, the Opticians
Association of America (OAA) and the National Academy of Opticianry (NAO) are
two excellent resources for your staff members.
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Training
Strategy and Syllabus
• Phase One:
Theory and application: First, introduce principles that
are useful at face value and that you will eventually build upon. For example,
that pupils constrict and eyeballs converge as the eye
accommodates for near vision. To the new trainee, this immediately explains why
reading glasses use a smaller pupillary distance (PD), and why bifocals have
two PDs.
Later, however, the trainee will
extend this concept and understand that the tolerance for PD is greater
horizontally than vertically because patients’ eyes are accustomed to moving
horizontally when they accommodate. And, they will understand why lenses often
de-center inward—because frame PD is usually greater than patient PD.
Eventually, he or she should learn that oblique astigmatism is challenging, because
it doesn’t follow the 180º-axis or the 90º-axis.
This
example demonstrates that one, simple
principle acts a foundation for knowledge that will be imparted or learned
experientially later in the training. Note the value of teaching simple
facts early in training.
Hands-on experience: If your practice has an in-house
finishing lab, have the trainee observe lens edging. Lensometry: checking in
simple spheres. Instruct the trainee to always move the lensmeter power drum
toward greater plus power to avoid having the operator’s eye add more plus
power. Even though the trainee may not understand fully what he or she is
doing, this is a building block for more complex concepts and skills. Also,
have him or her view blocked lenses from the back to show how their OCs are de-centered. Blocks get affixed to the lenses with a
sticker. The edger clamps the lens by the block. From the back, the dot marking
the optical center will be de-centered (to match the PD). Some people readily
grasp abstractions, but others will enjoy seeing the
lens blocked up and de-centered. This is
also a good opportunity to educate the trainee on the standard 1/3-2/3 edge
bevel—the bevel is one-third of the distance from the front edge of the lens
and two-thirds from the back—though this ratio will change with high-index
lenses.
Unanticipated learning: Some things that the trainee may learn during this phase during
situations that arise include custom lens tinting or how to de-center lenses
outward because of a wide PD.
Vocabulary: Frame measurements: A = horizontal, B = vertical;
DBL = distance between lenses (at their closest point); ED = effective diameter
(twice the greatest distance from center of box to lens edge. Sometimes this is greater than diagonal
measurement); MSDS = material safety data sheets, which are made
available for all substances used in the office and lab.
Goal: Manual
application of safety bevel to a finished lens. Although most edgers will apply this automatically, the trainee needs
to learn how to produce a safety bevel on a lens manually. At some point, he or
she will need to manually correct an imperfect lens bevel. As learning
continues, this may mean saving an otherwise-ruined lens, or re-edging patient
lenses in an emergency.
• Phase
Two:
Theory and application. Lens
power comes from the difference between the front and back curves, as well as
the lens material. During this phase, the trainee learns that lens material choice affects base curve or lenses
in the frame.
Hands-on experience. Now, the
trainee will learn how to apply the safety bevel to a finished lens in a
smooth, uninterrupted motion; observe the opticians in the front of office for
half of the day; practice manual application of safety bevel (on junk or rejected lenses at first, and later
applying safety bevel to a pair of finished lenses successfully); order
lenses via online form, fax form or telephone; dispense spectacles; observe frame adjustments made at dispensing;
and practice bending the eyewire of a frame that holds a high plus lens to get a good fit.
Unanticipated
learning: If the opportunity arises, the trainee may learn how
straight-top trifocal lenses compare with bifocals and single-vision lens
designs. The trainee may also have the opportunity to learn the importance of
reducing loss by resizing a chipped lens to prevent a remake.
Vocabulary: Understanding frame measurements
when ordering; index of refraction; myopia, hyperopia and presbyopia; and base
curve, back curve and lens clock. Trainees should also be knowledgeable about
progressive addition lenses—particularly, they should understand that the major
reference point on them is below the distance vision zone, which indicates how
much vertical prism is present. Likewise, the concept of accommodation and near/distance optical centers of bifocal lenses should be familiar, as well as
the idea of prism.
Goal:
Verification of more complex lenses on lensometer. The trainee should check at
least one pair of PALs each day to determine the distance power, add power, and the vertical or horizontal prism.
• Phase Three:
Theory and application: The
trainee will learn and understand the concept of index of refraction as a
measurement of lens material. Convey the idea that a higher index means greater density, so less lens material is needed
and the lens will be thinner. This may result in greater benefit from AR
lenses. The index of refraction is defined as the speed of light in a vacuum divided by the speed of light through
the lens material.
Hands-on
experience: The trainee applies a satisfactory hand-bevel to
lenses in most cases. Time is set aside for the trainee to use the manual
polisher and groover machines on junk or rejected lenses. This builds proficiency with the machinery, and
becomes a back-up method to the automatic edger’s polish and groove cycles. In
the future, difficult lenses may be grooved or polished using these manual
devices to get the best results. The trainee will also try his or her
hand at tinting a gradient lens, in order to learn the mechanics of the dipper and tint tank. Also, much discussion and
training will focus on PALs, allowing the trainee to have several reference points from which to
understand the lens.
Unanticipated
learning: If the doctor uses press-on prism as a diagnostic tool, and
spectacles with this prism are then verified, the trainee has the opportunity to observe how prism moves an
image, learning the tangible effect of optical theory. The trainee may
also gain further experience with severely chipped lenses, as something to repair or replace—the
trainee’s judgment abilities may be developed.
Vocabulary: Index of refraction is defined, understood and memorized for
several materials. The trainee
learns that prism is present in nearly all zones of PALs, and that
press-on prism is a diagnostic tool
that enables the doctor to try out prism added to prescription.
Goal: Verification of lenses to assist
lab team. The trainee is moving into a schedule in which less time is set aside to teach
verification, through which the trainee will be able to actively assist the
team. The trainee’s duties in the front of the office are expanded, and he or
she continues to edge lenses.
• Phase Four:
Theory and application: Actually, at this phase, there won’t be much
new material introduced—rather, this will be time for the trainee to work with
what he or she has learned to date, cementing the knowledge already gained.
Hands-on experience: The
trainee will work unsupervised for periods of time—e.g., covering lunch breaks.
And, he or she will continue to practice making a manual safety bevel.
Unanticipated learning: The
trainee may need to cover a staff member in the event of an absence or a busier
schedule.
Vocabulary:
The trainee should be comfortable with the concepts of myopia,
hyperopia and presbyopia by this
point, and he or she should be familiar with different needs from different
prescription eyeglasses.
Goal: Continuing verification of at
least one pair of PALs per day—more if possible.
• Phase
Five:
Theory and application: During the final phase of training, concepts already taught are
continuously refined and focused. New theories are fewer and farther between.
Hands-on experience: The trainee will learn how to
neutralize a PAL of unknown prescription for
pre-exam work-up information.
Unanticipated learning: The
trainee may have the opportunity to verify a prescription containing prism.
Vocabulary: By now, the trainee should
have a working knowledge of the principles of base curve, back curve and the
lens clock.
Goal: The trainee will understand
optical power and the mathematical
representation of front and back lens curves as well as powers in vertical and
horizontal meridians. Remember, not all trainees learn the same way. Some may
prefer the concept of the power cross to visualizing powers on an actual lens.
There you
have it––an overview of training. Through a grounded understanding of optics,
lenses and frames, your staff can reduce remakes, increase patient satisfaction
and solve problems more quickly.
Committing
to employee training is a win-win for both the employer and employee. While the
greater economic picture may be beyond the control of the individual, there are
things we can do as individuals within the practice to make ourselves more
valuable. Continue forward momentum by helping your staff members to maintain
professional growth and knowledge.
Mr. Coronis is an independent author, and an American Board of Opticianry-approved
speaker. He can be reached
at
timothy@opticianeducation.net.
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