title: Evaluations of refraction competencies of ophthalmic technicians in Mozambique.
abstract: OBJECTIVE
  Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction.
  
  
  METHODS
  Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills. Clinical competencies were assessed in relation to knowledge (theory exam) and clinical skills (patient exams). 11 OTs were upskilled and the clinical evaluations carried out post training.
  
  
  RESULTS
  Initial evaluations demonstrated that confidence and competence levels varied depending on the OTs training (location and duration), and their location of work (clinical load, availability of equipment and other eye care personnel). The qualified OTs were more competent than trainee OTs in most of the evaluations. Post upskilling results demonstrated significant positive impact on confidence and competence levels.
  
  
  CONCLUSIONS
  These evaluations identified factors affecting the refraction competencies of the OTs and demonstrated that upskilling is effective in improving confidence and competence levels for refraction. They demonstrate the need for a refraction competency framework. The overarching aim of this research was to inform the development of a nationwide programme of OT mentoring, upskilling and leading to the establishment of clinical competency standards for the new OT curricula, relevant to the professional demands.
authors: Dublin Institute of Technology, Dublin, Ireland. Electronic address: kajshah@aol.com.
authors: Kajal
authors: K
authors: Shah
authors: Brien Holden Vision Institute, Durban, South Africa; African Vision Research Institute, University of Kwazulu-Natal, South Africa.
authors: Kovin
authors: K
authors: Naidoo
authors: Ophthalmology Department, Central Hospital of Beira, Mozambique.
authors: Margarida
authors: M
authors: Chagunda
authors: Dublin Institute of Technology, Dublin, Ireland; African Vision Research Institute, University of Kwazulu-Natal, South Africa.
authors: James
authors: J
authors: Loughman
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D009881:Ophthalmic Assistants / Q000193:education / Q000592:standards*; D013508:Ophthalmologic Surgical Procedures; D009885:Ophthalmology / Q000193:education / Q000592:standards*; D009907:Optometry / Q000191:economics / Q000592:standards*; D012030:Refractive Errors / Q000175:diagnosis
keywords: Competency evaluation; Evaluación de competencia; Incremento de conocimientos; Mozambique; Ophthalmic technicians; Refracción; Refraction; Técnicos oftálmicos; Upskilling