Welcome to question of the day #199

Welcome to question of the day #199

There is an OCT machine being delivered to the practice tomorrow. I know that it can be used to scan the retina and provide detailed images and that it will have the ability to provide images of the anterior chamber angle but I’m worried that I won’t be able to learn how to use it properly. I graduated 20 years ago and struggle to learn new things. What can I do?

When I worked in practice there were three types of practitioners I worked with.

Those who knew they didn’t know everything and were keen to learn new things; and not just in eye care. These practitioners kept up to date with new technology, new techniques, and new contact lens and new spectacle lens materials by reading professional development articles and attending local and national professional development lectures and conferences.

Another group consisted of those who have obtained a degree or diploma in eye care didn’t think there was anything else for them to learn. They didn’t read and they didn’t go to professional development lectures. The third group, who were usually older, had been qualified for 20-40 years and were worried about keeping up with the pace of change in eye care. They occasionally read things and occasionally attended lectures but were very nervous when it came to using new technology and new techniques and did their best to avoid using them, reverting to the older technology and techniques, to the detriment, in my opinion, of the patients. Looking back they were overwhelmed and they were fearful.

This is what I do when faced with new technology coming into practice.

Obtain some clinical articles from the web about the technology. I focus on clinical articles because they are usually written with the clinician in mind. The peer-reviewed articles in research journals usually don’t have a clinical slant, are often aimed at other researchers and the clinical pearls can be difficult to locate amongst all the statistics and research language.

Sometimes when new technology is delivered someone from the company comes along and explains and shows how it works. I make sure I attend this, listen, take notes, and ask questions.

I get a copy of the manual, read it, and follow the instructions while practicing with the equipment. Sometimes I only have the manual because there wasn’t a person from the company to explain and show how it works.

Once I have some basic familiarity I practice using the technology. I practice on other staff in the practice and I practice on my relatives. I practice until I feel I’m good enough to use the technology on a patient.

When I do use it on a patient I don’t say things like ‘This is the first time I’ve used this. I hope I can get it to work.’ ‘Sorry if I mess this up, I’m not sure how it works’. ‘I might have to ask for help with this.’

Give clear instructions to the patient, be confident and follow the procedure you have practiced many times on the staff and relatives. Try your best.

If you can’t get the technology to work then ask for help from a more experienced colleague. If you can’t get the technology to work and there isn’t a more experienced colleague in the practice then ask the patient to come back on another day when a more experienced colleague is available.

If this happens then practice more on staff and relatives.

Some practitioners are fearful of new technology and new techniques and the first part of controlling this fear is preparation. Plenty of preparation will help control fear. In the clinical context, preparation comes in the form of reading, listening, working the technology and practicing on other people, and if possible being observed by a more experienced colleague who can give constructive feedback.

When the time comes to use it on a patient there will still be some fear but when I’m in this situation I think back to my preparation and use that to boost my confidence. I know I can’t have done any more and that I’m ready. Then I try my best.

I continue to practice. Practice might not make perfect but it certainly makes better.