Table 5 Lessons learnt from each of the pilot sites [16]

Pilot site 1: Aravind Eye Care, India (Aravind)

Workforce review in a hospital setting: Aravind used the ECCF to evaluate the competencies of the current workforce it employs

• The ECCF displays competencies at a high level, but it also enables a careful assessment of the skills and tasks expected of the eye care personnel

• The ECCF enabled Aravind to reflect on developing the aspirational leadership qualities for each “leader” staff member. It highlighted the need to have a structured training to holistically develop an ophthalmologist or AOP into a leader, particularly in the non-clinical domains, such as Evidence, Community and advocacy and Professionalism. Thus, key performance indicators and other methods for staff management should take into consideration for leadership development

• The ECCF can be used more effectively if it is simplified and contextualised

Pilot site 2: L’Ordre des Optométristes du Québec, Canada (OOQ)

Development of a professional body’s competency framework: the OOQ re-evaluated their existing competency framework using the ECCF to analyse if it reflected both current practices and best practices

• The existing competency framework had limited integration of the target workforce in the health care system. By identifying these gaps and adopting relevant competencies and activities from the ECCF that addressed this, the amended competency framework can now work towards a target workforce that has better integration within the health care system

• Competency frameworks are often complex and challenging for people unfamiliar with them to navigate. For people wanting to develop their own competency framework, it is helpful for them to have a solid understanding of the concept of a competency framework, before embarking on developing one

• During the adaptation process, the approach of researching best practices was used to resolve opposing feedback

Pilot site 3: International Joint Commission on Allied Health Professionals in Ophthalmology (IJCAHPO) in partnership with L V Prasad Eye Institute, India (LVPEI)

Development of professional body’s competency-based framework and curriculum: the ECCF was adapted and aligned to the IJCAHPO’s standards for education and training, certification and training programme accreditation of AOP; further application of the of the ECCF was made to LVPEI’s local ophthalmic practices in their training and education

• The ECCF enabled the need for focus on several non-clinical aspects such as professionalism and learning at the study site which were not emphasized in our previous curriculum. In addition, the pilot made IJCAHPO recognize they could assist other organizations working with AOPs to apply the ECCF to their training programmes

• Evidence-based practice is more emphasized in advanced programmes than in the IJCAHPO’s syllabus. This pilot study identified areas to focus on to bring evidence-based practice to the AOP/vision technician curriculum

• Although there was an existing programme, the alignment of the programme to the ECCF allowed for a structured and comprehensive competency approach to curriculum development

• Several gap areas were identified in the existing curriculum, such as quality assurance, integration of a patient-centred approach, application of a rational approach to problem-solving and decision making, and establishment of a collaborative eye care management plan

• The IJCAHPO curriculum had the opportunity now to include more components of research through the integration of the evidence domain from the ECCF

Pilot site 4: Singapore National Eye Centre

Development of a competency-based curriculum:

to apply the ECCF to an existing training programme, enabling the benchmarking of the selected curriculum against the ECCF

• It is important to consider the learning goals/objectives of the programme when implementing the ECCF, as not every competency and activity may be relevant, for example, leadership competencies for a basic upskill programme

• An iterative process should be maintained when designing the programme/curriculum using the ECCF, including review, monitoring and evaluation of outcomes to garner feedback from all stakeholders, and then return to improve the curriculum

• With existing programmes, it may be easier first to adapt the ECCF and then apply it rather than trying to apply an existing training programme to the full ECCF

• The ECCF serves as a reminder that non-clinical aspects of the programme are equally important to ensure the holistic development of an eye care professional

• There is potential for the adapted ECCF to be used for advocacy at the ministry/policy level, and other workforce areas such a service delivery facility at local and regional hospitals

• It is possible to determine whether the eye care system can produce personnel with the necessary expertise to deliver comprehensive eye care services within the health system, by outlining the competencies and activities of each position and a corresponding education/development plan in conjunction with human resources