Patient Care Perspectives in the Accelerated OD Program

To build upon the most recent series featuring faculty and students within the Pennsylvania College of Optometry (PCO) at Salus University’s Doctor of Optometry Accelerated Scholars Program, during part four, Alissa Coyne, OD ‘10, Resident ‘11, FAAO, PCO assistant professor, highlights some details of the program’s clinical education while students, Misa Sueyoshi ‘23OD and Israel Moore ‘23OD describe some specific patient care stories.

As previously described, a hands-on approach to direct patient care is what sets PCO graduates apart from their professional peers. The focus on clinical education through an on-site internship and externship rotations, along with small group-based learning, is integral to becoming a competent, practicing provider.

The Eye Institute (TEI) and its satellite facilities serve as PCO’s clinical teaching practice, which has more than 40,000 - 45,000 patient visits each year. Students care for patients ranging from infants to seniors in a multidisciplinary collaboration with optometrists, ophthalmologists, opticians, optometric technicians and others. At TEI, students are exposed to a broad range of eye diseases and conditions — including ones that many optometrists may not see in their practices. 

Q: Can you introduce yourself and your current role within the Scholars Program?

Coyne: Hi, my name is Alissa Coyne. I'm a PCO faculty member involved in both our Traditional and our Scholars Program. I'm originally from outside the Scranton, Pennsylvania area from a small town called Peckville. I went to undergraduate at Penn State University, where I was a bio behavior health major, chose PCO as my optometry school, and apparently my forever home. I did complete a residency in Primary Care/Ocular Disease at The Eye Institute and stayed on as faculty once that was completed. I've been involved in our Scholars Program since its implementation from our very first cohort, and have been involved with every cohort since then. At this time, I currently oversee our clinical program, which is underneath the professional practice title within the curriculum.

Q: When do students start seeing patients at The Eye Institute?

Coyne: When you start the program, usually July 1, you will be in the program's clinical facilities during that very first quarter in an observation mode. Once you end up taking and passing practicals in your clinical skills program, you are then allowed to help perform those skills in clinic on real patients when you're paired with second-year students.

After you complete your full series of clinical skills practicals, you will start seeing patients on your own. And, you're usually paired with someone from your cohort for the first few weeks in February, which would be the beginning of your spring quarter of your first year. You're usually scheduled in clinic at TEI three to four sessions a week, and each session is about four hours. One of the concerns we always hear, especially in an accelerated program, are the expectations in clinic. You will have set faculty members that work with you every session, and we appropriately set our expectations based on where you are in your didactic program. Therefore, we're not expecting the world of you, or to know way beyond what you would think as far as what's happening and comparing that to your didactic program.

In some instances, you may learn things at TEI first, and we have you look them up or we explain them to you even before you learn them in the classroom. It's a flipped learning environment in that manner. You also have Grand Rounds[1]  presented by you, or by the cohort above you, that also helps to expand your clinical knowledge.

The time you spend at TEI is considered an internship. You'll have all the way up to what's called Professional Practice Eight (PP Eight). That is every quarter from the time you start on campus until your very last quarter on campus, which would be spring of second year. Once you end up leaving that is considered an externship which will be included in the next series featuring Rachel Brackley, OD ‘09, Resident ‘10, FAAO, PCO assistant professor.

Q: How many patients do you see at The Eye Institute?

Coyne: When you're at TEI, we don't really look at the patient book beforehand. Whoever's on the book at that time, that's who's seen. We do see a lot of patients who have ocular disease, and you will see ocular disease from your very first session in clinic. Again, the biggest thing is the faculty on site in clinic at that time are there to help support you. We are going to make sure no matter what happens, you are going to swim, you are going to be successful in making sure you have a great clinical patient care experience, and making sure you can appropriately perform the different aspects of the exam despite it being challenging, or even before you've had that information in your didactic program.

Q: What are the different specialties students will experience in clinic at The Eye Institute?

Coyne: As I said before, you're usually in three to four sessions per week in clinic at TEI. That includes both primary care sessions, which include ocular disease, where you see patients that have diabetes and high blood pressure. It's not unusual that we see a lot of glaucoma, especially in our patient base. For some of those sessions, you'll also be scheduled in different specialties. Specialties that we have in house include anterior segment, which would be cornea and cataract. We also have retina, in which you would work with an ophthalmologist or a retinal specialist, it's a tertiary service where you know the patient is going to be referred in for some type of retinal issue. We also have neuro-ophthalmic disease, low vision rehabilitation, pediatrics, glaucoma, and a specific glaucoma service. You will also be in our urgency and emergency service. Those specialties usually start the summer of your second year. You'll have an entire quarter in clinic within our primary care block, getting prepared and expanding your knowledge base a little bit.

Again, don't be afraid, or don't be discouraged, or intimidated by seeing patients so early in your career, because we will make sure you are going to be successful and well supported in every single clinic session you have.

Q: Can you please introduce yourselves?

Sueyoshi: Hi, my name's Misa Sueyoshi. I'm from San Diego, California and I went to Point Loma Nazarene University. I am a second-year Scholars Doctor of Optometry student.

Moore: Hi, my name's Israel Moore. I'm from Western Pennsylvania. I went to Alvernia University in Reading, Pennsylvania, as a biochem undergrad and I'm a second-year Doctor of Optometry Scholars student.

Q: Can you describe being in patient care at The Eye Institute and any interesting cases you have come across?

Sueyoshi: Part of patient care is seeing patients really early before we learned about things like their diseases. But what helps is that I've gotten really good at describing what I see, so even though I don't know what it's called, I can say like, it's a different color, it's a different shape than what I'm used to. It's in a different area. It's in over here to the left or over to the right. So even though I don't know what it is, I definitely have become good at using descriptor words to try to verbally describe what I am seeing.

Moore: Absolutely. I know within my first week of actually being in clinic, I had a really complicated patient come in. They were actually a keratoconus – a condition in which the clear tissue on the front of the eye/cornea bulges outward - patient. So not knowing anything about the history of that or anything like that, we actually ended up doing specialty lenses as well. I feel like the preceptors were very understanding - we don't necessarily know what we're seeing, but being able to describe that something was actually a little bit different clinically presenting wise was really cool. And, having that basis helped further along when we actually got to the classwork to be able to be like, oh, I saw this in clinic. Now I can know the process behind it, which was really nice as well.