Confidence builder

Photography by Steve Craft

Excerpted from page 16 of the January/February 2023 edition of AOA Focus.

The AOA’s 2022 Educator of the Year, Andrew Kemp, O.D., muses about what makes a conducive learning environment for fourth-year students.

The didactic instruction is largely over. The hands-on experience in the real world has begun. For many students, it can be the most clarifying time of optometry school.

“Often the type of doctor the student becomes and the type of care they go into is directly influenced by their externships, and I enjoy being part of that process,” says Dr. Kemp, a University of Houston College of Optometry (UHCO) assistant professor who works with fourth-year externs on their clinical rotations at UHCO-affiliated Cedar Springs Eye (Dallas) and Community Eye (Fort Worth, Texas) clinics.

Dr. Kemp graduated from the University of Texas at Austin in 2010 and UHCO in 2014. He completed an ocular disease residency at the Cedar Springs Eye Clinic and is now on faculty there as well as at the Community Eye Clinic, working with fourth-year optometry externs and residents.

In a Q&A with AOA Focus, Dr. Kemp talks about preparing the next generation of doctors of optometry.

You mention the word “comfortable” in describing a desired learning environment. Can you explain?

We don’t want the students to be afraid to ask questions. We want to break down barriers and create an environment that is comfortable and promotes effective learning. We want to make sure all their questions get answered before they leave the college of optometry to provide care for patients in their communities.

In your observation, what happens in the fourth year that is so transformative for optometry students?

During their rotations, we challenge the students to integrate all the clinical knowledge they’ve learned up to that point into a coherent treatment management plan for patients. It’s similar to them transitioning from talking in question marks to talking in periods. The fourth year helps them transition from the mindset of being a student and presenting to attending doctors to being a doctor and being on their own, to make that final connection to a real-world setting. I call it the “aha” moment. It all comes together at once.

You completed an ocular disease residency at the Cedar Springs Eye Clinic. Can you recall your own “aha” moment?

I still have “aha” moments. At times, I have them as I try to explain things to the students. Having to verbally explain things to students forces me to really break down the knowledge we have into the individual parts and then rebuild it into something they can understand. This continues to push me to expand my own knowledge base.

How are you preparing students today to be the doctors of tomorrow?

The scope of optometry is continuing to expand, and the technology and medications available also are rapidly changing. We continue to focus on teaching evidence-based medicine while also understanding many barriers to care that patients may have. The care for a patient must be able to adapt to the situation a patient finds themselves in, and we help the students understand and recognize that. I also teach a lot on billing and coding of eye examinations and compliance with different state and federal laws. The regulations in medicine are another ever-changing aspect of our career, and understanding how to navigate this can be very important to students’ overall career success.

For what factors are you also preparing these soon-to-be doctors?

In the real world, they may be called on to be half doctor of optometry and half social worker. Treating and managing some patients’ problems may just be the first step to their care as a whole. We may have to be a source for how patients access the overall health care system. Optometrists are playing a larger role in the health care system and are often entry points for patients who may have never had a doctor’s appointment before. Part of knowing what is best for the eye is knowing what other health care providers should be brought into a patient’s health care team. Some patients may have restrictions on their medical insurance. How do we integrate future patients’ standard of care with telemedicine? Telemedicine can never replace in-person care, but what about for a patient who is wheelchair-bound? Telemedicine would be an option. We have to watch how not to lower the standard of care while incorporating telemedicine into the care of patients who could benefit from it. The scope of care is always changing. In Texas in 2021, we expanded doctors’ authority to prescribe oral eye medications and independently manage glaucoma. Around the country, the laser dam is breaking. We’re having to adapt students to feel comfortable in all treatment modalities.

Do you feel a responsibility to graduate good doctors?

I feel responsible in that we are one of the last stops before graduation. If a student still doesn’t know something or doesn’t understand something, we are the last place for them to ask their questions/complete their education.