Laurea (First cycle degree/Bachelor - 180 ECTS) in Orthoptic and ophtalmologic assistance

The main purpose of the degree programme in Orthoptics and Assistance in Ophthalmology is to form healthcare workers with duties attributed by decree of the Ministry of Health no. 743 of 14 September 1994 and amendments. Specifically, the programme provides theoretical and practical training in the following activities: orthoptical rehabilitation of motor and sensory anomalies of vision, performance of ophthalmo-diagnostic instrumental procedures and rehabilitation treatment.

At the end of the degree programme, graduates in Orthoptics and Assistance in Ophthalmology are able to:

Assess patients:

- Collecting data (clinical history concerning structure and function, activities, participation and personal and environmental factors) using instruments including case histories and/or interviews to patients and other reference figures to identify the patient's sight and posture, psychological and social needs concerning these questions as well as personal possibilities, problems and needs;

- Observe, physically examine and apply assessment instruments and procedures validated and recognised by the scientific community to patients' visual, postural, psychological and social skills;

- Analyse the data/information gathered to determine the abilities, functional capacities and potential results in full respect of the choices of patients and/or relatives/guardians.

Draw up orthoptical and ophthalmological diagnoses and prognoses under the supervision of the Ophthalmologist:

- Gather data concerning case history, functions, activities, participation and personal and environmental factors.

- Assess different functional systems using validated instruments and measurements, guidelines, following the principles of Evidence-Based Practice (EBP);

- Analyse and critically interpret relevant data to identify functional orthoptical diagnoses and prognoses considering also recovery indices;

- Identify the disability level according to the ICF (impairment, disability, social participation) (ICF);

- Define the possible alternatives in interpreting data;

- Explain the clinical reasoning behind functional orthoptical diagnosis;

- Compare the data emerging from the assessment with any bibliographic references in order to protect the patients' health.

Define and plan orthoptical and/or ophthalmological assistance:

- Involve the patients asking for their active participation and informing them about the orthoptical and/or ophthalmological treatment path;

- Describe orthoptical and/or ophthalmological problems and relative outcomes to be achieved throughout the treatment;

- Identify possible prevention, educational and palliative therapies.

- Select the resources to be used within the rehabilitation programme;

- Motivate planning choices according to theoretical knowledge, built on assessment data and based on the best possible evidence and choices/preferences of the patients;

- Draw up the orthoptical and/or ophthalmological plan and propose it to the team in order to define overall rehabilitation objectives;

- Participate in education and information planning suggesting activities for patient management and self-help for patients and families.

Manage their own work within the health service:

- Plan their own work considering the objectives and priorities of the service in compliance with the organisation needs and optimal use of the available resources;

- In planning orthoptical treatment, assess the duration and frequency of the treatment also with a view to the possible side effects of drugs which could affect orthoptical treatment;

- Plan individual rehabilitation sessions according to priorities, in relation to the problems and needs of each patient.

Implement orthoptical and/or ophthalmological assistance:

- Pursue orthoptical and/or ophthalmological objectives following the set programme;

- Select orthoptical and/or ophthalmological proposals considering any other pathologies/conditions;

- Prepare the setting for orthoptical and/or ophthalmological treatments;

- Implement preventive programmes;

- Propose activities consistent with the planned treatment, assuring patient safety and compliance with applicable laws;

- Propose and creatively suggest possible alternative solutions in line with the results obtained;

- Use aids/ortheses where required to facilitate functional abilities;

- Maintain and assure collaborative relations between patients, families and caregivers.

Assess the obtained results:

- Critically analyse the treatment and rehabilitation plans;

- Monitor the progress of the orthoptical and/or ophthalmological programme in collaboration with other stakeholders;

- Assess the achievement of objectives and measure outcomes using validated methods and instruments;

- Assess the whole care path according to the effectiveness and efficiency of the obtained results.

Document professional activities:

- Document the clinical activities in compliance with the sequence of the orthoptical and/or ophthalmological treatment methods, using forms and records inspired by the ICF principles for the required competencies;

- Produce reports relative to the internship using the methods used to produce scientific articles.

Undertake a professional attitude concerning the code of conduct:

- Ensure the confidentiality of patient information;

- Respect the individuality, ideas and expectations of the patients;

- Work using methodological rigour constantly applying new scientific knowledge to their professional activities;

- Demonstrate the awareness of and critically assess their own limits in terms of professional attitude, skills and competencies.

Establish effective relations with patients, families and the working team:

- Use effective communication in the care relationship through the understanding of non-verbal communication, body language and use behaviour which is consistent with the features of the patient;

- Illustrate to patients how the orthoptical programme can affect/modify functional activity.

Share the orthoptical programme with patients and families.

Manage clinic and professional risk in the work place:

- Ensure a physical and psycho-social environment that is suited to patient safety;

- Identify and analyse clinical risk;

- Prevent and monitory the main sources of clinical risk;

- Use professional practices to protect from physical, chemical and biological risk in the work place;

- Adopt professional measures for manual handling of loads.

To achieve the specific learning outcomes of the programme, 43 CFU are allocated to SSD MED/30 and MED/50 (this SSD, consistently with the SSD regulations, within the scientific subject field and care activities, is congruent with the technical and medical field applied to ophthalmology and orthoptics) (differentiated programmes under article 10, para. 3 of DM 270/2004) and 60 CFU to SSD MED/50 for internship activities, which are differentiated for each specific profile. The above professional skills will be achieved by graduates through the study programme which includes:

- all-round grounding in basic subjects (physical and chemical sciences, biomedical and psycho-pedagogical sciences), needed for the qualitative and quantitative understanding of biological and pathological phenomena linked to sight and vision, sight pathologies and relative treatments

- study of the principles of physiopathology (knowledge of the fundamental elements of anatomy and physiology of the visual system, ocular motility and binocular vision)

- the acquisition of a specific command of the principles of: visual physiopathology, physiology, ocular motility and mono- and binocular vision, general orthoptics, semiotics and orthoptical methods;

- gradual acquisition of professionals skills through practical work and internships (throughout the three years of the programme), to learn the following techniques and methods: techniques of ophthalmological and orthoptical instrumental diagnosis, methods of functional re-education, orthoptical rehabilitative treatments, semiological techniques (perimetery, corneal topography, fluorangiography, electrophysiology, etc.), visual re-education and rehabilitation methods, orthoptics in development, adults and old age. Practical work and internships will also be preceded by seminars to learn specific theoretical, methodological and technical-instrumentational notions of refractive errors and their correction;

- the acquisition of basic notions of psychology and psychopathology to ensure appropriate interaction with patients with cognitive, relational and personality disorders;

- knowledge of the principles of law, ethics, code of conduct and health management governing the profession.

The study plan includes 180 Credits (CFU) over 3 years, and 60 CFU per year. The CFU obtained in the core activities are allocated to the various subject fields according to the provisions of the Ministerial Decree, which establishes the minimum number in each field.

An average of 12 hours of lectures and internship/practical work are allocated to each CFU, which corresponds to an average of 25 hours of student work. The remaining portion of the credit is available to the student for self-study. More particularly, the curriculum covers the following study programme.

Study programme

Year 1

Provides the essential knowledge of physics, biology, ophthalmology, biomechanics, neuroanatomy and neurophysiology, ophthalmological psycho-pedagogy, basic hygiene and prevention, which are fundamentals of the subject and of professional method, and key requirements to manage the first internship experiences which aim to guide students in their relative professional field and acquire basic competencies.

Year 2

Course units and activities during year 2 aims to provide knowledge of pathological refractory, degenerative and functional pathologies of the visual system and, through the internship, the relative professional competencies in a clinical context which allows students to experiment their intellectual, interpersonal and practical skills (diagnosis, prevention, rehabilitation); it permits them to explore the theoretical aspects which emerge from clinical practice, searching for the best evidence available in literature in order to dialogue within the professional community to acquire the best possible practical skills.

Year 3

The course units and activities of year 3 aim to acquire specialist knowledge and methodologies for professional practice, team working skills and the ability to work in a complex organisation. By experimenting the progressive undertaking of autonomy and responsibility and with the supervision of experts from a range of specialist sectors, students acquire the methodological competencies required for assessing and planning scientific research also to support the production of the final dissertation, as well as management skills useful for career development in a professional environment.

This learning strategy is confirmed by the choice of credits allocated to the internship, which increase from year 1 to year 3.

At the end of the three-year programme, Orthoptics and Assistance in Ophthalmology graduates will have acquired the knowledge and technical abilities to work professionally in public and private bodies as employees or on a freelance basis.

Graduates will also have developed the learning skills needed to continue specialist studies.

KNOWLEDGE AND UNDERSTANDING:

Graduates in Orthoptics and Assistance in Ophthalmology will:

- possess fundamental knowledge of the different subjects, including physical and biomedical sciences (chemistry, biochemistry, anatomy, histology and genetics, physiology), essential for the qualitative and quantitative understanding of biological and pathological phenomena of the anatomophysiology of the visual system

- have in-depth knowledge of the fundamental elements of anatomy and physiology of the visual system, ocular motility and binocular vision

- be familiar with the principle ocular pathologies, particularly concerning the alteration of ocular motility, binocular vision and visual development

- possess in-depth knowledge of the main ophthalmological instrumental diagnoses

- possess basic knowledge of psychology and pedagogy

- possess basic knowledge of general and applied hygiene and notions of legal medicine

- have a command of healthcare management

- be familiar with statistics and computing

- be familiar with first aid activities

This knowledge is acquired through participation in lectures. Assessments take the form of oral exams, written projects, intermediate tests and e-learning.

APPLYING KNOWLEDGE AND UNDERSTANDING:

Graduates in Orthoptics and Assistance in Ophthalmology will be able to:

- carry out semiological diagnoses in the ophthalmological field using appropriate instruments

- recognise and assess ocular motility and binocular vision impairments in children, adults and the elderly

- monitor amblyopic treatment in children

- use orthoptical rehabilitation treatments

The ability to apply knowledge and understanding is achieved through learning methods based on problems and case studies, group work and the internship.

Skills are assessed through oral exams, written assignments and practical work. During the internship the acquired competencies will be assessed by a professional tutor.

MAKING JUDGEMENTS:

Graduates in Orthoptics and Assistance in Ophthalmology will be able to:

- autonomously assess the results of orthoptical and rehabilitative treatment in strabismic patients

- draw up amblyopic treatment and prismatic treatment

- assess residual vision in poor-sighted patients and suggest methods of rehabilitation

- according to their knowledge and technical skills, verify the validity of examinations

Students learn to make judgements through simulations, practical exercises, group work, analysis of case studies, internship and the production of the final dissertation.

Learning skills are assessed through written and oral exams, practical work and e-learning, as well as the assessment made by professional tutors.

COMMUNICATION SKILLS:

Graduates in Orthoptics and Assistance in Ophthalmology will be able to:

- interact appropriately, clearly, effectively and politely with patients

- carry out orthoptical exams on children (including pre-verbal children) using appropriate forms of verbal and non verbal communication

- interact with the relatives of strabismic children to correctly manage orthoptical treatments, communicating clearly and effectively

- interact with patients and with the ophthalmologist to discuss the results of the instrumental examinations

- adapt language styles to the type of interlocutor

- communicate in English to intermediate level (B1);

- interact with other professional figures involved in the management of patients with neurological and psychomotor handicaps

The teaching tools used to achieve these effective and interpersonal communication skills within the profession include small working groups, simulations, role playing, internship and the final examination, which include reporting to and periodical meetings with the supervising professor and presentation to a specific examination board.

Learning skills are assessed through written and oral exams, practical work and e-learning, as well as the assessment made by the professional tutor.

LEARNING SKILLS:

Graduates in Orthoptics and Assistance in Ophthalmology will be able to:

- Autonomously develop problem-solving skills, demonstrating the ability to continuously seek self-learning opportunities;

- Acquire study planning methods and the ability to work by objectives both individually and in groups;

- Undertake responsibility for their own professional advancement and respond to the continuous changes in knowledge and health and social needs;

- Use self-assessment methods to maintain the high level of knowledge required by professional practice;

- Interpret and apply the results of clinical research and link research to the theoretical development of orthoptics and assistance in ophthalmology.

Learning skills are developed throughout the study programme through self study, discussion with professors during oral exams, the review of written assignments and the final examination. The use of self-learning programmes and contracts is foreseen, in order to allow students to take responsibility for planning their own internships, self-assessment methods and the use of workshops to develop methods of on-line and paper bibliographic research.