Article Date: 7/1/2010

Developing an Instrument Training Strategy

Developing an Instrument Training Strategy

How to maximize learning opportunities for you and your staff


The power of today's ophthalmic instruments helps you manage more patients using less staff and fewer doctors. But that power can be easily wasted, especially if you don't take the time to learn how the technology works, then incorporate that knowledge into your practice.

Success depends on your ability to create an environment that encourages training — for you and your staff. This effort requires up-front time, but experts say the return on investment is well worth it, as measured in increased efficiency and better growth potential. Below are five key questions to ask as you assess your practice's instrument training strategy.

Instrument Training Services

Bob Gibson, senior director of marketing, Topcon Medical Systems, Inc., recommends looking for services that are tailored to your instruments and practice needs.

“For high-tech instruments — such as a retinal camera, OCT unit, wavefront analyzer, or corneal topographer — we have user and workflow optimization training for the doctors and technicians,” says Gibson. “We do this over several visits to avoid hitting customers with too much information at once. We give them the basics, then come back to see if they have questions. Later, we provide advanced-level training.”

Lower levels of training range from online courses to out-of-the-box manuals for other equipment, such as eye refractors or lensometers. “We train our dealers and they provide installation instructions for more basic devices,” says Gibson.

OPKO Instrumentation offers two full days of user/operator training, including patient OCT scanning during the training period. For ultrasound systems, OPKO offers one full day of user/operator training, including actual patient scanning, according to Rishard Weitz, executive vice president of OPKO.

The sales force and clinical application trainers at Optovue Inc. provide training for doctors and staff. Instructional videos and online videos, webinars, and advanced users' meetings held at major tradeshows complement this effort. A quick guide and user's manual are also available.

“View the decision to purchase advanced technology as a partnership with the manufacturer — not as a one-time buying decision.”

— Bill Schoenberger
Director of Business Development

Benefits of On-site Education

“On-site education by credentialed ophthalmology technicians provides a great way to incorporate new technology into your department,” says Kathy Lewis, national clinical applications manager of Carl Zeiss Meditec, Inc. “On-site education can be supplemented by self-directed training materials, such as online content, quick reference guides, and CD-ROMs.”

To benefit from on-site instrument training, Lewis says users should review training materials that are shipped with instruments. “The training will be much more successful with a little preparation,” she notes.

One important consideration: Adjust department schedules so technicians can learn from on-site instructors without interruptions. “The investment you make in your equipment should be coupled with an investment in your staff's education,” says Lewis.

Susan K. Corwin CO, COMT, director of training and education at Marco, says the company offers online training, in-service training in offices, individualized “go-to-meetings,” webinars, and two-day formal classes at Marco's headquarters in Jacksonville.

“We offer technician training for our Epic 5100 and TRS 5100 electronic refraction systems,” adds Bill Schoenberger, director of business development for Marco. “This course is certified by the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO), providing didactic and hands-on clinical training for skilled and unskilled technicians.”

The Marco sales force, trained in refraction techniques, provides on-site training for doctors who prefer to perform their own refractions.

Original Techniques

Some doctors develop techniques on their own to maximize the benefit of their instruments.

“I have found that most technicians and doctors don't know how to utilize the software options that come with digital retinal camera systems,” says Dan Beck, OD, of Leland, N.C. “There are wonderful image editing tools, such as increasing image contrast and sharpness. I increase the sharpness on just about every retinal image I view.”

In addition, Dr. Beck converts the images to negatives to obtain a more accurate view of optic nerve cupping. “Most doctors aren't aware of this feature,” he says.

Hiring Instrument Operators

Topcon's Gibson and others recommend hiring assistants who can type well and who demonstrate a basic knowledge of computers. “Instruments are becoming so user-friendly and automated that you might not need skills beyond that,” says Gibson. “In most cases, technicians just need to follow basic instructions.”

Because of the sophistication of today's instruments, you may only need staff members who are “compulsive enough to follow the product directions and get consistent results,” says Paul S. Koch, MD, medical director of Koch Eye Associates in Warwick, R.I. “We've even used high school students working on their senior projects.”

At the same time, he says, ensure your staff is trained according to the protocols established for each instrument. Make sure technicians understand the limitations of the instrument, so they will recognize when measurements are questionable or invalid, advises Dr. Koch.

Right Fit

Beyond technical skill, consider personality. Gibson says your staff should understand the functions of the instruments they operate and they should be able to communicate that information to patients in a way that they will understand. Staff should be able to explain what will happen during the test (such as preparing them for flashing lights) and why the test is necessary.

“Staff should — first and foremost — have great customer service and people skills,” says Corwin of Marco. “You can teach technology but you can't teach compassion.”

“Having a staff member who's very patient-oriented is an important quality when delegating the task of refractometry,” notes Schoenberger, who manages the Marco's sales and technician training program. “The personality of the technician factors heavily in the level of patient satisfaction and should always be a top consideration.”

Don't Forget Technical Skills

Despite the significant automation of today's ophthalmic instruments, technical skills are still valuable assets. “I recommend looking for an ophthalmic photographer, ophthalmic technician, or ultrasound technician, depending on the size of your practice and patient load,” says Weitz of OPKO. Some experts also recommend hiring certified professionals, including certified retinal angiographers (CRAs) and certified ophthalmic technicians (COTs).

Hiring skilled personnel is recommended by Carl Zeiss Meditec and Optovue, for example. “The ideal situation is to hire technicians certified by JCAHPO or the Ophthalmic Photographers Society (OPS) and people with experience operating ophthalmic equipment,” says Lewis of Carl Zeiss Meditec. “Or you can take a staff person who isn't certified and start him or her with a JCAHPO home study course.”

If you decide to train techs on the job, Lewis recommends you choose enthusiastic front-office staffers who show an interest in back-office operations, since they're already familiar with your practice. “Many doctors start students as scribes,” says Lewis. “Then the doctors can gradually teach them technician duties.”

Finally, Lewis recommends that you choose a lead technician to mentor trainees and develop training programs that can be repeated as new technicians come on board.

Recruiting, Hiring and Training Staff

Lewis recommends advertising for open positions at local JCAHPO or Association of Technical Personnel in Ophthalmology (ATPO) meetings. Corwin of Marco suggests using Craigslist, where respondents are likely to be computer literate.

“Many practices employ personality tests, such as the Myers-Briggs Test, to assess personality, or the Wonderlic Basic Skills Test, to determine aptitude and identify the best potential employees,” says Schoenberger of Marco. “Good employees are the essence of any successful practice, so taking time to recruit, screen, and interview pays great dividends.”

“Hire people based on referrals and good interviews,” says Gibson of Topcon. He recommends clearly defining your expectations and formulating interview questions that will help to identify key qualities in potential employees. “Look for people who get their work done, who don't mind multitasking, and have a history of managing many responsibilities,” he adds. “Staff members have to be flexible and friendly. Take your time to identify the right people and you will reduce turnover.”

Resources for Finding and
Training Technical Staff
Association of Technical Personnel
in Ophthalmology (ATPO)

Joint Commission on Allied
Health Personnel in Ophthalmology

Ophthalmic Photographers Society (OPS)

Ongoing Training for Staff

Weitz says OPKO offers additional training, typically provided online, for new software releases and other upgrades. “One-on-one training is also available,” he notes.

“We schedule technician time on day one,” he continues. “We recommend making your practice schedule light on day two, so technicians and doctors can review the results and share comments on each patient's results. The procedures can then be fine-tuned to meet the exact needs of each doctor.”

No additional training is necessary for Optovue's RTVue. Periodic software features or enhancements provided by Optovue are accompanied by instructions.

Meanwhile, Lewis of Carl Zeiss Meditec recommends providing additional training regularly. “There are many online sources, as well as local and regional workshops available,” she says.

Monthly Focus

Corwin says monthly staff meetings should highlight a product or instrument to review.

“You can never over-train good employees,” says Schoenberger of Marco. “Doctors should determine the level of skills and expertise that they expect from team members. We can help with online, interactive training tools, and online sessions to discuss advanced clinical skills. Many practices prefer to send team members back to our office in Jacksonville for advanced skills training.”

Gibson from Topcon says you should expect continual online support and face-to-face interactions with instrument manufacturers once or twice a year for high-tech instruments. “You can't emphasize training enough, even when instruments are easy to use,” says Gibson. “Don't skimp on the training. Challenges arise when technical support specialists come to practices and doctors or certain staff members aren't available. Avoid these situations, because they'll slow you down and create confusion later on.”

Take Advantage of Available Resources

The best way to stay informed about software upgrades, instrument improvements, and free training is to attend trade shows, read ophthalmic literature, and monitor the manufacturers' websites. “We keep practices informed through our newsletter and press releases on our website,” explains Gibson. Most companies also use their sites to keep practices up to date.

OPKO's website provides the most recent releases of software for each device. With a company-supplied password (obtained by email), you can download and install upgrades as needed. “We remind our customers to check the site regularly for news and updates,” says Weitz.

The Optovue marketing division recommends you ensure instrument companies have your current contact information, including email address, so that you'll receive updates in a timely manner. “Make sure to immediately open any mails you receive, especially those that pertain to software upgrade packages,” she says.

“Maintaining an ongoing relationship with each company's training staff is very helpful,” adds Schoenberger.

Moving Forward

View the decision to purchase advanced technology as a partnership with the manufacturer — not as a one-time buying decision. The relationship will encompass service, support, updated software, and the training support that your practice will need to maintain the peak performance of your investment, according to Schoenberger.

“To get the most out of your instruments, it's also important to have that one staff person who stays on the cutting edge of all of this new technology,” says Vincent R. Vann, MD, PhD, of Edinburg, Tex. “This person doesn't have to be a manager, but he or she should lead your ongoing training effort. Updates are coming out all of the time. The collaborative effort of an informed staff and support from the instrument companies will keep a progressive practice moving forward.” OM

Optometric Management, Issue: July 2010