igoee participant guide - touchstone...

IGOEE

Participant

Guide

Updated May 8, 2017 Internationally

Graduated

Optometrist

Evaluating

Exam (IGOEE)

Touchstone Institute May 08, 2017

IGOEE Participant Guide Page 1

Introduction

Touchstone Institute is honoured to be the national administrator of the Internationally Graduated

Optometrist Evaluating Examination (IGOEE). This standardized examination tests the knowledge, skill

and judgement of internationally graduated optometrists (IGOs).

Registrants of the IGOEE will complete the three-part examination:

1- MCQ Examination – up to 140 questions (2.5 hours of writing time)

2- Long case station OSCE – 3 stations (32 minutes each)

3- Short case station OSCE – 9 stations (17 minutes each)

We reserve the right to modify the configuration of OSCE tracks based on candidate numbers

The blueprint for the IGOEE is consistent with the Optometry Examining Board of Canada's National

Competency Profile for Entry-Level Optometry (2015).

We have created this participant guide to assist IGOs as they prepare for assessment at our facility. While

it is our hope that this guide will answer important questions about the IGOEE, registrants should seek

out other study resources as they prepare for the examination.

We look forward to welcoming all referred registrants to Touchstone Institute.

Sincerely,

Touchstone Institute

[email protected]

http://www.oebc.ca/clientuploads/National%20Competency%20Profile/CEO-ECO%20National%20Competency%20Profile%20in%20Optometry_English.pdf

http://www.oebc.ca/clientuploads/National%20Competency%20Profile/CEO-ECO%20National%20Competency%20Profile%20in%20Optometry_English.pdf

mailto:[email protected]



Written component

The multiple choice question (MCQ) exam consists of up to 140 questions. It assesses the following

professional competencies:

Role 1: Provide Comprehensive Eye and Vision Care

Optometrists meet their clients’ eye and vision care–related needs with the objectives of achieving appropriate outcomes and maintaining or improving their clients’ quality of life.

Role 2: Collaborate

Optometrists support an integrated health care system by collaborating with other health care professionals and service providers to facilitate the management of the overall health needs and to encourage the well-being of their clients.

Role 3: Manage

Optometrists apply management skills to optimize the care of their clients and make efficient use of health resources.

Role 4: Educate

Optometrists provide education with the goal of encouraging appropriate, effective, comprehensive eye and vision care.

The written component will assess:

Client assessment and diagnosis – particularly relating to glaucoma, macular degeneration, diabetes, hypertension, vascular diseases and other causes of visual impediments, including refractive error and binocular vision anomalies

Vision therapies – including eyeglasses, contact lenses, low-vision therapies, binocular-vision therapies and peri‐surgical care

Drug therapies – particularly those currently authorized to optometrists in Ontario

Prevention of visual disability, morbidity and mortality

Pediatrics

Geriatrics

Collaborative care

Format

Each MCQ begins with a case description, which may contain information about the client, main complaint, ocular history, medical history and clinical data. Visuals may also be provided for the candidate to interpret. Each case description is followed by up to four questions. Candidates are required to choose the correct or best answer from a list of four responses. Candidates will have 2.5 hours to complete the written component of the IGOEE.



Sample MCQ Question

Demographics

42-year-old white female; computer programmer

Chief complaint red right eye

History of present illness Character/signs/symptoms Location Severity Nature of onset Duration Frequency Exacerbations/remissions Relationship to activity or function Secondary complaints/symptoms

none redness worse in the inner corner OD moderate, getting worse sudden 2 days constant none mild discomfort, slight tearing none

Client ocular history last comprehensive eye exam 1 year ago; wears PALs

Family ocular history mother: cataract surgery at age 55

Client medical history Medications taken by Client Client allergy history Family medical history General health

inflammatory bowel disease diagnosed 5 years ago artificial tears four times per day for the past 2 days; oral prednisone; ibuprofen; multivitamin dust; pollen; NKDA mother: type 2 diabetes mellitus occasional malaise

Clinical findings BVA Pupils EOMs Confrontation fields Slit lamp

Distance OD: 20/20 /OS: 20/20 PERRL, negative APD full, no restrictions full to finger counting OD, OS lids/lashes/adnexa: unremarkable OD, OS conjunctiva: see Image 1 OD, normal OS cornea: clear OD, OS anterior chamber: deep and quiet OD, OS iris: normal OD, OS lens: trace NS OD, OS vitreous: clear OD, OS

IOPs Fundus OD Fundus OS

24 mmHg OD, 25 mmHg OS @ 9:30 AM by applanation tonometry C/D, macula, posterior pole: see Image 2 periphery: unremarkable C/D, macula, posterior pole: see Image 3 periphery: unremarkable

Blood pressure Pulse

124/88 mmHg, right arm, sitting 72 bpm, regular



Image 1: OD right gaze

Image 2

Image 3

1. Which of the following is the MOST likely diagnosis of this client’s anterior segment condition OD?

a. Nodular episcleritis b. Phlyctenular keratoconjunctivitis c. Conjunctival abrasion d. Inflamed pingueculum

2. Which of the following is the MOST likely extra-intestinal manifestation of idiopathic inflammatory bowel disease?

a. joint inflammation b. pulmonary infections c. orthostatic hypotension d. cardiac arrhythmia e. weight gain



3. Which of the following is the MOST appropriate treatment for this client’s anterior segment condition OD?

a. Polytrim® solution every 3 hours b. Natamycin suspension every 4 hours c. Viroptic® solution every 2 hours d. Erythromycin ointment twice per day e. FML® suspension 4 times per day

4. After initiating treatment, which of the following is the MOST appropriate follow-up interval?

a. 24 hours b. 4 days c. 4 weeks d. 3 months e. 6 months f. 1 year



Performance Component – The OSCE

The objective standardized clinical examination, or OSCE, is a performance test that evaluates a

candidate’s clinical proficiency while participating in a series of standardized client encounters. OSCEs

are a highly valid assessment tool in measuring a candidate’s clinical performance ability.

IGOEE candidates are being tested at the competency level of recent Canadian optometric graduate who

is ready to challenge the licensing examination.

The OSCE stations for this evaluating examination and represent common workplace examples of the

content areas. Candidates should manage each presenting case as they would in a real life practice

setting. There are no hidden surprises or tricks.

Role 1: Provide Comprehensive Eye and Vision Care

Candidates will be assessed on their ability to meet their clients’ eye and vision care needs with the objective of achieving appropriate outcomes and maintaining or improving their clients’ quality of life.

Role 2: Collaborate

Candidates will need to demonstrate their ability to work within an integrated healthcare system by collaborating with other health care professionals and service providers to facilitate the management of the overall health needs and to encourage the well-being of their clients. The OSCE will assess a candidate’s:

Knowledge integration

Clinical skills

Behaviour

Attitude

Values

OSCE stations will assess content from the following areas:

Refractive errors and presbyopia

Diabetes

Binocular vision

Retinal vascular disease

Cataract glaucoma or glaucoma suspects

Anterior segment disease

Macular disease

Format

The OSCE assessment is divided into two parts:

1- Three long case stations with standardized clients and examiner questions 2- Nine short case stations with standardized clients and examiner questions



Long Case OSCE Information

Three of the 12 OSCE stations fall within the long case category. Each long case is 32 minutes.

Timing

Candidate Instructions – 2 minutes reading time

On the wall outside each clinical station there is a written statement (candidate instructions) that may

include the following information:

Client’s name

Client’s age

Task you are being asked to perform (i.e., physical examination, history taking, etc.)

Candidates will have two minutes to read the candidate instructions outside the stations. Candidates may

make notes in their note booklet (provided). An announcement will indicate when candidates may enter

the station. A copy of the candidate instructions will also be available in the examination room for the

candidate to reference.

Equipment Check/Positioning – 2 minutes

After entering the station candidates will have 2 minutes to view equipment and position themselves appropriately. An announcement will indicate when they can begin their client interaction. Candidates may NOT begin the client interaction before the announcement.

Client Encounter – 22 minutes total interaction time with the standardized client

After the starting announcement, candidates will have 22 minutes to interact with the standardized client

and complete the required task(s) listed on the candidate instructions. Candidates should take some time

to familiarize themselves with the equipment and introduce themselves to the client.

During the client encounter candidates will be assessed on the following:

History and data collection

Physical examination skills

Communication skills

Planning

Implementation

Organization

Time management

Evaluation (of client understanding)

A standardized client is an actor trained to replicate a client’s signs and symptoms in a reliable and

consistent manner. Treat them as you would a real client in a real clinical environment.

Candidates are required to explain to the station examiner exactly what they are doing during the

assessment of the client. Remain focused and don’t forget that the examiner will be scoring your clinical

skills and process. Successful candidates will be able to demonstrate their clinical ability with the client in

a natural, focused, professional manner.

Examiners may move around the room to get the best view while you demonstrate your skills. Examiners

may also provide candidates additional information related to the client during the encounter.



At the 21-minute mark, candidates will hear an announcement indicating that they have 1 minute

remaining with the standardized client. This is a good time to provide a summary of the points covered

with the client.

Examiner Questions – 6 minutes

The client encounter is followed by a structured oral interview during which the examiner may ask up to

10 questions about the presenting case and may present visual photographs or data for interpretation.

During this time, the standardized client will no longer engage with the candidate.

Time is up – Exit and proceed to next station

An announcement will be made to indicate when time is up. Candidates will be asked to leave the station

immediately, move to the next station and begin reading the candidate instructions for that station.

Candidates are not allowed to enter or leave a station before they are told to do so.

Candidates should note that they will be expected to perform the following optometric procedures on

standardized clients:

Dilated fundus exam

Binocular indirect ophthalmoscopy

Contact Tonometry

Gonioscopy with fundus lenses

Failure to identify your inexperience in these procedures could place the client at risk. Candidates will be

required to complete an acknowledgment form on the day of the exam attesting that they have the

training and experience to perform these procedures on standardized clients in a safe manner.



Sample Performance (OSCE) Senario Long Case

CANDIDATE INSTRUCTIONS

• Julia is a 70-year-old female. • Referred by her family doctor after complaining of blurred

vision for the past month. Also complains of seeing double while getting out of bed in the morning.

• Has not had an eye exam for the last 8 years.

IN THE NEXT 22 MINUTES:

OBTAIN A HISTORY OF THE PRESENTING COMPLAINT

CONDUCT A FOCUSED AND RELEVANT PHYSICAL EXAMINATION

ADDRESS CLIENT CONCERNS

As you proceed with the physical examination, EXPLAIN TO THE EXAMINER what you are doing and DESCRIBE ANY FINDINGS.

After the 22-minute warning signal, you will have six minutes to answer the examiner’s questions related to the scenario.

Once you enter the station you will have 2 minutes to view equipment and position yourself appropriately. An announcement will indicate when you can begin your client interaction. You may NOT begin your client interaction before the announcement.

Please hand one (1) barcode to examiner

Total station time = 32 minutes



Short Case OSCE Information

Nine of the 12 OSCE stations are short cases. Each short case station is 17 minutes in length.

Timing

Candidate Instructions – 2 minutes reading time

On the wall outside each clinical station there is a written statement (candidate instructions) that may

include the following information:

Client’s name

Client’s age

Task you are being asked to perform (i.e., history taking)

Candidates will have two minutes to read the candidate instructions outside the stations. Candidates may

make notes in their note booklet (provided). An announcement will indicate when candidates may enter

the station to begin their interaction with the standardized client. A copy of the candidate instructions will

also be available in the examination room for the candidate to reference.

Client Encounter – 5 minutes total interaction time with the standardized client

Upon entering the station, candidates will have five minutes to interact with the standardized client and

complete the required task(s) listed on the candidate instructions. Candidates should take some time to

introduce themselves to the client.

During the client encounter, candidates will not be required to perform a physical examination but will be

assessed on the following:

History and data collection

Communication skills

Planning

Implementation

Organization

Time management

Evaluation (of client understanding)

A standardized client is an actor trained to replicate a client’s signs and symptoms in a reliable and

consistent manner. Treat them as you would a real client in a real clinical environment.

At the four-minute mark, candidates will hear an announcement indicating that they have one minute

remaining with the standardized client. This time should be used by the candidate to summarize the

encounter for the client, if possible.

Examiner Questions – 10 minutes

The client encounter is followed by a structured oral interview. The examiner may ask up to 10 questions

about the presenting case and may present visual photographs or data for interpretation. During this time,

the standardized client will no longer engage with the candidate.

Time is up – Exit and proceed to next station



An announcement will be made to indicate when time is up. Candidates will be asked to leave the station

immediately, move to the next station and begin reading the candidate instructions. Candidates are not

allowed to enter or leave a station before they are told to do so.

Sample Performance (OSCE) Scenario Short Case

CANDIDATE INSTRUCTIONS

• Alex is a 65-year-old male. • Referred by his family doctor to rule out diabetic

complications and vascular pathologies. • Has not had an eye exam for the last 5 years. • You have just completed your fundus exam. There is 1

image of the relevant clinical findings OD in the room for your reference.

IN THE NEXT 5 MINUTES:

OBTAIN A HISTORY OF THE PRESENTING COMPLAINT

FORMULATE YOUR DIAGNOSIS TO ADDRESS CLFIENT CONCERNS AND SUGGEST MANAGEMENT

Do not conduct a physical examination.

After the 5-minute warning signal, you will have ten (10) minutes to answer the examiner’s questions related to the scenario.

You have fifteen (15) minutes for this station.

Please hand one (1) barcode to examiner



Long Case Station Equipment List

Room 1

S4 Optik Combo Chair and Stand

Nidek Manual Refractor – Model Sly – 100

Nidek CP770 Auto Projector With Remote



Mirror – Shadow Box – Single

Heine BETA 200 Streak Retinoscope

Heine Beta NT Lithium Handle – AV

http://www.praxisdienst.com/out/pictures/generated/product/1/500_500_100/130014_zoom1_z1.jpg



Reliance 4240 Pneumatic Stool

Black Occluder Long Handle

Prism Set Luneau Loose 16 Prisms

Prisms Bar Set Berens Luneau



Children’s Fixation Bar

Card Nearpoint Reading – Bilingual



Room 2

S4 Optik Combo Chair and Stand

S4Optik Z2 LED Lamp

Nidek CP770 Auto Projector With Remote



Mirror – Shadowbox – Single

Applaination Tonometer For Z2 Slit Lamp

Volk 78D Slit Lamp Lens Clear

Volk 90D Slit Lamp Lens Clear

http://www.google.ca/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://carletonltd.com/products/slit-lamps-and-ophthalmic-lenses/ophthalmic-lenses/volk-78d-lens&ei=0G9KVez6DIaoyAS0woEw&bvm=bv.92291466,d.aWw&psig=AFQjCNGGyXNSc8tl5DqTW81S6Ho6u3P1Pw&ust=1431028036742214

http://www.keeler.co.uk/90d-59.htm



Volk G4 4-Mirror Goniolaser Lens – Flange


Black Occluder Long Handle

LED Penlight Disposable 6 pack

http://www.google.ca/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.bibonline.co.uk/products/volk-g-4-high-mag-gonio-lens-no-flange&ei=NHBKVZiEMsP4yQTkj4BI&bvm=bv.92291466,d.aWw&psig=AFQjCNFxS1QUD8rWWKiQliuWKJQA5tsQQw&ust=1431028142076304

http://www.google.ca/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.newpig.com/pig/US/stylus-pro-led-penlight-els212&ei=53NKVZvcK9WdygTyioF4&bvm=bv.92291466,d.aWw&psig=AFQjCNGXOZzubX-UBrk2uyfi-6KPZl6rEA&ust=1431029083497032



Haag Streit Tonometer Measuring Prism Tip

Volk 4-mirror Hi-Mag Lens – Flange

http://www.google.ca/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.eyedoctorsupply.com/haag-streit-applanation-tonometer-measuring-prism-tip/&ei=F3RKVZmxJMGZyASR64FI&bvm=bv.92291466,d.aWw&psig=AFQjCNEdKbweIT_vwHpKBdeG3PQ9vpOtMg&ust=1431029140049438

http://www.google.ca/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.bibonline.co.uk/products/volk-g-4-high-mag-gonio-lens-no-flange&ei=NHBKVZiEMsP4yQTkj4BI&bvm=bv.92291466,d.aWw&psig=AFQjCNFxS1QUD8rWWKiQliuWKJQA5tsQQw&ust=1431028142076304



Room 3

S40PTIK COMBO Chair/Stand

S40PTIK Z2 Led Slit Lamp

Applaination Tonometer for Z2 Slit Lamp



Heine Omega 500 BIO

VOLK 20D BIO LENS


VOLK 78D Slit Lamp Lens Clear

https://www.google.ca/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=https://www.eyefficient.com/product/volk-20d-acs/&ei=gnVKVe2mG4KayATFzoA4&bvm=bv.92291466,d.aWw&psig=AFQjCNGqordJE9sXadQZTenKrNvE6VkFig&ust=1431029502166667



VOLK 90D Slit Lamp Lens Clear

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