Off the Cuff: Professional Education Has Irreversibly Changed—It’s Time We Recognized This New Virtual Reality

I can think of very few positive things that have come from the COVID pandemic. However, one that stands out was the forced pivot from live in-person meetings and events to live virtual ones. While the Zoom world seemed to explode overnight, in reality, the pandemic only sped up changes that were already well underway.

For example, optometric education has been changing for quite some time. Many students no longer bother to attend live classes, instead relying on recordings and group notes. While educators with a more rigid traditionalist perspective might view this as troubling or try to turn a blind eye, today’s students expect flexibility and view live attendance as unnecessary and burdensome. As I see it, greater flexibility and greater utilization of advanced learning technology may yet be the salvation of our profession. More on this to come, but today I want to focus on continuing education.

Compared to optometric education, continuing practitioner education poses even greater challenges given the number of stakeholders involved and the conflation of financial, educational and regulatory objectives. The primary goal of continuing professional education is to assure that the practitioner is competent, knowledgeable and up to date. Ultimately, CE exists to protect the public. The reality is not that simple

Differing state CE requirements reflect one of the professions greatest weaknesses—the lack of uniform national licensure regulations. COPE was formed to minimize the resulting maze of different rules and regulations and, for the most part, it has done a decent job of it. However, COPE regulations and requirements have become increasingly outdated, are increasingly out of touch and are occasionally misguided.

At the start of the pandemic, the shutdown of live CE events prompted COPE to temporarily grant equivalence between virtual interactive distance learning and a live presentation. However, I understand that this will be discontinued at the end of 2021. I believe that this is a major step backward for the profession and a huge mistake.

Anyone with experience presenting live CE knows that physically being present is no guarantee that educational objectives are being met. Even top tier, super-popular speakers routinely see attendees playing games or texting on cell phones or occasionally even sleeping. The only thing being physically present generally assures is that someone is generating income from granting CE credits.

While virtual interactive distance learning can suffer from many of the same flaws as live CE, it also has many potential advantages. Leveraging existing technology, both attendance and attention can be better monitored and knowledge transfer more easily and directly assessed. Interactive distance learning is far more cost-effective. In 2020 when pivoting my Dry Eye Masterclass series from live to virtual interactive, we went from colleagues having to fly in from distant cities and stay overnight in hotels or drive for miles, to having them comfortably stay in their own homes and participate undistracted. Rather than reach only 100 attendees in a cramped and expensive hotel ballroom, the first virtual Masterclass had over 2,000 attendees. Instead of being swarmed by participants at the end of the presentation to get questions answered individually, I was able to respond sequentially online, with answers visible to all. Regarding concerns about sustained attention in a virtual environment, at the end of the CE portion of the presentation nearly 90% of attendees stayed for the uncredited Q&A session. The 2021 Dry Eye Masterclass programs remained well attended with similar results. Virtual interactive distance learning works.

While neither live in-person or virtual interactive distance learning are perfect, there is no reason why both cannot coexist as effective and equivalent means of ongoing practitioner education. I do understand that our national and state organizations gain a significant amount of income by providing CE and that, for those attending it may be a convenient and effective way to learn and gain CE credit. However, that does not justify forcing healthcare professionals to physically attend educational meetings when equivalent or better virtual alternatives are available. We need to find other less conflicted ways to support our professional organizations even if that means consolidating them to reduce redundancy and cost.

Understand that I am not calling for the end of live CE, but I think it is time we recognize that things have changed and that they are not going back to how they were. By embracing this new virtual reality, we can change our profession for the better and maybe even save it in the process.

Arthur B. Epstein, OD, FAAO Chief Medical Editor artepstein@optometricphysician.com

Want to share your perspective?
Write to Dr. Epstein at artepstein@optometricphysician.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.