Final Report to the Macular Disease Foundation, Vision Rehabilitation Therapy

These Professional Practice Guidelines support the work of Vision Rehabilitation Therapists and others dedicated to excellence in the training of people with visual impairments or blindness.  The scope and guidelines defined in this document have and will continue to evolve to meet the needs of Vision Rehabilitation Therapists and other service providers, and above all, foster excellence of vision rehabilitation to the benefit of persons with visual impairments or blindness.

Executive Summary

We requested the financial support of the Macular Disease Foundation to conduct the research necessary to produce a Vision Rehabilitation Therapist (VRT) discipline consensus statement that includes Clinical Practice Guidelines. The Guidelines document will provide support and guidance to clinicians in the field and university faculty who train new clinicians, and provide an enhanced standard of care for people with visual impairments and their families. During the course of this project many VRT professionals suggested that the document be called “Professional Practice Guidelines” rather than “Clinical Practice Guidelines;” therefore, the rest of this document will reflect that recommendation.

Our research plan consisted of multiple steps. We used qualitative research methodologies to (1) gather input from a many VRTs regarding their current clinical practices, (2) compile current practices into a cohesive document, and (3) share the guideline document with several VRT key field leaders for peer review and consensus building using a Modified Dephi technique. Initial input was collected during multiple facilitated focus group discussions at an international professional association meeting during the summer of 2008. The peer review/consensus building portion of the project was completed by key informant reviews using the newly created Professional Practice Guidelines document as the structured review guide.

The Professional Practice Guidelines document is organized by activity. Each core activity domain includes sub-activities. The core activity domains are:

1. Assessment: A VRT conducts a thorough individualized assessment of the person with blindness or low vision (PBLV). The assessment process requires ongoing collection and interpretation of relevant data.
2. Planning: The VRT works with the PBLV to establish mutually acceptable goals leading to a plan for services. The goals reflect information obtained through initial and ongoing assessments.
3. Implementation: The VRT provides culturally sensitive instruction based on mutually agreed upon goals and objectives, and adjusts training to accommodate individual needs, abilities, and other factors.
4. Evaluation: The VRT continually monitors learner progress throughout the training process, gathering both self-reported progress as well as qualitative and quantitative improvement based upon pre-established, mutually agreed upon goals and objectives.
5. Documentation: The VRT establishes a complete, accurate, objective and confidential documentation of the PBLV’s services and performance.
6. Quality of Services: The VRT engages in continuing professionalism and must consider both what is done (the content of the care) and how it is done (the process of care).
7. Professionalism: The VRT appraises his or her own performance to identify areas of strength and areas for improvement and to develop a plan for improvement and growth.

There is considerable interest in the VRT field to widely disseminate these Professional Practice Guidelines through published research articles, professional conference presentations, and professional websites utilized by VRTs for reference and resource information. We plan to submit research articles to peer reviewed journals regarding the research aspects of this project. Additionally, we plan to present this information through conference presentations and are considering the most appropriate professional websites and document format for web dissemination as well.

Main Report

BACKGROUND

While the field of Vision Rehabilitation Therapy (VRT) (formerly Rehabilitation Teaching) is not new, much of the training provided by VRTs has been developed informally over time and taught to VRTs in training programs such as those offered in university programs. This development spans service provision location, either center-based or itinerant, and has been based on personal or shared experience, and creativity. Many VRTs consider their work “an art,” resulting from individual client/student needs, wisdom gained from working with many clients/students over time, professional maturity, and the creative energy necessary to meet the individual needs of the people with which one works. However, most VRTs agree that there are key activities that should at least be considered when working with people who are blind or have low vision. Field consensus and documentation of those key activities ensures consistent service delivery regardless of provision location, a resource for VRTs, a product that improve understanding of what VRT’s do, and tool to enhance services for the people who should be referred (the people experiencing blindness or low vision).

Many fields similar to VRT have developed, widely agreed upon, and disseminated professional practice guidelines. Fields that rely on medical licensure such as Occupational Therapy, Physical Therapy, and Speech Therapy have formal Clinical Practice Guidelines, which has helped to organize, formalize, and guide training practices when these professionals are working with clients. Professionals from these fields also share that the Clinical Practice Guidelines can be used as educational and advocacy tools with new clients and other referring professionals. Noting an absence of field-wide guidelines in the field of VRT, we were compelled to begin the work on this project, which was made possible by the generous financial assistance of the Macular Disease Foundation.

This work was very important to the project’s principal investigator, Dr. Susan Ponchillia. Throughout this project Dr. Ponchillia battled cancer, which tragically took her life in September 2009. These Professional Practice Guidelines reflect her passion for advancing the field of VRT and she was incredibly grateful for the generosity of the Macular Disease Foundation and the patience the Foundation has shown in awaiting this final product. Following her passing, Dr. Amy Freeland worked to complete the project started by Dr. Ponchilla.

METHODOLOGY

We proposed a two-tiered qualitative approach to develop the Vision Rehabilitation Therapy Professional Practice Guidelines.

• During Phase 1 of the project we conducted an extensive literature review of Vision Rehabilitation Therapy “best practices.” We also convened several focus groups to gather information from clinicians, university personnel preparation faculty, and agency administrators about current scope of practice in the field and practice standards and approaches.
• Phase 2 of the project built on the information gathered during the 2008 Association for the Education and Rehabilitation of the Blind and Visually Impaired (AER) conference in Phase 1. In Phase 2, we compiled the input from professionals during the 2008 AER conference; and we used a modified Delphi Method approach for peer review and to attain consensus from field leaders identified during focus group gatherings in Phase 1. Delphi Method is a widely used research strategy for obtaining consensus on the characteristics of complex behavioral and social phenomena. We plan to conclude with a published Professional Practice Guidelines document, which will be widely disseminated in published reports, conference presentations, and professional websites.

Phase 1

Phase 1 began with a review of available “best practices” literature in the field of VRT, Clinical Practice Guidelines from similar disciplines, and VRT core domains when training clients/students. Literature in the field of VRT contained case studies, studies concerning Braille instruction training, studies containing very small samples sizes, and clinical advice on topics such as diabetes management, technology use, and falls prevention. As mentioned earlier, Clinical Practice Guidelines were examined for similar disciplines such as Occupational Therapy, Physical Therapy, Speech Therapy, and Diabetes Education. Core VRT training domains were obtained from the primary textbook used in VRT university training programs, and the primary certifying body for the field of VRT. This review of the literature will be updated and included in detail in published articles resulting from the Professional Practice Guideline development project.

Following the initial literature review, we organized and facilitated eight (8) focus groups at the VRT Division Day during the 2008 AER International Conference in Chicago, Illinois. All attendees were currently or had previously provided VRT services. The purpose of the focus group discussions was to provide a forum for participants to share information, perspectives, and expert knowledge based on clinical experience in order to help guide the development of these Professional Practice Guidelines.

Participants

Participants included practicing VRTs, university personnel, and administrators and staff from agencies that provide VRT services. Each focus group was presented a case study and then asked to outline the things they would consider for that case, what services and resources they would provide, how they would provide the services, and what activities they might complete during their working relationship with the case (e.g., assessment, training, evaluation).

Procedure

Participants were conference attendees who self-selected to attend this announced session. We described the study to those in attendance and informed them that their participation was voluntary. Additionally, participants were told that the focus group session was an information sharing forum, not problem solving. We explained that our hope was to walk away with more information than we had coming in, with the goal in mind to develop a set of practice guidelines that will be useful in field clinical practice settings.

Participants agreeing to contribute were separated into eight small groups (8-10 people), with two groups separately considering one of four case studies (see Appendix A). Participants were asked to consider the case study and provide feedback based on clinical decisions they would make for a particular case. Additionally, the following instructions were given:

• Discussion Ground Rules
  • All ideas are welcomed.
  • One person speaks at a time. Avoid interrupting others.
  • Limit “war stories” to 2 minutes.
• Rules for Brainstorming
  • All ideas are permitted
  • Produce as many ideas as possible
  • Postpone discussion until after the list is completed
  • Do not repeat another’s idea
  • Building on others’ ideas is desirable
  • Passing is okay

Focus group notes were written on large sheets of paper by the group facilitator. This allowed the group to verify that their ideas were recorded accurately, organize information shared by group members, and serve as a record keeping method for project investigators.

Phase 2

Information collected during the focus group sessions was compiled by the primary investigator and incorporated in the form of an outline of key activities, considerations, resources, and values shared by focus group participants. That document was then shared with key field leaders that were identified by the principal investigator following Phase 1 of this project. Key field leaders were invited to review the document in a formal peer review process called the Delphi Method. This method is especially useful when group consensus is desired. In the Delphi Method, reviewer information and comments are kept secret from other reviewers. The coordinating investigator (in this case, the replacement for the principal investigator following her death) is the only person who knows the document reviewers and saw each reviewer’s comments. This is different than a typical peer review process, where comments are shared with the other reviewers following the review period.

Reviewers were asked to assess several components of the draft Professional Practice Guidelines. First, reviewers were asked to examine the document’s contents and determine if items included were appropriate for inclusion, if there were items that should be removed, and then to assess the format of the document and provide feedback regarding areas of improvement for accessibility, usage in the field, terminology, and language. Next, reviewers were asked to consider how important formal training for new VRTs is for each domain and sub-domain. Finally, reviewers were asked to consider the importance of accuracy for VRTs in a given domain and sub-domain.

RESULTS

Approximately 60 VRTs participated in focus group discussions during the VRT Division Day session of the 2008 AER International Conference in Chicago, Illinois. Information gathered from the focus groups were compiled and disseminated to nine key field leaders for review. Four reviews were received during the two-week timeframe given for review, resulting in 44% response rate. Three additional reviewers responded with interest in assisting with this project but were unable to participate during the timeframe given; however, those reviewers offered to participate in additional rounds of review should it be determined that further opportunities for evaluation are needed.

Reviewer comments were incorporated in the Professional Practice Guidelines included in this final report (see Appendix B). Additionally, it was recommended that we partner with the Academy for the Certification of Vision Rehabilitation and Educational Professionals (ACVREP) to both disseminate these guidelines and include them in the certification process. Finally, reviewers recommended that the format be written in HTML using hierarchical nested list structure to enable users to more easily use and navigate the lengthy document. This recommendation will be incorporated in the disseminated version of the document.

Reviewers generally agreed with each other regarding the importance of skill training and accuracy for practicing VRTs for each domain and sub-domain. Using a Modified Lickert Scale (very important, important, somewhat important, not important), reviewers generally considered each of the listed domains and sub-domains as important, with some variation in opinion of the importance of research for a practicing VRT (responses were either “important” or “somewhat important”).

When considering the importance of VRT accuracy during skill training, reviewers’ opinions varied. The general consensus is that accuracy should be either “high” or “medium” high for most domains and sub-domains, using a Modified Lickert Scale (high [0-1 errors], medium high [2-3 errors], medium [4-5 errors], low [≥6 errors]).

CONCLUSIONS AND RECOMMENDATIONS

The VRTs consulted during this project consider its contribution to the field as extremely important. The information gathered during focus group discussions revealed that VRTs often rely on personal or shared experience and creativity to meet the training needs of their clients/students; however, many VRTs expressed interest and a desire to use field-wide Professional Practice Guidelines vetted within the field and disseminated widely. The Professional Practice Guideline contained in this final report (see Appendix B) is a significant step in the direction of filling a field-wide need revealed both through current literature in the field as well as qualitative data obtained through focus group discussions and key information leader reviews of the draft document.

We recommend the following:

• Additional reviews by:
  • Key leaders in the field of VRT
  • Practicing VRTs domestically and abroad, and
  • Professionals in similar fields currently using field-specific practice guidelines
• Dissemination by:
  • Published research articles
  • Conference presentations
  • Professional websites
• Dissemination to:
  • Practicing VRTs
  • People who are blind or visually impaired
  • Referring professionals

Appendix A, Focus Group Case Studies

Case Study 1

Female, 83, macular degeneration. Lives alone in her own home. Referral indicates she has difficulty reading newspaper, mail, appliance controls with dials, medication labels and other print. Owns her own vehicle and has a valid driver’s license.

Questions:

• Assessment: What assessments would you conduct or use? List subjects or skills that would be assessed as well.
• Planning: What subjects or skills would you likely plan to teach?
• Referrals: What referrals are you like to make for the consumer? Are there skills such as assistive technology within the usual realm of VRT’s that you would refer out for? List the types of referrals or the skills that you would “refer out”.
• List suggestions for continuing education that you or others may need.

Case Study 2

Young adult male, unemployed. Type I diabetes. Recent loss of all vision due to diabetic retinopathy and other ocular complications. Left eye enucleation with prosthesis. Some peripheral neuropathy. History of right leg spontaneous fracture, likely from brittle bones due to medications necessary after kidney and pancreas transplants.

Questions:

• Assessment: What assessments would you conduct or use? List subjects or skills that would be assessed as well.
• Planning: What subjects or skills would you likely plan to teach?
• Referrals: What referrals are you like to make for the consumer? Are there skills such as assistive technology within the usual realm of VRT’s that you would refer out for? List the types of referrals or the skills that you would “refer out”.
• List suggestions for continuing education that you or others may need.

Case Study 3

College age female with retinitis pigmentosa. Most recent eye report indicates legal blindness and has led to a referral to the local blindness agency. Completed high school without services from O&M, TCVI, or VRT. Is not sure what career she wants to pursue, but is definite that she wishes to earn a college degree that leads to employment.

Questions:

• Assessment: What assessments would you conduct or use? List subjects or skills that would be assessed as well.
• Planning: What subjects or skills would you likely plan to teach?
• Referrals: What referrals are you like to make for the consumer? Are there skills such as assistive technology within the usual realm of VRT’s that you would refer out for? List the types of referrals or the skills that you would “refer out”.
• List suggestions for continuing education that you or others may need.

Case Study 4

Male veteran of Iraq war. Injured when a roadside bomb blew up the humvee he was riding in. Shrapnel injuries on much of his body. Total blindness, brain injury, left hand and forearm amputation; prosthesis planned for but not yet received.

Questions:

• Assessment: What assessments would you conduct or use? List subjects or skills that would be assessed as well.
• Planning: What subjects or skills would you likely plan to teach?
• Referrals: What referrals are you like to make for the consumer? Are there skills such as assistive technology within the usual realm of VRT’s that you would refer out for? List the types of referrals or the skills that you would “refer out”.
• List suggestions for continuing education that you or others may need.

Appendix B, VRT Professional Practice Guidelines

Competency Guidelines

The following guidelines are intended to provide VRTs with a resource while providing skills of blindness and independent living skills training “in the field.” These guidelines are informed by qualitative data collected during focus group discussions at a VRT professional association conference, along with current literature in the field. The guidelines are intended to provide assessment and training content areas that should be considered and provided as appropriate to ensure individualized training program development.

Assessment

A VRT conducts a thorough individualized assessment of the person with blindness or low vision (PBLV). The assessment process requires ongoing assessment of functional implications and appropriate application of the teaching plan.

Assessment includes a review of case file history and functional implication of each piece of information

• Current eye report
• Assessment form from referring agency
• Health and medical history
  • Other medical conditions? Identifying other medical conditions
  • Current mental health status
• Medications- Current medications
• Living environment
  • Home environment
  • Family/friend supports
  • Community environment and supports
• Prior training
• Identification of other service providers currently involved on the team
• Employment history, previous education, skills and training, occupation, vocation, and financial status
  • “Factors that influence learning such as education, literacy level and level of comprehension, perceived learning needs, motivation to learn.”
• Purpose of Rehabilitation: Combination of PBLV’s stated needs and a referral sources stated recommendations.
• Physical factors including age, mobility, functional hearing and communication, manual dexterity, Functional tactile ability, alertness, memory, attention span, limitation requiring adaptive support and or use of alternative skills.
• O&M—Indoor and outdoor household environment assessment

Interview assessment

• The PBLV’s stated needs or perception of needs
  • Prescription and Over the Counter Medications—PBLV ability to identify and self-manage (including ability to take when necessary or scheduled
  • Living environment
    • Home environment
    • Family/friend support systems
    • Community environment and support systems
  • Identification of other service providers currently involved on the team and their respective role
  • Employment history, previous education, skills and training, occupation, vocation, and financial status
  • Factors that influence learning such as education, literacy level and level of comprehension, perceived learning needs, motivation to learn.
  • The PBLV’s understanding of his or her visual condition, treatment and prognosis , and family member’s or caregiver’s understanding or knowledge
  • The PBLV’s need for counseling or peer support, and the PBLV’s level of adjustment to blindness.
  • Purpose of Rehabilitation: Combination of PBLV’s stated needs and a referral sources’ stated recommendations.
  • Physical factors including age, mobility, functional hearing and communication, manual dexterity, functional tactile ability, alertness, memory, attention span, limitation requiring adaptive support and or use of alternative skills.
  • O&M—Indoor and outdoor household environment assessment
  • Diabetes Self Management abilities and needs
  • Social, cultural and religious practices
  • Quality of Life (QOL) factors such as leisure needs, hobbies, and interests
  • Home and work place Assessments, including:
    • Lighting
    • Glare
    • Safety dangers
    • Fall hazards
    • Organizational techniques

Behavioral observation

• • Living environment, including:
    • Home environment
    • Family/friend supports
    • Community environment and supports
  • Employment history, previous education, skills and training, occupation, vocation, and financial status
  • Factors that influence learning such as education, literacy level and level of comprehension, perceived learning needs, motivation to learn.
  • Physical factors including age, mobility, functional hearing and communication, manual dexterity, Functional tactile ability, alertness, memory, attention span, limitation requiring adaptive support and or use of alternative skills.
  • O&M—Indoor and outdoor household environment assessment
  • Diabetes Self Management abilities and needs
  • Medical self-management – both prescription and Over the Counter
  • Ergonomic Assessments
  • Home and work place Assessments, including:
    • Lighting
    • Glare
    • Safety dangers
    • Fall hazards
    • Organizational techniques

Planning:

The VRT works with the PBLV to establish mutually acceptable goals leading to a plan for services. The goals reflect information obtained through initial and ongoing assessments. The plan for services integrates current rehabilitation practices and established principles of teaching and learning including information related to the unique instructional needs of PBLV. The plan for services is coordinated with agency and community programs and other relevant service providers and benefits the PBLV by ensuring a logical sequence of training

• Goals and objectives:
  • Measurable (qualitative/quantitative) behavioral objective format
  • Effective as evidenced by evaluation
  • Consistent with recognized VRT Professional Practice Guidelines
  • Prioritized as necessary to best meet the PBLV’s needs based upon immediate and ongoing considerations.
• Multisensory training program for optimal benefit, to include appropriate:
  • Methods
  • Strategies
  • Materials, and
  • Technologies
• Partnerships developed to define goals and identify methods to achieve them, with:
  • PBLV
  • Family or significant others, and
  • Other service providers

Implementation

The VRT provides culturally sensitive instruction based on mutually agreed upon goals and objectives, and adjusts training to accommodate individual needs, abilities, and other factors.

• Conducts, monitors, and supervises individual and group training sessions appropriate to planned goals and objectives
• Identifies and uses instructional strategies appropriate to the PBLV’s vision level, needs, skills, learning style, and preferences.
• Creates and implements a plan that follows a sequence for optimal skill training, encouraging and empowering the learner to apply newly acquired skills for maximum independence.
• Provides sufficient training to have the PBLV reach the highest level of empowerment possible (wean the PBLV from a need for the VRT). Empowerment is defined as the process of enhancing an individual’s or group’s capacity to make choices and transform those into desired actions and outcomes.
  • Increasing the capacity of individuals to become more self-reliant.
• Teaches problem solving skills, resource acquisition and appropriate utilization including adapted equipment, and self-evaluation skills.
• Shares the VRT plan for services with PBLV (and referring provider when indicated).
• Involves family members or significant others (as appropriate) in supporting the PBLV’s use of new skills.
• Teaches adapted skills needed for independent living including personal management (including self diabetes management), household management, communications (assistive technology usage, digital recording, braille, keyboarding, handwriting, use of low vision devices), leisure activities, emergency preparedness, orientation and movement in the indoor environment appropriate to the individual’s level of vision.

Evaluation:

The VRT continually monitors learner progress throughout the training process, gathering both self-reported progress as well as qualitative and quantitative improvement based upon pre-established, mutually agreed upon goals and objectives.

• Measures behavior change at baseline and then throughout instruction/therapy
• Reassesses the initial goals and objectives based on PBLV’s performance and any new findings.
• Shares the performance evaluations with the PBLV. Gives the learner positive reinforcement on mastery of learning which increases self esteem and motivation for further efforts.
• Re-evaluates effectiveness of PBLV’s social support systems and enhances support network as needed.

Documentation

The VRT establishes a complete, accurate, objective and confidential documentation of the PBLV’s services and performance.

• Documents all components of services in measurable terms.
  • Assessment
  • Planning
  • Implementation, and
  • Evaluation
• Ensures that documentation of specific PBLV’s information and any release thereof complies with the federal Health Information Portability and Accountability Act (HIPAA) and VRT Code of Ethics.

Quality of Services:

The VRT engages in continuing professionalism and must consider both what is done (the content of the care) and how it is done (the process of care).

• Strives for excellence and professionalism in the provision of Vision Rehabilitation Therapy through continuing education and actions consistent with professional Guidelines and certification requirements.
• Advocate for optimal empowerment, optimal quality of life, optimal independent living, and optimal employment of PBLVs.
• Systematically reviews and evaluates processes and outcomes of VRT services.
• Implements appropriate actions to address discrepancies between planned processes and expected outcomes and actual processes and outcomes.
• Advocates for the provision of VRT care and education as part of public policy.
• Provides referrals for other service providers and community agencies as appropriate

Professionalism

Professional Performance Appraisal: The VRT appraises his or her own performance to identify areas of strength and areas for improvement and to develop a plan for improvement and growth.

Engages in planned, systematic self-evaluation at regular intervals to identify professional strengths and weaknesses.

• Seeks and uses input from colleagues and clients in the self-evaluation process.
• Identifies and describes specific needs for professional development.
• Documents findings and monitors professional appraisal and plans for professional development.

Professional Development: The VRT assumes responsibility for his or her own professional development and pursues continuing education to develop and maintain knowledge and skills.

• Develops, implements, and evaluates a plan for professional growth based on findings from the performance appraisal
• Pursues professional continuing education, progressing from basic through advanced curricula.
• Strives to meet academic, professional, and experiential requirements and to achieve and maintains certification within the VRT specialty and documents professional development activities, which facilitates ongoing monitoring and awareness of progress to achieve personal and professional goals.

Collegiality: The VRT recognizes and respects the unique knowledge and experience of professional colleagues from a variety of disciplines.

• Shares his or her unique VRT knowledge and skills with colleagues (both health care providers in related disciplines, students, interns, or other individuals in training), lay leaders, and policy makers involved in rehabilitation programs, particularly when new therapies, information, and technological advancements in vision rehabilitation occur.
• Acknowledges and supports aspect of rehabilitation provided by other team members.
• Contributes to the development of students, interns, and other trainees through formal education and mentorship.
• Collaborates with colleagues and clients to influence public policy so that quality and availability of vision rehabilitation therapists are improved.
• Provides constructive feedback to colleagues regarding practices to improve rehabilitative care.

Ethics: Ethical decisions and actions reflect the interests of the person with visual impairments or blindness. The VRT code of ethics represents the values of the vision rehabilitation therapy profession and provides guidance for professional behavior.

• Respects and upholds basic human rights.
• Demonstrates professional integrity.
• Maintains client confidentiality.
• Discloses all potential or perceived conflicts of interest when appropriate.
• Respects the uniqueness, dignity, and autonomy of each individual.
• Accepts responsibility and accountability for professional competence.

Collaboration: The VRT is one member of a group of professionals with shared responsibility for promoting and providing quality care to persons with visual impairments or blindness.

• Participates in developing and maintaining a multidisciplinary team that may include (but is not limited to) vocational rehabilitation counselors, orientation and mobility specialists, other health professionals, referring providers, and members of the community with special interest or expertise relative to the care of persons with visual impairments or blindness.
• Communicates the role of the VRT to consumers and members of their support system, multidisciplinary team members, referring service providers and others.
• Works in partnership with the client, his or her family, significant others, and other health care providers to define outcome and processes to achieve them.
• Promotes positive conflict resolution strategies to resolve differences.
• Promotes delivery of consistent information among clients and health care providers.
• Provides referrals for appropriate follow-up.
• Shares the plan for services and progress with referring providers.

Research: The VRT, to enhance practice, seeks, critically evaluates, and applies research findings. The educator participates in research to enhance practice when appropriate.

• Seeks and critically evaluates research to enhance practice.
• Applies research findings to develop or revise policies, procedures, practice guidelines, protocols, education, and behavior change strategies.
• When appropriate, the VRT :
  • Identifies and prioritizes research problems.
  • Identifies sources and applies for funding for research questions.
  • Promotes research through alliances and collaborations with other professions and organizations.
  • Conducts research activities in compliance with human subject protection and HIPAA regulations.
  • Reports research findings.

Resource Use: The VRT uses resources effectively and efficiently.

• Identifies available and needed resources to support a personal plan for professional development.
• Identifies available and needed resources to facilitate vision rehabilitation therapy process.
• Provides a training environment that addresses:
  • Client privacy, safety, and accessibility.
  • Space requirement for training activities and storage of materials.
  • Client comfort, including but not limited to adequate lighting, ventilation, and furniture.
• Incorporates available and emerging technologies into the vision rehabilitation therapy process.
• Ensures that additional professional and support staff are appropriately trained to meet the needs of the client population.
• Systematically documents resources used (including personnel, funds, materials, equipment, and space)
• Justifies the need for additional resources through careful documentation of the impact of the resource on defined program goals.
• Provides information regarding appropriate and available vision rehabilitation and related resources and services to clients, their support systems, and other professionals.
• Seeks to expand and maintain knowledge of pertinent outside resources such as other health professionals, community agencies, community programs and services.