I have been able to move into a more autonomous role while still feeling supported

What drew you to the ACP in paediatric ophthalmology masters course?

“In 2021 I started a new role at the Newcastle Eye Centre as an advanced orthoptist in paediatric ophthalmology. The ACP in paediatric ophthalmology course at the University of Sheffield felt like a good way to learn the knowledge and skills I needed for the role.

“Myself and my department were new to the concept of an ACP so it was interesting to learn how the role could benefit our department and the area of paediatric ophthalmology.”

What have you found the most rewarding part of working at a tACP level?

“I have found it rewarding being able to develop my clinical decision-making skills and have more responsibility for patient care and the development of services.

I’ve come to appreciate that the role isn’t just about clinical skills, but also about leadership, evidence-based practice, and service improvement. I’ve learned to think more holistically, manage risk, and take more ownership in patient care pathways within paediatric ophthalmology.

Jenny Earl

Advanced Clinical Practice Ophthalmology (Paediatrics)

“Throughout the programme I have had the opportunity to develop both clinical skills and confidence. I’ve developed competence in new skills such as using the slit lamp for anterior and posterior eye examinations as well as performing tonometry, and interpreting OCT and fundus images. It’s been a learning curve, but incredibly rewarding.”

What has been the biggest challenge for you in this role?

“The biggest challenge has been coming out of my comfort zone and being a trainee again. Initially, I felt a lot of pressure in making clinical decisions, especially in specialist paediatric ophthalmology areas. I overcame this through regular mentorship and by actively seeking feedback, shadowing experienced clinicians, attending advanced clinical skills training, and gradually building confidence through supervised practice and reflective learning.

“Another barrier I encountered early on was that not everyone in the wider team fully understood the scope of my new trainee ACP role. Because it’s still relatively new, there was occasionally confusion about what I was able to do, or where I fit in the team structure. At times this led to uncertainty around delegation, expectations, and involvement in decision-making. It was challenging because I was trying to develop and demonstrate new skills, while also navigating some of the role boundaries.

“To address this, I’ve tried to clearly communicate the scope of my role, what I’m working towards, and how I can support the team. As colleagues have seen my clinical skills and confidence grow, their understanding and acceptance of my role has improved. It has been a good opportunity to advocate for the trainee ACP pathway and highlight the benefits it brings to patient care and service delivery especially within paediatric ophthalmology.”

How has your practice changed since starting the course?

“I have been able to move into a more autonomous role while still feeling supported. I have used my medical exemptions for orthoptists qualification to be able to supply and administer certain eye drops and medications, and I’m working on developing some Patient Group directions (PGDs) for other commonly used medications to help tackle the barrier of no independent prescribing rights for orthoptists.”

What difference do you think this course has made to patient care in your area?

“I feel that patient care has improved as my role has helped reduce waiting times and tackle some capacity and demand challenges. I have been able to develop new patient information leaflets for patients to better understand their condition and management options.

“In doing this course I have been able to have a positive impact on the efficacy of our patient pathways within paediatric ophthalmology.”

How have you found the support of the University and your workplace since starting your studies?

“The University has supported me through regular contact and tutorials, whilst my workplace has given me time to study and my clinical mentor has provided regular, constructive feedback to support my development. Peer support from other trainee ACPs has also been key.

“Having a clear structure to supervision and access to informal support has made a big difference in how confident and capable I feel in the role.”