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The oldest continuously operating optometry college in the country hopes to also be the first doctoral-level institution to offer a hybrid online/in-person degree, according to New England College of Optometry president and CEO Dr. Howard Purcell, who is spearheading the effort to bring online medical education to his 127-year-old university.

Dr. Purcell has partnered with Noodle, an online program management platform that bills itself as “Google for education” and that was designed to compete directly with 2U and other online program managers by creating a network of technology and other service providers that agree to a set of technology and business standards.

Now, NECO and Noodle are beginning their march to accreditation, driven by a shared interest in increasing access to optometry education, which as it stands is only available at 23 institutions nationwide. Thirty-three states are without a school of optometry, Dr. Purcell said.

Optometric education is famously hands-on, as anyone who has been to an eye doctor knows. Dr. Purcell said his vision for the hybrid program rests in part on building a network of what he calls “clinical homes” across the country to ensure that students who want to remain in rural and underserved areas can still matriculate.

NECO enrolls about 150 students a year at its Boston campus, and Dr. Purcell said he hopes to ultimately have an additional 55 students a year attending from afar via the hybrid model. The goal is to launch in the fall of 2023 with 25 students, Dr. Purcell said, and add 10 students a year from there.

Dr. Purcell said about 1,000 optometry positions remain unfilled nationwide each year, mostly in rural areas. One goal for the new hybrid program, he said, will be to train people as optometrists who can stay in their hometowns and “serve their local communities” when they have finished their education.

Nursing programs have been offered online for well over a decade; the first elite school to offer online nursing instruction was Georgetown University’s School of Nursing, which began its program about 10 years ago. Physical therapy schools started offering online education about six years ago. Noodle is currently partnering with the No. 1 physical therapy school in the country, the University of Pittsburgh’s School of Health and Rehabilitation Science, to design an online doctorate program in physical therapy.

Lee Bradshaw, Noodle’s chief strategy officer, said the challenges of designing hybrid programs that capture the clinical experience is part of what prevents many medical and health-science programs from attempting what NECO is pursuing with its hybrid model.

Institutions typically have a network of hospitals, offices and agencies in their region, perhaps in a 30-mile radius, Bradshaw said, and they don’t know how to think about clinical education outside their region.

“These are degrees and practices where you are with humans,” Bradshaw said. “Your competency is based on what you can do in person, full stop, always. Our ability to find high-quality clinical placements in the states that currently don’t have any optometry programs is a huge piece of where we’re delivering.”

Bradshaw said Noodle will begin to investigate clinical home options in a given locality as soon as a prospective student asks for information. It will be imperative to be up and running with a high-quality clinical home that meets the high standards accreditors expect from NECO before a student matriculates, he said. NECO has a sophisticated clinical training center and a network of partner community health centers in Boston, and the hybrid program will seek to match the quality offered on campus.

Virtual reality and other new technologies have made high-quality online medical education much easier to achieve, Bradshaw said, recalling a virtual reality simulation he encountered as Noodle built an online physical therapy program a few years ago: students could use an iPad and augmented reality to better see and understand leg muscles at a granular level.

“There’s been a lot of investment, billions of dollars, invested in education technology in the last five years,” Bradshaw said. “You’ve seen an emergence of really sophisticated tools that Noodle is acutely aware of and knows how to deploy within the arc of the curriculum.”

NECO plans to seek approval from its regional accrediting body, the New England Commission of Higher Education, in March. From there, it will submit its plans to the national accrediting body, the Accreditation Council on Optometric Education.

American Optometric Association president Dr. Robert C. Layman was unavailable to be interviewed but said in a statement that “the profession’s advancement and expanding role in health care has always been based on the recognized strength of optometric education. AOA consistently advocates for high academic standards that will preserve the standard of excellence expected of optometry.”

Dr. Purcell said he has been working on his vision of a hybrid program since before the pandemic. He began thinking about how to achieve a hybrid model after noticing that many students watched classes on their own schedule using the videotapes and notes NECO provides. It made him realize that it would be possible to engage students online and, in doing so, increase access.

He said his team has been speaking with Noodle about plans for at least a year. The conversations have focused on how to offer high-quality education online because, as Dr. Purcell said, “our students will have to take the same exams, the same national boards that everyone takes.”

The online classes will cost the same as in-person classes do, Dr. Purcell said. They will be highly edited and produced and will allow students to work both synchronously and asynchronously.

Bradshaw said the Noodle team prides itself on the time and resources it pours into the videos it makes of lectures.

“It looks like something people are watching on their couch with their families, and they’re paying a $10 [per] month subscription for,” he said. “Like Netflix put hundreds of millions of dollars in to produce it.”

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