Ambidexterity

[AndyOptom]

Context:
Optometrist who covers multiple practices, due to my interest in dispensing + ophthalmic optics, am sometimes asked to supervise newbies and interns, for both optometry and opticianry. Not very common, since apparently I'm rather blunt + don't sugarcoat things with the kids, so they find me intimidating to work with.

So, had an intern recently, bright young chap, IMHO nothing that time and experience wouldn't remedy for the most part, one of the better ones I've had in a long while. Did well enough during his rotation, I signed off on his log sheets, and thought it was done with.

Then the intern's supervisor (a former varsity senior of mine), contacts me to enquire about a remark I made, where I marked down said intern for his hands on skills. Apparently, it is no longer considered grounds for docking marks if the candidate sticks to just their dominant hand during patient examination (refraction, slit lamp, funduscopy, etc), dispensing (within reason, no one I know does the most delicate spectacle adjustments with the non-dominant hand), and fitting of contact lenses. Said intern was not disabled to the extent of my knowledge, and did try to do as such after it was brought to his attention (but did keep defaulting to his dominant hand mostly).

Is yet another aspect of my training back in the day gone obsolete? Personally, I appreciate ambidexterity for the tasks as noted above to work around space and ergonomic constraints... no big deal if that's how the educators deem fit to evaluate their students these days, my job carries on either way, though.

[dwlk]

im ambidextrous as i broke my thumb on my dominant hand a ways back and had to learn, and do find it immensely helpful to be able to use both hands as needed now. However, I did work with an ophthalmologist once who after carpal tunnel surgery, I challenged them to a contest using our non-dominant hands (w/o them knowing i could use both hands)...and boy was that funny to watch them fail and accept the need to learn to do their exam left handed

[Steve Machol]

FWIW, most left handers, like myself, are somewhat ambidextrous because we are forced to use right-handed tools, school desks, etc. at an early age. Some stuff I can actually do better right handed, such as playing guitar. When I played baseball as a kid I was able to bat both left and right handed equally well.

[AndyOptom]

FWIW, most left handers, like myself, are somewhat ambidextrous because we are forced to use right-handed tools, school desks, etc. at an early age. Some stuff I can actually do better right handed, such as playing guitar. When I played baseball as a kid I was able to bat both left and right handed equally well.

Seen it many times, actually! And unsurprising, the brain is a wondrous + mysterious organ. Myself, despite being right handed, somehow find my left hand more adept at manipulating lenses for retinal exams.

But anyway.

I was lucky enough to be from a (now defunct) optometry school that relied extensively on guest lecturer ophthalmologists to teach us pathology + how to use instruments like the slit lamp, ophthalmoscopes, etc. From day one of being taught, it was drilled into us that the gold standard was to use the appropriate hand so the patient's eye not being examined could have a clear line of sight to a fixation target. And so your hand working nearer to the patient's face doesn't run into their nose.

So we just learned it as such, and when I do get assigned a junior, that's been the standard I hold them to if they expect top marks by my evaluation. I know none of the hundreds of optometrists who graduated from where I did scored a distinction in their clinical exams if they couldn't do this.

Be that as it may, in fairness to the next generations moving forward, if it's not just a local educator's consensus that ambidexterity for clinical tasks is no longer a must, then by all means, I may reconsider my metrics for future such cases. Or perhaps I'll ask the relevant intern supervisors if this is then grounds for extra credit as opposed to marking them down from the top.

Side note: As a patient, I have been subjected to ophthalmologists and optometrists who examined my eyes with ambidextrous technique vs dominant hand only, I do find it easier to fixate accordingly when there isn't a hand up close and personal in front of the eye not being examined.

Thanks for putting up with my odd rambles. May seem like OCD behaviour over the most trivial of matters, I know...

[waynegilpin]

I don't think you realize how difficult this is for some people. I'm mostly righthanded. I can do somethings lefthanded. I shoot a handgun righthanded. Long guns lefthanded. If necessary, I can use a full size screwdriver with my left hand. Optical screwdriver lefthanded? Nope. Handwriting with my left hand? Even more illegible than righthanded. I was beveling a lens one day and the sales rep watching said, "I didn't know you were left handed." I never realized that I did that lefthanded.

My wife is extremely lefthanded. "Take a right at the stop light honey." And to the left we go. Even when I told the dog to shake, she'd lift up her left paw.

I don't think it's fair to expect all people to be able to do things with both hands. Have them try. If they can, Bravo. But if they can't, it's not a demerit.

[AndyOptom]

Agreed that some finer motor tasks would be near impossible for some with the non-dominant hand.

Hence my earlier qualifier, for dispensing, 'within reason'. I do not expect anyone to handle optical screwdrivers with their non-dominant hand for sure, and even those old schoolers who taught me wouldn't mind. I myself avoid doing so unless my dominant hand is injured, or I pass it to a colleague if available.

But if it comes to adjusting frames and they always assume a particular skewed configuration based on the dispenser's dominant hand, then that's not something I'd let pass. Granted, proper such adjustments also doable with just the dominant hand... so that's the extent to which I'd evaluate practitioner handedness for dispensing.

Patient examination (refraction + eye health screening) and contact lens fitting, however, I do still believe are best served by practitioners being able to swap hands. Can't always turn and shift a patient like you would a pair of glasses to get a better working angle.

End of the day, as noted, I remain open to the possibility of no longer making it a means of demerit, since times change and so I should likewise remain open to adapting... maybe it'll be an extra credit factor in the future.

Handwriting, use whichever hand or foot you want or even your mouth, as long as the EMR is updated. I know my own handwriting is equally ghastly for both hands, nearly failed my paediatrics paper twice due to that :P

NB - As mentioned in the first post, I rarely get assigned juniors for supervision, and the last few were definitely in need of remedial action... none came close to what I'd consider passable (including one who didn't even bring their retinoscope to work consistently), and were put under my watch since gentler souls had produced less than desirable results for their first round of supervision. This intern was more than competently past the passing grade, so for the first time in ages I had to consider what differentiates Good and Very Good. Given the academic supervisor's discussion with me, though, my remark on this matter on his log sheets was struck off with my agreement... this thread was me wondering how I'd go about dealing with any future cases.

[Alfredo Alaniz]

Not everyone can be fully ambidextrous, but for exams and fittings, being able to switch hands does help a lot. I think it's more about adaptability, and if it's not a big deal now, maybe it shouldn't be a big point to dock marks for either. Just my two cents.