CORE DOMAIN AREA CHECKLIST (Complete only for Category 2 applicants only) The CLVT practice supervisor must complete this checklist to verify that the intern possesses knowledge of the LVT core domain areas. Please place an X under or to indicate “yes” “no” whether or not the intern has knowledge of the respective core domain area. Intern’s Name: ______________________________________________________________ YES NO Knowledge of the visual system 1. Know the visual system (oculomotor system, eye, optic pathway, and brain) _____ _____ 2. Know eye conditions and their implications. _____ _____ Knowledge of the impact of disease, trauma & aging on visual system 1. Know normal changes in vision with aging, such as changes in the lens, pupil size, light/dark adaptation, and glare sensitivity. _____ _____ 2. Know visual and non-visual effects of other medical conditions such as diabetes, head injury, multiple sclerosis, cerebral palsy or Parkinson’s on vision rehabilitation. _____ _____ 3. Know psychosocial consequences of vision impairment. Knowledge of optical and non-optical equipment and intervention strategies 1. Know and use principles of optics including implications of refractive errors, effects of lenses on magnification, effects of prisms, and the different definitions of magnification. _____ _____ 2. Know clinical rationales for prescription of optical devices. _____ _____ 3. Know optical devices used for near tasks including magnification and optical specifications, advantages and limitations, positioning requirements, appropriate visual skills, and care and maintenance. _____ _____
CORE DOMAIN AREA CHECKLIST (Complete only for Category 2 applicants only) The CLVT practice supervisor must complete this checklist to verify that the intern possesses knowledge of the LVT core domain areas. Please place an X under “yes” or “no” to indicate whether or not the intern has knowledge of the respective core domain area. Intern’s Name: ______________________________________________________________ YES NO Knowledge of the visual system 1. Know the visual system (oculomotor system, eye, optic pathway, and brain) _____ _____ 2. Know eye conditions and their implications. _____ _____ Knowledge of the impact of disease, trauma & aging on visual system 1. Know normal changes in vision with aging, such as changes in the lens, pupil size, light/dark adaptation, and glare sensitivity. _____ _____ 2. Know visual and non-visual effects of other medical conditions such as diabetes, head injury, multiple sclerosis, cerebral palsy or Parkinson’s on vision rehabilitation. _____ _____ 3. Know psychosocial consequences of vision impairment. Knowledge of optical and non-optical equipment and intervention strategies 1. Know and use principles of optics including implications of refractive errors, effects of lenses on magnification, effects of prisms, and the different definitions of magnification. _____ _____ 2. Know clinical rationales for prescription of optical devices. _____ _____ 3. Know optical devices used for near tasks including magnification and optical specifications, advantages and limitations, positioning requirements, appropriate visual skills, and care and maintenance. _____ _____
CLVT%20Core%20Domain%20Checklist.docx