Student Perspectives of Extended Clinical Placements in Optometry: A Qualitative Study

Abstract

BackgroundThe number of students enrolled in health courses at Australian universities is rising, increasing demand for clinical placements. Optometry students have historically undertaken clinical training in short-block rotations at University-led teaching clinics in metropolitan locations. This is changing, with some optometry programs adopting extended placements similar to the longitudinal clerkships seen in the medical field. These placements are conducted in private community-based practices across Australia and New Zealand with many incorporating a rural component to the training. This study sought to explore optometry students’ experience of extended placements. MethodsNine focus groups were undertaken with 42 final year optometry students upon completion of a 26 week placement (of which at least half was undertaken in a non-metropolitan area, or area where a shortage of optometrists has been identified). Focus groups were audio recorded and transcribed verbatim. Thematic analysis was conducted according to Braun and Clarke’s 6 step method. Key themes were determined following an inductive qualitative descriptive approach to analysis. ResultsFour key themes emerged from the analysis. ‘Changing identity’, was about how the students grew both personally and professionally, with the extended placement being considered the vital component that allowed students to begin thinking of themselves as clinicians. ‘Practicing resilience’ related to circumstances where students experienced personality clashes, miscommunications, bullying, and boundary crossing. ‘Optometrist under instruction’, related to students feeling that the placement was an ideal opportunity to trial the everyday reality of work without the obligation of an ongoing commitment or employment contract. Finally, ‘Rural practice is more rewarding’, was about practicing rurally being a ‘rite of passage’, a chance to seek different experiences, meet new people and for students to challenge themselves professionally. ConclusionsStudents felt that the placement prepared them for real-world practice. The majority of students enjoyed their placements. However, there were instances where the student-supervisor relationship was strained. This resulted in high levels of anxiety that was made worse by a perceived lack of university support. Students believed rural placements offered them a richer experience when compared with metropolitan placements.