Optometry students’ perceptions of patient-centred clinical training at a South African university: a cross-sectional survey

Patient-centred care (PCC) is an approach to healthcare that emphasizes understanding patients’ needs and perspectives, effective communication, shared decision-making, and collaborative patient–practitioner relationships. Developing these orientations during health professions education may support students’ preparedness for patient-centred clinical practice. The Patient-Practitioner Orientation Scale (PPOS) is an 18-item instrument that assesses attitudes towards patient-centred care across two dimensions, Sharing and Caring, making it relevant for examining students’ orientations towards patient–practitioner relationships. This study used the PPOS to assess optometry students’ perceptions of PCC and examined its reliability and factor structure in this educational context. A cross-sectional exploratory study was conducted among students enrolled across all four years of the Bachelor of Optometry (BOptom) programme and students enrolled in the Master of Health Sciences in Optometry (MHSc Optometry) programme at the University of Johannesburg, South Africa. The questionnaire had 21 items, including the 18-item Patient-Practitioner Orientation Scale (PPOS), and was administered online using Google Forms. Completion took approximately 10 min. Descriptive statistics, reliability analyses, exploratory factor analysis and correlations were conducted. A total of 167 students participated (70.5% response rate; mean age 20.87 years, SD = 3.16; range 18–52), of whom 74.3% were female. The original PPOS structure demonstrated suboptimal internal consistency (overall α = 0.665). Exploratory factor analysis identified three factors: Clinical Skills vs. Patient Relationships (M = 4.78, SD = 1.06), Practitioner Reliance vs. Patient Education (M = 3.39, SD = 1.04), and Practitioner Authority (M = 3.56, SD = 1.29). The resulting factor structure demonstrated improved overall internal consistency (α = 0.816). Year of study was positively associated with Clinical Skills vs. Patient Relationships ( r = 0.174, p = 0.025) and Practitioner Authority ( r = 0.189, p = 0.014), while age was positively associated with Practitioner Authority ( r = 0.175, p = 0.024). Optometry students demonstrated stronger patient-centred orientations regarding patient relationships, while perceptions of practitioner reliance, patient education, and clinical authority were more mixed. Higher year of study was associated with more patient-centred perceptions in two of the three identified domains. The exploratory three-factor structure demonstrated better internal consistency than the original PPOS structure in this sample; however, further validation in independent and multi-institutional optometry student populations is required.