Survey finds mixed patient-centred orientations among South African optometry students

A cross-sectional survey of 167 optometry students at the University of Johannesburg found that participants generally expressed stronger patient-centred attitudes toward their relationships with patients than toward practitioner authority, patient education or reliance on practitioners. The study, published in BMC Medical Education as early peer-reviewed research, examined students’ perceptions of patient-centred care across all four years of the Bachelor of Optometry programme and the Master of Health Sciences in Optometry programme.

Patient-centred care emphasizes understanding patients’ needs and perspectives, communicating effectively, sharing decisions and maintaining collaborative relationships between patients and practitioners. To assess these orientations, the researchers administered an online questionnaire containing the 18-item Patient-Practitioner Orientation Scale, known as PPOS, along with three additional items. The PPOS was designed to evaluate attitudes toward patient-centred care through two dimensions: Sharing and Caring. Students completed the survey through Google Forms in approximately 10 minutes.

Participants had a mean age of 20.87 years, with a standard deviation of 3.16 years and a range of 18 to 52, and 74.3% were female. The response rate was 70.5%. Exploratory factor analysis identified three dimensions in the responses: Clinical Skills versus Patient Relationships, Practitioner Reliance versus Patient Education, and Practitioner Authority. The first dimension had the highest mean score, 4.78 with a standard deviation of 1.06, compared with 3.56, standard deviation 1.29, for Practitioner Authority and 3.39, standard deviation 1.04, for Practitioner Reliance versus Patient Education. These results indicate that students’ responses were more consistently oriented toward patient relationships than toward the other measured aspects of clinical practice.

The original two-factor PPOS structure showed only suboptimal internal consistency in this sample, with an overall Cronbach’s alpha of 0.665. The three-factor structure produced by exploratory factor analysis had improved internal consistency, with an overall alpha of 0.816. Year of study was positively associated with Clinical Skills versus Patient Relationships, with a correlation coefficient of 0.174 and a p-value of 0.025, and with Practitioner Authority, at r = 0.189 and p = 0.014. Age was also positively associated with Practitioner Authority, at r = 0.175 and p = 0.024. Because the study was cross-sectional, these associations do not establish that students become more patient-centred as they progress through training or that age causes changes in attitudes.

The study provides a snapshot of how these students responded to questions about patient-centred care, with the strongest orientation appearing in the patient-relationship domain and more mixed responses concerning practitioner reliance, patient education and clinical authority. The findings do not establish how students’ attitudes changed over time or how the responses corresponded to performance in clinical encounters. The three-factor pattern was exploratory and requires validation in independent samples and across multiple optometry institutions. The single-university setting, self-reported questionnaire responses and relatively modest associations with year of study also limit how broadly the results can be generalized.

Subject of Research: Cross-sectional assessment of patient-centred care perceptions among South African optometry students

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

Article References: Van Dyk, N., Ismail, F., & Hasrod, N. (2026). Optometry students’ perceptions of patient-centred clinical training at a South African university: a cross-sectional survey. BMC Medical Education. https://doi.org/10.1186/s12909-026-10680-2

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10680-2

Keywords: optometry education, patient-centred care, clinical training, South Africa, student perceptions, Patient-Practitioner Orientation Scale, exploratory factor analysis, health professions education, University of Johannesburg, Optometry, students, perceptions