A pioneering Australian study into the plight of orthoptic students has revealed almost all surveyed experienced at least one negative act during their clinical placement.
The La Trobe University study, published in the British and Irish Orthoptic Journal, also demonstrated the negative consequences of bullying, with most orthoptic students surveyed reporting feelings of humiliation, self-doubt, and loss of confidence from the incidents, while some reported sleep disturbances, depression, and affected personal relationships.
The study – albeit limited in nature – is thought to be the first to investigate bullying of orthoptic students during clinical placements.
“The most striking result was that 95% of students reported experiencing at least one negative act during placement. These were not always labelled as ‘bullying’, but included behaviours that made students feel overlooked, dismissed, or uncomfortable,” said study lead Associate Professor Konstandina Koklanis.
“It was surprising to see just how common these experiences were, especially given how committed educators and clinicians are in supporting students. The fact that many of these acts went unreported also suggests there may be uncertainty about what constitutes inappropriate behaviour, or how to raise concerns safely.”
A/Prof Koklanis, discipline lead of orthoptics at La Trobe’s School of Allied Health, Human Services and Sport, along with Associate Professor Meri Vukicevic (La Trobe), Dr Bojana Šarkić (La Trobe) and Dr Andrea Simpson (Charles Darwin University), found half of the respondents experienced bullying. Clinical staff emerged as the most common perpetrators, followed by the clinic manager. Incidents were most frequently during the patient consultation.
The study was motivated “by the recognition that clinical placements are critical learning opportunities, but they can also be complex environments”, A/Prof Koklanis said.
“While much of the existing literature focuses on medicine and nursing, there is limited insight into orthoptic students’ real-world placement experiences. Given the importance of clinical education, we felt it was important to explore whether students encounter behaviours that might undermine their confidence or learning. Understanding both the nature and impact of these negative behaviours is vital to supporting student development and resilience,” she said.
“Placement experiences play a formative role in shaping how students view the profession, how they engage with patients, and their confidence as future orthoptists.”
A/Prof Koklanis said creating positive placement environments began with fostering open, respectful communication and encouraging reflective supervision.
It was equally important to raise awareness – not only of bullying, but of the more subtle behaviours that can negatively impact student wellbeing and learning, she said.
“Building a shared understanding of what constitutes inappropriate behaviour, and promoting clear, consistent communication around expectations and feedback are key steps toward cultivating safe, supportive clinical learning experiences.”
The study authors stressed there were various limitations, notably a small sample size and self-selection bias. With only 20 participants, the broader usefulness of the findings is also limited.
But they said the findings suggested universities must better prepare students for their clinical placement experience, including familiarising them with the bullying and harassment policies and procedures.
“Healthcare facilities and the orthoptic community must also be cognisant of the experiences of students on placement and its impact on their wellbeing,” they concluded.
“Addressing the issue of bullying in orthoptics will likely require a multifaceted approach where initiatives include not only enhancing awareness of the issue, but also include developing comprehensive anti-bullying education programs with an aim to proactively prevent instances of bullying and to create a more supportive and inclusive environment within healthcare facilities.”
A/Prof Koklanis and her team are now looking towards in-depth qualitative interviews to explore the nuanced experiences of orthoptic students.
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