Perfect Was Never the Plan: What a Week of Chaos Taught Me About Student Placements
Author: Christian (Director | Principal OT)
I have wanted to offer OT student placements at Legacy Allied Health for a long time. Every time the idea came up, I found a reason to wait. I wanted the induction process sorted. I wanted clear supervision structures, proper documentation, a clean system for matching students to clients. I wanted it to be ready, because that is how I like to do things.
Then, about a week before a group of Flinders University students were due to start placement, several of their existing placements fell through with no warning. The university was scrambling, and as an associate lecturer at the uni, I heard about it early, and before I had really thought it through, I put my hand up.
I told the placement coordinator the truth: things at Legacy weren't quite set up yet. That was, after all, the whole reason I hadn't offered before. She said that was fine, the students needed somewhere to go, and imperfect was better than nothing.
Getting myself out of the way
I will be honest about how uncomfortable that week was. I am someone who likes a plan, and I did not have one. What I had instead was a week to get the essentials sorted, and a choice to make about what "essential" actually meant.
In the end, that pressure did something really useful. It forced me to separate what students genuinely needed from what I had built up in my head as necessary. It turns out the list was much shorter than I had imagined. Clear expectations. A supervision structure that made sense for a private practice, not a hospital. A handful of clients whose goals were a good fit. Everything else, I decided, could be figured out as we went.
That is not naturally how I operate. But it turned out to be the right call, and it gave me a nudge that at times, my own standards can be the thing standing in my way. The setup didn't need to be perfect for the students or our clients to benefit, it just needed to exist. I probably could have offered placements a year earlier if I'd some to that realisation! That's a different conversation to how I hold myself to account clinically, where getting things right still matters as much as it ever did, but it was a useful reminder not to let being stuck in preparation be the reason something good doesn't happen.
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What actually happened once the students arrived
What followed genuinely surprised me, in the best way. Having students on placement did not just mean supervising them through the motions of a placement checklist. It meant I could blend my teaching role with my clinical one in a way I hadn't properly anticipated, and it meant our clients received a level of service that their funding alone would never have stretched to.
A client with only enough NDIS funding for a Functional Capacity Assessment ended up receiving life skills training multiple times a week, delivered by students under my supervision. Another client, funded only for a fortnightly OT review, received intensive upper limb therapy two to three times a week. We ran wheelchair training with a client's support workers so he could get out into his community more confidently and more often. None of this was billed. I see that as part of our responsibility as OTs to provide these services to the community. If we have the capacity to deliver more equitable, more genuinely useful care, and a way to do it that also serves students well, that feels like exactly the kind of work our profession exists for.
Learning that sticks, because it is real
Alongside my clinical work, I have spent a good amount of time this year thinking and writing about what I actually value in teaching, and this placement brought a lot of that into focus.
I care about learning that is engaging, not in the sense of being entertaining, but in the sense of genuinely connecting students to ideas, to real practice, and to who they are becoming as clinicians. I care about learning that is impactful, in that it prepares students not just to pass a placement but to navigate a profession that is, honestly, becoming more complex and more demanding by the year. And I care about learning that is relational, built on trust and consistency, where students can be uncertain or get something wrong without fear of judgement.
Private practice, it turns out, is a great setting for all three of those things. Students weren't slotted into a fixed structure and asked to fit themselves around it. They had room to work things out, to see what kind of clinician they wanted to be, and to be trusted with real clinical reasoning rather than just observing mine.
One of the students summed it up better than I could:
"The placement's flexibility was instrumental in helping me understand how I work best, giving me deeper insight into my emerging strengths and preferences as a clinician. In my previous placements in public health, I often felt I was trying to mould myself to fit within a fixed structure. In contrast, this setting allowed me the space to explore, grow, and uncover the kind of clinician I want to become."
Why I think more private practices need to do this
Private practice placements have been declining, and I understand exactly why. There hasn't been a price increase in the NDIS space in eight years. Last year's changes to travel funding effectively made it a price decrease. Taking on a student is a genuine cost. It takes supervision time, planning, mentoring capacity, and none of that shows up neatly on a balance sheet. I don't think practices choosing not to take on students are making the wrong call financially, and I understand exactly why business viability has to be part of that conversation.
But I don't think viability can be the only conversation we're having, because it doesn't feel like the NDIS is having that conversation with us. Pricing hasn't tracked the real cost of delivering good care, and that isn't likely to change just because we explain our margins more clearly. So alongside viability, I think we need to be talking more about value.
For me, that's exactly what student-delivered services are. Providing genuinely useful therapy at little or no cost to clients who wouldn't otherwise be able to access it, while giving students real clinical exposure, is value. A client whose funding only covers a fortnightly review getting upper limb therapy three times a week isn't a nice-to-have, it's the difference between progress and maintenance. That's value delivered to the client, to the student, and in my eyes, it's a pretty clear demonstration of the value of our profession.
When I think about the values that drove many of us to go into occupational therapy in the first place, and about the values that Legacy is built on, such as excellence, compassion, and courage, I think student placements sit right at the centre of those values. Taking on a student is very rarely the profitable choice in the short term. It is, more often, the values-aligned one. Government funding decisions have made the business case harder to make, and that's a real and valid factor to consider, but I don't think it has to be the whole story of why we do or don't take students on.
I am not saying every private practice can or should take this on right now. I am saying that if you are a private practice OT sitting on the fence the way I was, waiting for things to be properly ready before you offer a placement, it might be worth asking whether "ready" is really the thing you're waiting for, and what your clients might be missing out on in the meantime.
If we wait for the system to make it easy, we might be waiting a long time. Some things are still worth doing anyway.
