**Background:** International and Australian occupational therapy accreditation standards require consumer perspectives to be integrated into student education. While consumers have contributed to on-campus learning (e.g., curriculum development, simulations), no research had explored consumer involvement during practice placements—a core component requiring 1000 hours of supervised practice. Feedback during placements is traditionally provided by practice educators, and the Student Practice Evaluation Form-Revised (SPEF-R) suggests a role for consumer feedback but provides no guidance. This study aimed to answer: What are Australian occupational therapists' perspectives of consumers actively contributing feedback to student occupational therapists during placements?
**Methods:** A qualitative descriptive approach was used. A qualitative questionnaire was developed via Qualtrics and distributed from September to December 2018 using snowball sampling through professional networks, email lists (ANZOTFA, ANZCOTE), and social media (Facebook, Twitter, LinkedIn, Occupational Therapy Australia web page). The questionnaire included 20 questions (7 demographic, 3 closed-ended, 10 open-ended) asking participants to reflect on risks, challenges, and benefits of consumer feedback from all stakeholder perspectives. Five AHPRA-registered occupational therapists and three non-occupational therapists piloted the questionnaire. Reflexive thematic analysis using Braun and Clarke's six-stage approach was conducted by four authors (three occupational therapists, one dietitian). Ethical approval was granted by the University of Canberra (project ID: 218).
**Key Results:** Eighty-one usable responses were received (7 excluded for incomplete data). Respondents came from all Australian states/territories except the Northern Territory: Queensland (32%, n=26), Australian Capital Territory (22%, n=18), Victoria (20%, n=16), New South Wales (12%, n=10), Western Australia (5%, n=4), Tasmania (3%, n=2), South Australia (1%, n=1). Most worked in major cities (67%, n=54). Primary practice areas included disability (15%, n=12), paediatrics (15%, n=12), acute care/surgical (12%, n=10), academic/clinical education (12%, n=10), mental health (10%, n=8), and rehabilitation (10%, n=8). Most respondents were experienced supervisors: proficient (32%, n=26) or expert (32%, n=26). Three themes were constructed:
Theme 1: Personal capability of consumers and students will enable, inhibit, and be developed by engaging in a feedback process. Respondents described capability as skills, knowledge, and behaviours needed for safe learning. They expressed concerns that consumers 'would not know what level the student is at' (R7) and that students 'may not have the experience to interpret or tease out meaning in a non-professionals delivery of feedback' (R5). However, some noted consumer feedback could be empowering: 'It will be empowering for the consumer. They will feel like active participants in their care' (R33).
Theme 2: An educator-controlled process is required for time-poor practice contexts to ensure safety for all stakeholders. Respondents wanted a clear process, with one noting the SPEF-R 'doesn't prompt me to request feedback from consumers' (R25). Time concerns were prominent: 'If nonconstructive feedback is provided then the practice educator needs to be able to manage this to help rebuild confidence, which takes time in a time-poor environment' (R21).
Theme 3: Us versus them: Shifting control to consumers can disempower practice educators. Respondents feared consumer feedback could contradict educator feedback: 'If the consumer provides positive feedback and the educator has a different perspective... it can be difficult to provide conflicting feedback' (R17). One noted: 'The practice educator may feel their “power” in the student/relationship is diminished or shared' (R5).
**Clinical Implications:** Practice educators perceived consumer feedback as potentially powerful but requiring a comprehensive process to ensure safety. The study challenges assumptions that consumers will deliver harmful feedback and that students will process it similarly to educator feedback—contrary to existing nursing/medical research showing students perceive consumer feedback as authentic and non-threatening. The authors argue that direct (rather than anonymous/filtered) consumer feedback may better prepare students for employment and develop professional competencies. A co-design approach involving all stakeholders is recommended to develop feedback processes that balance safety with authentic consumer contribution.