Accessibility and Challenges to Ophthalmic Instruments Acquisition among Optometry Students in Ghana

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The purpose of this study was to investigate the factors that influence the acquisition of personal ophthalmic instruments (POIs) among optometry students in Ghana. Methods The cross-sectional study was conducted among optometry students in Ghana. The analytic sample consisted of 485 optometry students from the Schools of Optometry and Visual Science at the Kwame Nkrumah University of Science and Technology (KNUST) and the University of Cape Coast (UCC) in Ghana. Participant characteristics and patterns of ophthalmic instrument acquisition were collected using a structured questionnaire. Bivariate and multivariate logistic regression was used to examine the relationships between factors influencing POI acquisition. Results Slightly more than one third (39.8%) owned a POI that was primarily an ophthalmoscope. Multiple logistic regression showed that financial difficulty (AOR: 0.45, CI: 0.29–0.71, p = 0.001 ), and lack of access to reliable information on instrument quality (AOR: 0.26, CI: 0.10–0.66, p = 0.005 ) were significantly associated with lower odds of POI acquisition. About 63.3% of students cited financial difficulty as the main barrier to POI acquisition. Conclusion Overall, 60.1% of students did not have their own ophthalmic instruments that was mainly due to financial constraints and lack access to reliable information on the quality of the instruments. The findings call for cost adjustments by stakeholders and increase awareness to optimize POIs acquisition among students. Taken together, the findings aim to improve clinical training and reduce disparities in optometry education among optometry students in Ghana. ophthalmoscope retinoscope access barriers facilitators clinical training Ghana Figures Figure 1 Figure 2 Introduction Optometrists form a key component in the eye care industry responsible for addressing vision impairment and blindness known to affect an estimated 295 million and 23.9 million patient population respectively. 1 , 2 In Ghana, the scope of practice of optometrists encompasses refraction and dispensing, diagnosis, and rehabilitation of the conditions of the visual system. 3 More specifically, optometrists use optical and pharmacotherapeutic approaches to uniquely manage non-communicable and infectious diseases, particularly refractive errors, glaucoma, diabetic retinopathy, and eye infections, which are prevalent in both the paediatric and geriatric populations in Ghana. 3 , 4 To this end, their role underscores their substantial contribution towards managing vision impairments consistent with sustainable development goals (SDG) 3 of promoting health and wellbeing. 5 Optometry students represent upcoming optometry professionals in Ghana. 6 – 8 They are annually enrolled after completing their mandatory licensure examination. 8 In juxtaposition, to other medical professional programs, optometry students in Ghana receive professional educational training from only two optometry schools in Ghana, Kwame Nkrumah University of Science and Technology (KNUST) and the University of Cape Coast (UCC). 8 Upon graduation, optometry students assume various roles in clinical and academic settings independent of the geographical jurisdiction to advance optometric education and eye care practice. 6 , 8 Therefore, their access to high-quality clinical training at these institutions of study remains critical for the advancement of the professional optometric landscape in Ghana. 4 , 7 Ophthalmic instruments remain central to optometric education in both technical and practical contexts. Previous research among optometrists in Ghana has shown that the lack of ophthalmic instruments is a major barrier to the provision of care by practicing optometrists in Ghana who provide both general and specialised eye care services. 4 , 9 However, evidence on the adequacy of ophthalmic instruments for training optometry students in Ghana remains scarce. Currently, the student population in these preeminent schools of optometry has seen an exponential growth rate and this can result in a high student-to-instrument ratio. 10 , 11 In this regard, optometry educators (lecturers, senior colleagues, and practicing optometrists) advocate for optometry students to secure personal ophthalmic instruments (POIs) to complement their institutional practical training and, importantly, to allow them to hone their skills through continuous practice during optometric internships and outreaches. Currently, however, no institutional policies mandate the acquisition of POI by students, nor are there provisions to supply these instruments at no cost or a subsidized rate. The quest of students to own their POI may be affected by the economic fluctuations in prices and commodities that have resulted in an increasing trend in the cost of ophthalmic instruments in Ghana. Currently, an ophthalmoscope and retinoscope set and trial lens kit are priced at $ 720 and $ 230, respectively. In a staked contrast, the average monthly salary of an optometrist is approximately $ 330 and the average tuition for optometry students is approximately $ 170, making self-acquisition of ophthalmic instruments a significant financial burden. A practicing optometrist would need to allocate almost three month’s salary to afford both sets of instruments. Compared to optometrists, most optometry students lack a steady income, relying instead on occasional, modest stipends from their parents for necessities. However, to date, the proportion of optometry students who personally own at least one ophthalmic instrument and the challenges they face in securing these ophthalmic instruments remain unclear. The purpose of this study is to examine the factors that influence the acquisition of personal ophthalmic instruments (POIs) among optometry students in Ghana. Specifically, the study sheds light on the level of access, barriers, and facilitators of POI acquisition. Overall, the study revealed that over sixty percent did not personally own ophthalmic instruments, mainly due to financial difficulties. The above findings suggest that the cost of ophthalmic instruments should be subsidised to improve student access and optimise clinical optometry training in Ghana. Material and methods Study design, population, and setting The multi-centre, cross-sectional study was conducted among Optometry students enrolled in the two Schools of Optometry and Visual Sciences specifically at the Kwame Nkrumah University of Science and Technology in Kumasi (KNUST), Ghana and the University of Cape Coast (UCC) in Cape Coast, Ghana from January 2023 to August 2023. A total of four hundred and eighty-five (485) students were purposively sampled from the two institutions, 283 from KNUST and 202 from UCC. Participants characteristics, nature of ophthalmic instruments owed, as well as the facilitators, and barriers to ophthalmic acquisition patterns were collated with a pretested structured questionnaire. Data collection The data collection instrument covered four broad areas: Participant characteristics (age, sex, institution of study), type of ophthalmic instruments (Fig. 1 ), facilitators (year of study, frequency of use of POI, importance POI acquisition, advised or prompted to acquire POI, year advised or prompted to acquire POI, source of prompt and/or advice to acquired POI), and barriers (financial difficulties, lack of access to reliable information on instrument quality, lack of access to purchase options, lack of knowledge on which instruments to purchase, lack of information from parents or guardians, not considering it important to purchase POI, wasting all money allocated for purchase) to ophthalmic instrument purchase (Fig. 2 ). Statistical analysis The survey data were imported into Microsoft Excel and checked for duplicates. The cleaned dataset was imported into Statistical Package and Service Solution version 25 compatible with Windows 11 for formal analysis. The distribution of the data was examined using Chi-square statistics, and the association between explanatory and response variables was determined using bivariate and multivariate logistic regression at a significance of p ≤ 0.05. For analytical purposes having an ophthalmoscope was considered the main outcome variable. The ophthalmoscope was used because of its basic use in clinical practice by both clinical and non-clinical year optometry students, with the former using it for demonstration purposes and/or clinical rotations and the latter using it for in-house clinical practice and during outreach or clinical rotations. Further, the ophthalmoscope was also the commonly owed POI in this study (Fig. 1 ). Ethical considerations The study was approved by the Committee on Human Research, Publication and Ethics of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (CHRPE/AP/407/23) after formalized institutional approval from authorities of the Departments of Optometry and Visual Sciences at KNUST and UCC. The study obtained informed consent from all student participants and adhered to the Tenets of the Declaration of Helsinki. Results Description of the sample Table 1 shows the distribution of participant characteristics, facilitators, and barriers by whether or not they acquired POI. Of the 485 optometry students enrolled, there was a significant age ( p = 0.016 ) but not sex ( p = 0.341 ) differences among participants with and without their own POI. There was statistically significant difference in clinical and/or non-clinical years of study and having POI (p = 0.009). However, no significant difference was observed in the frequency of use of POI, importance POI acquisition, advised or prompted to acquire POI, year advised or prompted to acquire POI, source of prompt and/or advice to acquired POI ( p > 0.05 ). Among the barriers to POI purchase, there was a statistically significant difference in financial difficulty ( p = 0.001 ) and lack of access to reliable information about device quality (p = 0.004), as shown in Table 1 . Table 1 Description of the sample Variables Total (n = 485, 100%) Acquired (n = 193, 39.8%) Not acquired (n = 292,60.2%) p-value % (frequency) % (frequency) % (frequency) Participant characteristics Age (± SD) 21.66 (± 2.246) 21.97 (± 2.389) 21.45 (± 2.120) 0.016 Sex 0.341 Male 55.5 (268) 52.8 (102) 57.2 (166) Female 44.5 (215) 47.2 (91) 42.8 (124) Facilitators to POI acquisition Year of study 0.009 Non-clinical years 53.9 (261) 46.6 (90) 58.8 (171) Clinical years 46.1 (223) 53.4 (103) 41.2 (120) Frequency of use of POI in studies 0.204 Never 17.2 (83) 21.8 (42) 14.1 (41) Rarely 14.7 (71) 14.0 (27) 15.2 (44) Sometimes 21.9 (106) 22.3 (43) 21.7 (63) Often 21.1 (102) 20.7 (40) 21.4 (62) Very often 25.1 (121) 21.2 (41) 27.6 (80) Importance of POI acquisition 0.118 Not important 0.4 (2) 1.0 (2) 0.0 (0) Slightly important 0.6 (3) 1.0 (2) 0.3 (1) Moderately important 3.3 (16) 3.6 (7) 3.1 (9) Important 8.7 (42) 5.7 (11) 10.7 (31) Very important 87.0 (420) 88.5 (170) 85.9 (250) Prompted/Advised on POI acquisition 0.957 Yes 95.2 (461) 95.3 (183) 95.2 (278) No 4.8 (23) 4.7 (9) 4.8 (14) Year prompt/advise was received 0.125 Non-clinical years 97.2 (454) 95.8 (183) 98.2 (271) Clinical years 2.8 (13) 4.2 (8) 1.8 (5) Source of prompt/advise 0.112 Lecturers 77.0 (364) 83.2 (159) 72.7 (205) Head of department 15.4 (73) 11.0 (21) 18.4 (52) Course mates 1.1 (5) 1.6 (3) 0.7 (2) Senior course mates 4.9 (23) 3.1 (6) 6.0 (17) Clinic/Hospital 0.8 (4) 0.5 (1) 1.1 (3) Parent/Guardian 0.4 (2) 0.5 (1) 0.4 (1) Others 0.4 (2) 0.0 (0) 0.7 (2) Barriers to POI acquisition Financial difficulty (Yes) 75.1 (364) 67.4 (130) 80.1 (234) 0.001 Lack of access to reliable information on instrument quality (Yes) 8.0 (39) 3.6 (7) 11.0 (32) 0.004 Lack of access to purchasing options (Yes) 14.4 (70) 11.9 (23) 16.2 (47) 0.200 Lack of knowledge on which instruments to buy (Yes) 8.7 (42) 8.3 (16) 8.9 (26) 0.814 Not informed parents or guardians (Yes) 9.5 (46) 10.4 (20) 8.9 (26) 0.592 Not finding it important to acquire POI (Yes) 1.4 (7) 1.6 (3) 1.4 (4) 0.868 Squandered all money allocated for purchasing (Yes) 0.2 (1) 0.0 (0) 0.3 (1) 0.416 Other reasons (Yes) 1.2 (6) 0.5 (1) 1.7 (5) 0.244 %, percentage frequency; KNUST, Kwame Nkrumah University of Science and Technology; UCC, University of Cape coast; POI, Personal Ophthalmic Instrument; Chi-square analyses showing the distribution between the predictors and outcome at a significance of p ≤ 0.05. The outcome was dichotomized as acquired and not-acquired of POI. For clinical relevance and analytical purposes, having an ophthalmoscope has been considered to have a POI. Patterns of POI acquisition among Optometry students in Ghana Slightly more than one-third (39.8%) of the students had purchased a POI ( see Table 1 ). The most common instruments were an ophthalmoscope (39.2%) and a retinoscope (18.5%), as shown in Fig. 1 . The main barriers to POI acquisition were financial difficulties (63.3%), lack of access to purchase options (12.2%), uninformed parents or guardians (8.0%), lack of knowledge about which instrument to buy (7.3%), and lack of access to reliable information about instrument quality (6.8%), as shown in Fig. 2 . Factors associated with POI acquisition among optometry students in Ghana In the bivariate logistic regression, age (COR: 1.11, CI: 1.02–1.21, p = 0.017 ) and being in clinical years (COR: 1.63, CI: 1.13–2.35, p = 0.009 ) were significantly associated with increased odds of acquiring personal ophthalmic instruments among students, whereas financial difficulty (COR: 0.51, CI: 0.34–0.78, p = 0.002 ), and lack of access to reliable information on instrument quality (COR: 0.31, CI: 0.13–0.71, p = 0.006 ) were significantly associated with decreased odds of acquiring personal ophthalmic instruments among students After statistical adjustment in the multiple logistic regression, financial difficulty (AOR: 0.45, CI: 0.29–0.71, p = 0.001 ) and lack of access to reliable information on instrument quality (AOR: 0.26, CI: 0.10–0.66, p = 0.005 ) as seen in Table 2 . Table 2 Factors associated with POI acquisition among optometry students in Ghana Variables Bivariate regression Multivariate regression COR 95% CI p-value AOR 95% CI p-value Participant characteristics Age 1.11 1.02–1.21 0.017 1.10 0.98–1.23 0.098 Sex Male Ref Female 1.19 0.83–1.72 0.342 Facilitators to POI acquisition Year of study Non-clinical years Ref Ref Clinical years 1.63 1.13–2.35 0.009 1.31 0.80–2.14 0.282 Frequency of use of POIs in studies Never Ref Rarely 0.60 0.32–1.14 0.119 Sometimes 0.67 0.37–1.19 0.169 Often 0.63 0.35–1.13 0.122 Very often 0.50 0.28–0.89 0.018 Prompted/Advised on POI acquisition No Ref Yes 1.02 0.43–2.42 0.957 Year prompt/advise was received Non-clinical years Ref Clinical years 2.37 0.76–7.36 0.136 Source of prompt/advise Lecturers Ref Head of department 0.52 0.30–0.90 0.019 Course mates 1.93 0.32–11.71 0.473 Senior course mates 0.46 0.18–1.18 0.106 Clinic/Hospital 0.43 0.04–4.17 0.466 Parent/Guardian 1.29 0.08–20.77 0.858 Others 0.00 0 0.999 Barriers to POI acquisition Financial difficulty, Yes 0.51 0.34–0.78 0.002 0.45 0.29–0.71 0.001 Lack of access to reliable information on instrument quality (Yes) 0.31 0.13–0.71 0.006 0.26 0.10–0.66 0.005 Lack of access to reliable information on instrument quality (Yes) 0.71 0.41–1.21 0.201 Lack of knowledge on which instruments to buy (Yes) 0.93 0.48–1.77 0.814 Not informed parents or guardians (Yes) 1.18 0.64–2.19 0.592 Not finding it important to acquire POI (Yes) 1.14 0.25–5.14 0.868 Squandered all money allocated for purchasing (Yes) 1.000 Other reasons (Yes) 0.30 0.04–2.58 0.272 Received support/assistance from institution, (Yes) 0.82 0.48–1.39 0.460 COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; Ref, reference; Bivariate logistic regression analysis was performed with significance set at p < 0.05. All variables that were significant in the bivariate analysis were included in the multiple logistic regression model with a significance level of p < 0.05. Discussion This is the first study to investigate the acquisition of ophthalmic instruments among optometry students in Ghana. The study elucidated the proportion of optometry students who acquired their own POI and unravelled the factors that influence the acquisition of these instruments and the barriers students face in acquiring POI. Slightly more than third of the students owned POIs, with ophthalmoscopes being the most commonly owned instruments. After statistical adjustment, financial difficulties and lacked access to reliable information about instrument quality were less likely to acquire POIs. Financial difficulties were the main barrier to POI acquisition among optometry students in Ghana. Optometry education in Ghana has experienced remarkable growth in recent years, resulting in a significant increase in the number of student population. 8 The surge in enrolment at the two training institutions has strained the existing infrastructure, human resources, and teaching and learning resources. These unsatisfactory trends are compounded by economic instability, which has led to unprecedented inflation in the prices of goods and commodities, including ophthalmic instruments. As a result, optometric institutions are limited in their ability to secure these clinical arsenals in sufficient quantities to meet student demand. While the acquisition of instruments increases hands-on training that may translate into technical knowledge, 12 financial challenges and lack of access to reliable information on the quality of POIs may limit the ability of optometry students to own their own POI and gain this technical knowledge. Slightly more than one-third optometry student population owned POIs, although nearly ninety percent agreed that it was very important to acquire them for their studies 13 . The acquisition of clinical instruments among students goes beyond their usage during clinical training to encompass their utility during professional clinical practice and outreaches 7 . In this study, ophthalmoscopes were the most commonly owned POI among optometry students (Fig. 1 ). A challenging and fascinating observation among optometry students 14 , 15 is to use an ophthalmoscope to view the fundus, a collective term for the back of the retina that includes the retina, optic nerve head, macula, and retinal vessels 16 . Therefore, the desire to view the fundus through ophthalmoscopy demonstrates that the student has solid observational, interpretive, and analytical may have led more optometry students to own an ophthalmoscope 17 . Having financial difficulties were significantly associated with less likelihood to own POI (Table 2 ). The findings call for a cost adjustment among ophthalmic manufacturers and suppliers to subsidize costs through student discounts to help increase student access to ophthalmic equipment for clinical training and practice, as most cited financial difficulty as a major barrier to purchasing POI (Fig. 2 ) Lack of access to reliable information on instrument quality were significantly associated with less likelihood to own POI among the students (Table 2 ). Unlike automobiles where Lemon Law aims to protect consumers who purchase inferior products by requiring manufacturers or retailers to replace the product or refund the full purchase price. There is less applicability to POI and the fear of purchasing substandard POI with no clear-cut return policies may have hindered students ophthalmic acquisition patterns. Increasing advocacy programs and establishing formal networks by ophthalmic instrument manufacturers with optometric institutions in Ghana may be essential to increase student POI acquisition. The study has several strengths. First, it presents the initial report of the pattern of acquisition of ophthalmic instruments among optometry students in Ghana, which has profound implications for optometry education in Ghana. The unravelling of key facilitators and barriers among respondents provides a situational overview to underscore the initiation of policy and advocacy programs aimed at optimising ease of access to ophthalmic instruments for clinical training. The results are less susceptible to social bias - the tendency of respondents to answer questions in a way that is viewed favourably by others as a student - as students are less likely to report not owning a POI if they do own one. Nonetheless, in this study the authors did not investigate whether students who own POIs relative to those who do not had superior clinical skills. Future studies should test this hypothesis in the same population. In light of the above findings, the authors recommend the following: First, the acquisition of a standard ophthalmic diagnostic kit (containing ophthalmoscope, retinoscope, pencil lamp/transilluminator and PD ruler) should be established as a prerequisite prior to the commencement of optometry training in schools of optometry. Second, fostering of collaborations between optometry institutions and manufacturers of ophthalmic instruments to formulate procurement plan and provide student discounted prices. Third, the training institutions, together with relevant bodies such as the Ministry of Health and the Ghana Optometric Association, can advocate for the establishment of equipment grants and financial assistance for students from key non-governmental and non-profit organizations. Lastly, parents must be involved and made aware of the importance of POIs in the training of students and their clinical practice. Conclusion About sixty percent (60.1%) of optometry students did not have their own ophthalmic instruments, with the main reasons being financial difficulties and lack of access to reliable information about the quality of ophthalmic instruments. These findings are concerning given the key role of ophthalmic instruments in clinical training and practice. The study sheds light on the poor POI acquisition patterns among optometry students in Ghana and the potential impact on their clinical training and practice, and recommends strong measures to address the associated challenges. Taken together, the findings have strong implications for improving optometric education in Ghana. Abbreviations AOR Adjusted odds ratio CI Confidence interval, COR:Crude odds ratio POIs Personal ophthalmic instruments UCC University of Cape Coast KNUST Kwame Nkrumah University of Science and Technology. Declarations Acknowledgement The authors thank the authorities of the Schools of Optometry and Visual Science at the Kwame Nkrumah University of Science and Technology and the University of Cape Coast for permission to conduct this study and the students for their willing participation. The authors also appreciate the services of Josephine Ampong (Department of Optometry and Visual Science at the Kwame Nkrumah University of Science and Technology) and Dr. Jessica Eyeson (School Medical Sciences University of Cape Coast) for expertly proofreading the entire manuscripts for language clarity and typographical errors which undeniably have improved the readership of the manuscript. Contributions: Conceptualization: K.O.A.; drafted the original manuscript: I.O.D.J., K.O.A., B.O., and E.A.A.; Data collection: P.M., M.K.A., A.A., B.OK. and S.B.O; data curation: I.O.D.J., K.O.A., E.A.A, A.K.A.A, formal analysis: I.O.D.J and E.A.A; data interpretation: I.O.D.J, K.O.A., E.A.A., A.K.A.A., D.B.K., P.M., M.K.A, A.A., B.O.K. and S.B.O.; review and editing: I.O.D.J, K.O.A., E.A.A., A.A. A.K.A.A., D.B.K., P.M., M.K.A, A.A., B.O.K., B.O, and S.B.O.; supervision: K.O.A. correspondence: K.O.A. Funding: The authors received no funding support from government, private, and not-for-profit organization. Ethical considerations The study was approved by the Committee on Human Research, Publication and Ethics of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (CHRPE/AP/407/23) after formalized institutional approval from authorities of the Departments of Optometry and Visual Sciences at KNUST and UCC. The study obtained written informed consent from all student participants and adhered to the Tenets of the Declaration of Helsinki. Data availability statement: The datasets used and analysed during the current study are available from the corresponding author upon reasonable request. Consent for participation Written informed consent was obtained from all participants prior to enrolment. Consent for Publication Not applicable. Competing Interests The authors declare no conflict of interest. References GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9:e130–43. 10.1016/S2214-109X(20)30425-3 . Abdulhussein D, Abdul Hussein M. WHO Vision 2020: have we done it? Ophthalmic Epidemiol. 2023; 30: 331–339. 10.1080/09286586.2022.2127784 Boadi-Kusi SB, Ntodie M, Mashige KP, et al. A cross-sectional survey of optometrists and optometric practices in Ghana. Clin Exp Optom. 2015;98:473–7. 10.1111/cxo.12291 . Akuffo KO, Osei Duah Junior I, Acquah EA, et al. Low vision practice and service provision among optometrists in Ghana: a nationwide survey. Ophthalmic Epidemiol. 2025;32:1–8. 10.1080/09286586.2024.2317816 . Zhang JH, Ramke J, Jan C, et al. Advancing the Sustainable Development Goals through improving eye health: a scoping review. Lancet Planet Health. 2022;6:e270–80. 10.1016/S2542-5196(21)00351-X . Kobia-Acquah E, Owusu E, Akuffo KO, et al. Career aspirations and factors influencing career choices of optometry students in Ghana. PLoS ONE. 2020;15:e0233862. 10.1371/journal.pone.0233862 . Acheampong HO, Kumah DB, Addo EK, et al. Practice patterns in the management of amblyopia among optometrists in Ghana. 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J Chem Educ. 2016;93:1223–31. Cornwell K. Comparing equipment for optometry students: which diagnostic set is best? Eyes On Eyecare. 2020. https://eyesoneyecare.com/resources/comparison-best-diagnostic-sets-optometry-students/ Gilmour-White JA, Picton A, Blaikie A et al. Does access to a portable ophthalmoscope improve skill acquisition in direct ophthalmoscopy? A method comparison study in undergraduate medical education. BMC Med Educ. 2019;19(1):201. Published 2019 Jun 13. 10.1186/s12909-019-1644-5 Kohler J, Tran TM, Sun S, Montezuma SR. Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education. Clin Ophthalmol. 2021;15:2013–23. 10.2147/OPTH.S266123 . Published 2021 May 13. Kelly LP, Garza PS, Bruce BB, et al. Teaching ophthalmoscopy to medical students (the TOTeMS study). Am J Ophthalmol. 2013;156:1056–e106110. 10.1016/j.ajo.2013.06.022 . Doria C. The ophthalmoscope and the physician: Technical innovations and professionalization of medicine. 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Cite Share Download PDF Status: Published Journal Publication published 16 Jul, 2025 Read the published version in BMC Research Notes → Version 1 posted Editorial decision: Revision requested 14 May, 2025 Reviews received at journal 13 May, 2025 Reviews received at journal 12 May, 2025 Reviews received at journal 30 Apr, 2025 Reviewers agreed at journal 27 Apr, 2025 Reviewers agreed at journal 26 Apr, 2025 Reviewers agreed at journal 24 Apr, 2025 Reviewers agreed at journal 24 Apr, 2025 Reviewers agreed at journal 24 Apr, 2025 Reviewers agreed at journal 24 Apr, 2025 Reviewers agreed at journal 24 Apr, 2025 Reviewers invited by journal 24 Apr, 2025 Editor invited by journal 15 Apr, 2025 Editor assigned by journal 14 Apr, 2025 Submission checks completed at journal 14 Apr, 2025 First submitted to journal 13 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6437290","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":448584635,"identity":"6367fb51-e62a-4d80-9961-7ac2e4c7d5b1","order_by":0,"name":"Eldrick Adu Acquah","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Eldrick","middleName":"Adu","lastName":"Acquah","suffix":""},{"id":448584636,"identity":"4ab5b9fe-075c-425b-96ce-bd5b858f3108","order_by":1,"name":"Isaiah Osei Duah Junior","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Isaiah","middleName":"Osei Duah","lastName":"Junior","suffix":""},{"id":448584637,"identity":"9c95b315-bbb5-47e6-9b40-cea16dbc1ed0","order_by":2,"name":"Albert Kwadjo Amoah Andoh","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Albert","middleName":"Kwadjo Amoah","lastName":"Andoh","suffix":""},{"id":448584639,"identity":"0a414828-8267-4a4f-b89d-d835d7d90716","order_by":3,"name":"Prince Mintah","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Prince","middleName":"","lastName":"Mintah","suffix":""},{"id":448584640,"identity":"dda50f76-b7e1-4947-a8d5-9d12a3b48da9","order_by":4,"name":"Anderson Andrews","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Anderson","middleName":"","lastName":"Andrews","suffix":""},{"id":448584641,"identity":"9c42577a-880d-4579-b6b2-31d087eae2ac","order_by":5,"name":"Michael Kwesi Asante","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Michael","middleName":"Kwesi","lastName":"Asante","suffix":""},{"id":448584642,"identity":"8b1f582d-a9e0-4c65-a7d0-0d56d7e5176b","order_by":6,"name":"Bright Osei Kusi","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Bright","middleName":"Osei","lastName":"Kusi","suffix":""},{"id":448584643,"identity":"511d1626-a8b4-46b6-ba58-605c021ca851","order_by":7,"name":"Samuel Benaiah Oppong","email":"","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"Benaiah","lastName":"Oppong","suffix":""},{"id":448584644,"identity":"abc9d237-bfcf-442d-afd7-9e061a6da9fc","order_by":8,"name":"Beatrice Okrah","email":"","orcid":"","institution":"School of Medicine and Dentistry, College of Health and Allied Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":false,"prefix":"","firstName":"Beatrice","middleName":"","lastName":"Okrah","suffix":""},{"id":448584645,"identity":"de37c98d-3361-4158-bef1-6377d3d1100e","order_by":9,"name":"Kwadwo Owusu Akuffo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYBACCQYGZgYGGzkGfhAvoYBoLWnGDJINIC0GpGgxOADiEqNFsr35sTFPgoGc8fnViR8eGDDI84sdwK9FmueYcTJQi7HZjbebJYAOM5w5OwG/FjmJBOPDvD/+JG67cXYDSEuCwW2CWtI/Hwbakrh5xtnNP4jSIi2RA3ZY4gb+3m3E2SLZc6bYcA7QLxI3eLdZJBhIEPaLxPH2zRJvgCHG3392880fFTby/NIEtCBpBquUIFY5CPAfIEX1KBgFo2AUjCQAACZUQDtrJ+yOAAAAAElFTkSuQmCC","orcid":"","institution":"Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi","correspondingAuthor":true,"prefix":"","firstName":"Kwadwo","middleName":"Owusu","lastName":"Akuffo","suffix":""}],"badges":[],"createdAt":"2025-04-13 04:53:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6437290/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6437290/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13104-025-07385-y","type":"published","date":"2025-07-16T15:57:11+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":82140418,"identity":"c98cc84e-ddc1-4ff8-9be6-9f886558c338","added_by":"auto","created_at":"2025-05-07 06:30:24","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":50824,"visible":true,"origin":"","legend":"\u003cp\u003eSpecific personal ophthalmic instruments acquired by Optometry students.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6437290/v1/4105c544c612cc85137b16d2.png"},{"id":82136710,"identity":"d02fe12a-f80e-4dae-aa7d-9d7347013bef","added_by":"auto","created_at":"2025-05-07 06:14:24","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":24954,"visible":true,"origin":"","legend":"\u003cp\u003eBarriers to acquisition of personal ophthalmic instrument by Optometry students\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6437290/v1/cb185dc9b103f2f0fc954ea8.png"},{"id":87219319,"identity":"7e995088-22ae-420b-9595-da5a7af89a47","added_by":"auto","created_at":"2025-07-21 16:03:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1529293,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6437290/v1/8625c179-ab58-4fc6-aef8-95323f18e586.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Accessibility and Challenges to Ophthalmic Instruments Acquisition among Optometry Students in Ghana","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOptometrists form a key component in the eye care industry responsible for addressing vision impairment and blindness known to affect an estimated 295\u0026nbsp;million and 23.9\u0026nbsp;million patient population respectively.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e In Ghana, the scope of practice of optometrists encompasses refraction and dispensing, diagnosis, and rehabilitation of the conditions of the visual system.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e More specifically, optometrists use optical and pharmacotherapeutic approaches to uniquely manage non-communicable and infectious diseases, particularly refractive errors, glaucoma, diabetic retinopathy, and eye infections, which are prevalent in both the paediatric and geriatric populations in Ghana.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e To this end, their role underscores their substantial contribution towards managing vision impairments consistent with sustainable development goals (SDG) 3 of promoting health and wellbeing.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOptometry students represent upcoming optometry professionals in Ghana.\u003csup\u003e\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e They are annually enrolled after completing their mandatory licensure examination.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e In juxtaposition, to other medical professional programs, optometry students in Ghana receive professional educational training from only two optometry schools in Ghana, Kwame Nkrumah University of Science and Technology (KNUST) and the University of Cape Coast (UCC).\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Upon graduation, optometry students assume various roles in clinical and academic settings independent of the geographical jurisdiction to advance optometric education and eye care practice.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Therefore, their access to high-quality clinical training at these institutions of study remains critical for the advancement of the professional optometric landscape in Ghana.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOphthalmic instruments remain central to optometric education in both technical and practical contexts. Previous research among optometrists in Ghana has shown that the lack of ophthalmic instruments is a major barrier to the provision of care by practicing optometrists in Ghana who provide both general and specialised eye care services.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e However, evidence on the adequacy of ophthalmic instruments for training optometry students in Ghana remains scarce. Currently, the student population in these preeminent schools of optometry has seen an exponential growth rate and this can result in a high student-to-instrument ratio.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e In this regard, optometry educators (lecturers, senior colleagues, and practicing optometrists) advocate for optometry students to secure personal ophthalmic instruments (POIs) to complement their institutional practical training and, importantly, to allow them to hone their skills through continuous practice during optometric internships and outreaches.\u003c/p\u003e \u003cp\u003eCurrently, however, no institutional policies mandate the acquisition of POI by students, nor are there provisions to supply these instruments at no cost or a subsidized rate. The quest of students to own their POI may be affected by the economic fluctuations in prices and commodities that have resulted in an increasing trend in the cost of ophthalmic instruments in Ghana. Currently, an ophthalmoscope and retinoscope set and trial lens kit are priced at \u003cspan\u003e$\u003c/span\u003e720 and \u003cspan\u003e$\u003c/span\u003e230, respectively. In a staked contrast, the average monthly salary of an optometrist is approximately \u003cspan\u003e$\u003c/span\u003e330 and the average tuition for optometry students is approximately \u003cspan\u003e$\u003c/span\u003e170, making self-acquisition of ophthalmic instruments a significant financial burden. A practicing optometrist would need to allocate almost three month\u0026rsquo;s salary to afford both sets of instruments. Compared to optometrists, most optometry students lack a steady income, relying instead on occasional, modest stipends from their parents for necessities. However, to date, the proportion of optometry students who personally own at least one ophthalmic instrument and the challenges they face in securing these ophthalmic instruments remain unclear.\u003c/p\u003e \u003cp\u003eThe purpose of this study is to examine the factors that influence the acquisition of personal ophthalmic instruments (POIs) among optometry students in Ghana. Specifically, the study sheds light on the level of access, barriers, and facilitators of POI acquisition. Overall, the study revealed that over sixty percent did not personally own ophthalmic instruments, mainly due to financial difficulties. The above findings suggest that the cost of ophthalmic instruments should be subsidised to improve student access and optimise clinical optometry training in Ghana.\u003c/p\u003e"},{"header":"Material and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design, population, and setting\u003c/h2\u003e \u003cp\u003eThe multi-centre, cross-sectional study was conducted among Optometry students enrolled in the two Schools of Optometry and Visual Sciences specifically at the Kwame Nkrumah University of Science and Technology in Kumasi (KNUST), Ghana and the University of Cape Coast (UCC) in Cape Coast, Ghana from January 2023 to August 2023. A total of four hundred and eighty-five (485) students were purposively sampled from the two institutions, 283 from KNUST and 202 from UCC. Participants characteristics, nature of ophthalmic instruments owed, as well as the facilitators, and barriers to ophthalmic acquisition patterns were collated with a pretested structured questionnaire.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eThe data collection instrument covered four broad areas: Participant characteristics (age, sex, institution of study), type of ophthalmic instruments (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), facilitators (year of study, frequency of use of POI, importance POI acquisition, advised or prompted to acquire POI, year advised or prompted to acquire POI, source of prompt and/or advice to acquired POI), and barriers (financial difficulties, lack of access to reliable information on instrument quality, lack of access to purchase options, lack of knowledge on which instruments to purchase, lack of information from parents or guardians, not considering it important to purchase POI, wasting all money allocated for purchase) to ophthalmic instrument purchase (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe survey data were imported into Microsoft Excel and checked for duplicates. The cleaned dataset was imported into Statistical Package and Service Solution version 25 compatible with Windows 11 for formal analysis. The distribution of the data was examined using Chi-square statistics, and the association between explanatory and response variables was determined using bivariate and multivariate logistic regression at a significance of p\u0026thinsp;\u0026le;\u0026thinsp;0.05. For analytical purposes having an ophthalmoscope was considered the main outcome variable. The ophthalmoscope was used because of its basic use in clinical practice by both clinical and non-clinical year optometry students, with the former using it for demonstration purposes and/or clinical rotations and the latter using it for in-house clinical practice and during outreach or clinical rotations. Further, the ophthalmoscope was also the commonly owed POI in this study (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003e The study was approved by the Committee on Human Research, Publication and Ethics of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (CHRPE/AP/407/23) after formalized institutional approval from authorities of the Departments of Optometry and Visual Sciences at KNUST and UCC. The study obtained informed consent from all student participants and adhered to the Tenets of the Declaration of Helsinki.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDescription of the sample\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the distribution of participant characteristics, facilitators, and barriers by whether or not they acquired POI. Of the 485 optometry students enrolled, there was a significant age (\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.016\u003c/em\u003e) but not sex (\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.341\u003c/em\u003e) differences among participants with and without their own POI. There was statistically significant difference in clinical and/or non-clinical years of study and having POI (p\u0026thinsp;=\u0026thinsp;0.009). However, no significant difference was observed in the frequency of use of POI, importance POI acquisition, advised or prompted to acquire POI, year advised or prompted to acquire POI, source of prompt and/or advice to acquired POI (\u003cem\u003ep\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/em\u003e). Among the barriers to POI purchase, there was a statistically significant difference in financial difficulty (\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/em\u003e) and lack of access to reliable information about device quality (p\u0026thinsp;=\u0026thinsp;0.004), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescription of the sample\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;485, 100%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAcquired (n\u0026thinsp;=\u0026thinsp;193, 39.8%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot acquired\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;292,60.2%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e% (frequency)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% (frequency)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e% (frequency)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eParticipant characteristics\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.66 (\u0026plusmn;\u0026thinsp;2.246)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.97 (\u0026plusmn;\u0026thinsp;2.389)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.45 (\u0026plusmn;\u0026thinsp;2.120)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.341\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55.5 (268)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.8 (102)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.2 (166)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44.5 (215)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.2 (91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.8 (124)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFacilitators to POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear of study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-clinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.9 (261)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.6 (90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.8 (171)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46.1 (223)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.4 (103)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.2 (120)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of use of POI in studies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.204\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.2 (83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.8 (42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.1 (41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.7 (71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0 (27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.2 (44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.9 (106)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.3 (43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.7 (63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOften\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.1 (102)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.7 (40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.4 (62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.1 (121)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.2 (41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.6 (80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImportance of POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.118\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.4 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSlightly important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.6 (3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.3 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerately important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.3 (16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.6 (7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.1 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImportant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.7 (42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7 (11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.7 (31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87.0 (420)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88.5 (170)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85.9 (250)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrompted/Advised on POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95.2 (461)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.3 (183)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95.2 (278)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.8 (23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7 (9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.8 (14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear prompt/advise was received\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-clinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e97.2 (454)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.8 (183)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98.2 (271)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.8 (13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.2 (8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.8 (5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSource of prompt/advise\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLecturers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77.0 (364)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83.2 (159)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.7 (205)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHead of department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.4 (73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.0 (21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.4 (52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCourse mates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.1 (5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.6 (3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.7 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior course mates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.9 (23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1 (6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.0 (17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinic/Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.8 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.1 (3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParent/Guardian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.4 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.4 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.4 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.7 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBarriers to POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial difficulty (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75.1 (364)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.4 (130)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80.1 (234)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of access to reliable information on instrument quality (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.0 (39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.6 (7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.0 (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of access to purchasing options (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.4 (70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.9 (23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.2 (47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.200\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of knowledge on which instruments to buy (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.7 (42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.3 (16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9 (26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.814\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot informed parents or guardians (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.5 (46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.4 (20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9 (26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot finding it important to acquire POI (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.4 (7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.6 (3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.4 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.868\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSquandered all money allocated for purchasing (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.2 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.3 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.416\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther reasons (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.2 (6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5 (1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.7 (5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.244\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e%, percentage frequency; KNUST, Kwame Nkrumah University of Science and Technology; UCC, University of Cape coast; POI, Personal Ophthalmic Instrument; Chi-square analyses showing the distribution between the predictors and outcome at a significance of p\u0026thinsp;\u0026le;\u0026thinsp;0.05. The outcome was dichotomized as acquired and not-acquired of POI. For clinical relevance and analytical purposes, having an ophthalmoscope has been considered to have a POI.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePatterns of POI acquisition among Optometry students in Ghana\u003c/h3\u003e\n\u003cp\u003eSlightly more than one-third (39.8%) of the students had purchased a POI (\u003cb\u003esee\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The most common instruments were an ophthalmoscope (39.2%) and a retinoscope (18.5%), as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The main barriers to POI acquisition were financial difficulties (63.3%), lack of access to purchase options (12.2%), uninformed parents or guardians (8.0%), lack of knowledge about which instrument to buy (7.3%), and lack of access to reliable information about instrument quality (6.8%), as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003ch3\u003eFactors associated with POI acquisition among optometry students in Ghana\u003c/h3\u003e\n\u003cp\u003eIn the bivariate logistic regression, age (COR: 1.11, CI: 1.02\u0026ndash;1.21, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.017\u003c/em\u003e) and being in clinical years (COR: 1.63, CI: 1.13\u0026ndash;2.35, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.009\u003c/em\u003e) were significantly associated with increased odds of acquiring personal ophthalmic instruments among students, whereas financial difficulty (COR: 0.51, CI: 0.34\u0026ndash;0.78, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.002\u003c/em\u003e), and lack of access to reliable information on instrument quality (COR: 0.31, CI: 0.13\u0026ndash;0.71, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.006\u003c/em\u003e) were significantly associated with decreased odds of acquiring personal ophthalmic instruments among students After statistical adjustment in the multiple logistic regression, financial difficulty (AOR: 0.45, CI: 0.29\u0026ndash;0.71, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/em\u003e) and lack of access to reliable information on instrument quality (AOR: 0.26, CI: 0.10\u0026ndash;0.66, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.005\u003c/em\u003e) as seen in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with POI acquisition among optometry students in Ghana\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eBivariate regression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e \u003cp\u003eMultivariate regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eParticipant characteristics\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.02\u0026ndash;1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.98\u0026ndash;1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.83\u0026ndash;1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFacilitators to POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear of study\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-clinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.13\u0026ndash;2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.80\u0026ndash;2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of use of POIs in studies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.32\u0026ndash;1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.37\u0026ndash;1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOften\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.35\u0026ndash;1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.28\u0026ndash;0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrompted/Advised on POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.43\u0026ndash;2.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear prompt/advise was received\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-clinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.76\u0026ndash;7.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSource of prompt/advise\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLecturers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHead of department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.30\u0026ndash;0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCourse mates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.32\u0026ndash;11.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.473\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSenior course mates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.18\u0026ndash;1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinic/Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026ndash;4.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParent/Guardian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.08\u0026ndash;20.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBarriers to POI acquisition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinancial difficulty, Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.34\u0026ndash;0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.29\u0026ndash;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of access to reliable information on instrument quality (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.13\u0026ndash;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.10\u0026ndash;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of access to reliable information on instrument quality (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.41\u0026ndash;1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of knowledge on which instruments to buy (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.48\u0026ndash;1.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.814\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot informed parents or guardians (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.64\u0026ndash;2.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot finding it important to acquire POI (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.25\u0026ndash;5.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.868\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSquandered all money allocated for purchasing (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther reasons (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026ndash;2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReceived support/assistance from institution, (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.48\u0026ndash;1.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eCOR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; Ref, reference; Bivariate logistic regression analysis was performed with significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. All variables that were significant in the bivariate analysis were included in the multiple logistic regression model with a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis is the first study to investigate the acquisition of ophthalmic instruments among optometry students in Ghana. The study elucidated the proportion of optometry students who acquired their own POI and unravelled the factors that influence the acquisition of these instruments and the barriers students face in acquiring POI. Slightly more than third of the students owned POIs, with ophthalmoscopes being the most commonly owned instruments. After statistical adjustment, financial difficulties and lacked access to reliable information about instrument quality were less likely to acquire POIs. Financial difficulties were the main barrier to POI acquisition among optometry students in Ghana.\u003c/p\u003e \u003cp\u003eOptometry education in Ghana has experienced remarkable growth in recent years, resulting in a significant increase in the number of student population.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e The surge in enrolment at the two training institutions has strained the existing infrastructure, human resources, and teaching and learning resources. These unsatisfactory trends are compounded by economic instability, which has led to unprecedented inflation in the prices of goods and commodities, including ophthalmic instruments. As a result, optometric institutions are limited in their ability to secure these clinical arsenals in sufficient quantities to meet student demand. While the acquisition of instruments increases hands-on training that may translate into technical knowledge,\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e financial challenges and lack of access to reliable information on the quality of POIs may limit the ability of optometry students to own their own POI and gain this technical knowledge.\u003c/p\u003e \u003cp\u003eSlightly more than one-third optometry student population owned POIs, although nearly ninety percent agreed that it was very important to acquire them for their studies\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The acquisition of clinical instruments among students goes beyond their usage during clinical training to encompass their utility during professional clinical practice and outreaches\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this study, ophthalmoscopes were the most commonly owned POI among optometry students (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). A challenging and fascinating observation among optometry students\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e is to use an ophthalmoscope to view the fundus, a collective term for the back of the retina that includes the retina, optic nerve head, macula, and retinal vessels\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Therefore, the desire to view the fundus through ophthalmoscopy demonstrates that the student has solid observational, interpretive, and analytical may have led more optometry students to own an ophthalmoscope\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHaving financial difficulties were significantly associated with less likelihood to own POI (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The findings call for a cost adjustment among ophthalmic manufacturers and suppliers to subsidize costs through student discounts to help increase student access to ophthalmic equipment for clinical training and practice, as most cited financial difficulty as a major barrier to purchasing POI (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eLack of access to reliable information on instrument quality were significantly associated with less likelihood to own POI among the students (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Unlike automobiles where Lemon Law aims to protect consumers who purchase inferior products by requiring manufacturers or retailers to replace the product or refund the full purchase price. There is less applicability to POI and the fear of purchasing substandard POI with no clear-cut return policies may have hindered students ophthalmic acquisition patterns. Increasing advocacy programs and establishing formal networks by ophthalmic instrument manufacturers with optometric institutions in Ghana may be essential to increase student POI acquisition.\u003c/p\u003e \u003cp\u003eThe study has several strengths. First, it presents the initial report of the pattern of acquisition of ophthalmic instruments among optometry students in Ghana, which has profound implications for optometry education in Ghana. The unravelling of key facilitators and barriers among respondents provides a situational overview to underscore the initiation of policy and advocacy programs aimed at optimising ease of access to ophthalmic instruments for clinical training. The results are less susceptible to social bias - the tendency of respondents to answer questions in a way that is viewed favourably by others as a student - as students are less likely to report not owning a POI if they do own one. Nonetheless, in this study the authors did not investigate whether students who own POIs relative to those who do not had superior clinical skills. Future studies should test this hypothesis in the same population.\u003c/p\u003e \u003cp\u003eIn light of the above findings, the authors recommend the following: First, the acquisition of a standard ophthalmic diagnostic kit (containing ophthalmoscope, retinoscope, pencil lamp/transilluminator and PD ruler) should be established as a prerequisite prior to the commencement of optometry training in schools of optometry. Second, fostering of collaborations between optometry institutions and manufacturers of ophthalmic instruments to formulate procurement plan and provide student discounted prices. Third, the training institutions, together with relevant bodies such as the Ministry of Health and the Ghana Optometric Association, can advocate for the establishment of equipment grants and financial assistance for students from key non-governmental and non-profit organizations. Lastly, parents must be involved and made aware of the importance of POIs in the training of students and their clinical practice.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAbout sixty percent (60.1%) of optometry students did not have their own ophthalmic instruments, with the main reasons being financial difficulties and lack of access to reliable information about the quality of ophthalmic instruments. These findings are concerning given the key role of ophthalmic instruments in clinical training and practice. The study sheds light on the poor POI acquisition patterns among optometry students in Ghana and the potential impact on their clinical training and practice, and recommends strong measures to address the associated challenges. Taken together, the findings have strong implications for improving optometric education in Ghana.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAdjusted odds ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence interval, COR:Crude odds ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePOIs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePersonal ophthalmic instruments\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUCC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUniversity of Cape Coast\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eKNUST\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eKwame Nkrumah University of Science and Technology.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank the authorities of the Schools of Optometry and Visual Science at the Kwame Nkrumah University of Science and Technology and the University of Cape Coast for permission to conduct this study and the students for their willing participation. The authors also appreciate the services of Josephine Ampong (Department of Optometry and Visual Science at the Kwame Nkrumah University of Science and Technology) and Dr. Jessica Eyeson (School Medical Sciences University of Cape Coast) for expertly proofreading the entire manuscripts for language clarity and typographical errors which undeniably have improved the readership of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions:\u0026nbsp;\u003c/strong\u003eConceptualization: K.O.A.; drafted the original manuscript: I.O.D.J., K.O.A., B.O., and E.A.A.; Data collection: P.M., M.K.A., A.A., B.OK. and S.B.O; data curation: I.O.D.J., K.O.A., E.A.A, A.K.A.A, formal analysis: I.O.D.J and E.A.A; data interpretation: I.O.D.J, K.O.A., E.A.A., A.K.A.A., D.B.K., P.M., M.K.A, A.A., B.O.K. and S.B.O.; review and editing: I.O.D.J, K.O.A., E.A.A., A.A. A.K.A.A., D.B.K., P.M., M.K.A, A.A., B.O.K., B.O, and S.B.O.; supervision: K.O.A. correspondence: \u0026nbsp; K.O.A.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe authors received no funding support from government, private, and not-for-profit organization.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Committee on Human Research, Publication and Ethics of the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (CHRPE/AP/407/23) after formalized institutional approval from authorities of the Departments of Optometry and Visual Sciences at KNUST and UCC. The study obtained written informed consent from all student participants and adhered to the Tenets of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement:\u0026nbsp;\u003c/strong\u003eThe datasets used and analysed during the current study are available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for participation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants prior to enrolment.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. 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Availability of low vision services and barriers to their provision and uptake in Ghana: practitioners' perspectives. Afr Health Sci. 2021;21:896\u0026ndash;903. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4314/ahs.v21i2.51\u003c/span\u003e\u003cspan address=\"10.4314/ahs.v21i2.51\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoadi-Kusi SB, Kyei S, Okyere VB, et al. Factors influencing the decision of Ghanaian optometry students to practice in rural areas after graduation. BMC Med Educ. 2018;18:188. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12909-018-1302-3\u003c/span\u003e\u003cspan address=\"10.1186/s12909-018-1302-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOvenseri-Ogbomo G, Kio FE, Morny EK, et al. Two decades of optometric education in Ghana: update and recent developments. Afr Vis Eye Health. 2011;70:136\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWarner DL, Brown EC, Shadle SE. Laboratory instrumentation: An exploration of the impact of instrumentation on student learning. J Chem Educ. 2016;93:1223\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCornwell K. Comparing equipment for optometry students: which diagnostic set is best? 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Published 2019 Jun 13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12909-019-1644-5\u003c/span\u003e\u003cspan address=\"10.1186/s12909-019-1644-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKohler J, Tran TM, Sun S, Montezuma SR. Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education. Clin Ophthalmol. 2021;15:2013\u0026ndash;23. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/OPTH.S266123\u003c/span\u003e\u003cspan address=\"10.2147/OPTH.S266123\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2021 May 13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKelly LP, Garza PS, Bruce BB, et al. Teaching ophthalmoscopy to medical students (the TOTeMS study). Am J Ophthalmol. 2013;156:1056\u0026ndash;e106110. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ajo.2013.06.022\u003c/span\u003e\u003cspan address=\"10.1016/j.ajo.2013.06.022\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDoria C. The ophthalmoscope and the physician: Technical innovations and professionalization of medicine. J Mater Cult. 2023;28:264\u0026ndash;86.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-research-notes","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"resn","sideBox":"Learn more about [BMC Research Notes](http://bmcresnotes.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/resn/default.aspx","title":"BMC Research Notes","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"ophthalmoscope, retinoscope, access, barriers, facilitators clinical training, Ghana","lastPublishedDoi":"10.21203/rs.3.rs-6437290/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6437290/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction\u003c/h2\u003e \u003cp\u003eUnderstanding the factors that influence the acquisition of ophthalmic instruments may have a profound impact on the clinical training of optometry students though this has not been previously studied. The purpose of this study was to investigate the factors that influence the acquisition of personal ophthalmic instruments (POIs) among optometry students in Ghana.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe cross-sectional study was conducted among optometry students in Ghana. The analytic sample consisted of 485 optometry students from the Schools of Optometry and Visual Science at the Kwame Nkrumah University of Science and Technology (KNUST) and the University of Cape Coast (UCC) in Ghana. Participant characteristics and patterns of ophthalmic instrument acquisition were collected using a structured questionnaire. Bivariate and multivariate logistic regression was used to examine the relationships between factors influencing POI acquisition.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eSlightly more than one third (39.8%) owned a POI that was primarily an ophthalmoscope. Multiple logistic regression showed that financial difficulty (AOR: 0.45, CI: 0.29\u0026ndash;0.71, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/em\u003e), and lack of access to reliable information on instrument quality (AOR: 0.26, CI: 0.10\u0026ndash;0.66, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.005\u003c/em\u003e) were significantly associated with lower odds of POI acquisition. About 63.3% of students cited financial difficulty as the main barrier to POI acquisition.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOverall, 60.1% of students did not have their own ophthalmic instruments that was mainly due to financial constraints and lack access to reliable information on the quality of the instruments. The findings call for cost adjustments by stakeholders and increase awareness to optimize POIs acquisition among students. Taken together, the findings aim to improve clinical training and reduce disparities in optometry education among optometry students in Ghana.\u003c/p\u003e","manuscriptTitle":"Accessibility and Challenges to Ophthalmic Instruments Acquisition among Optometry Students in Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-07 06:14:20","doi":"10.21203/rs.3.rs-6437290/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-14T10:31:07+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-13T10:19:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-12T13:59:41+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-01T00:21:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"302201966689472532921517490064154834058","date":"2025-04-27T10:18:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11523372706861881559162327594436110908","date":"2025-04-26T09:28:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"30540449042924096368247124851480351455","date":"2025-04-24T15:52:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"102369640818357472416386435428041763647","date":"2025-04-24T14:55:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"278263198248932293782108610772679422041","date":"2025-04-24T10:38:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"162764756956759871187328589894525030020","date":"2025-04-24T09:55:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144311251969654446498074850342572483805","date":"2025-04-24T09:52:59+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-24T09:25:15+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-15T09:01:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-15T02:51:13+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-15T02:50:06+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Research Notes","date":"2025-04-13T04:48:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-research-notes","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"resn","sideBox":"Learn more about [BMC Research Notes](http://bmcresnotes.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/resn/default.aspx","title":"BMC Research Notes","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9ebcef00-af65-4908-be8d-47ecbc355298","owner":[],"postedDate":"May 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-21T15:59:35+00:00","versionOfRecord":{"articleIdentity":"rs-6437290","link":"https://doi.org/10.1186/s13104-025-07385-y","journal":{"identity":"bmc-research-notes","isVorOnly":false,"title":"BMC Research Notes"},"publishedOn":"2025-07-16 15:57:11","publishedOnDateReadable":"July 16th, 2025"},"versionCreatedAt":"2025-05-07 06:14:20","video":"","vorDoi":"10.1186/s13104-025-07385-y","vorDoiUrl":"https://doi.org/10.1186/s13104-025-07385-y","workflowStages":[]},"version":"v1","identity":"rs-6437290","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6437290","identity":"rs-6437290","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}