Influences on students' decisions to study occupational therapy at a regional Australian university: A mixed methods study

Abstract

Introduction

There is limited information about why students decide to study occupational therapy as a course in Australian higher education. Understanding what influences students' decisions is important to ensure adequate workforce growth to support Australia's growing population. Therefore, the study's aim was to identify what influences students' decisions to study occupational therapy at a regional Australian university, as well as potential facilitators and barriers affecting these decisions.

Methods

An explanatory mixed methods design was used. One hundred and thirty‐four student participants completed an online survey through purposeful sampling, and a convenience sample of 13 survey participants completed follow‐up semi‐structured interviews. Descriptive statistics were used to analyse survey data, and reflexive thematic analysis was used to analyse the interview data.

Consumer and Community Involvement

Consumers and community members were not involved in the development or undertaking of this research.

Results

Occupational therapy aligned with students' values, skills, and roles, which influenced their decision to study the profession. These influences included making a positive impact on people's lives (83.2%) and a desire to work in health care (77.1%). Financial supports facilitated their decision to study occupational therapy through family, flexible employment, and government supports. Students primarily heard about the profession through family (30.6%) or friends (18.7%), with their decision heavily influenced by personal connections affording positive exposure to the profession. Narrow societal knowledge and perception of occupational therapy resulted in students gaining a limited understanding of the broad scope and role of the profession.

Conclusion

The key findings showed the influence of personal networks in course decision‐making, in addition to a narrow societal knowledge and perception of occupational therapy. This finding suggests the need for greater opportunity for diverse exposure to the occupational therapy profession, with more information provided to prospective students about the scope of occupational therapy practice.

PLAIN LANGUAGE SUMMARY

Occupational therapists are an important part of the Australian health‐care system. However, there is a shortage of occupational therapy workers in Australia, and people are having to wait a long time to see a therapist. To recruit and train new occupational therapists, we need to understand why people decide to study occupational therapy and what supports them or holds them back from making this decision. In this study, 134 occupational therapy students from a regional Australian university completed an online survey, and 13 of these students were interviewed. Both the survey and interviews asked questions about the things that helped students to make their decision to study occupational therapy and the things that supported or held them back in the decision‐making process. The results showed that students' decisions were strongly affected by knowing an occupational therapist, who gave them a positive sense of the profession. Students found the profession matched their values, skills, and roles and knew they could grow within the profession. Financial help allowed students to make their decision to enrol. However, the lack of understanding of what occupational therapists do and the areas in which they work affected the amount of information and understanding students had of the role and scope of the profession. We need more people, including those thinking of studying occupational therapy, to be aware of what occupational therapists do and the many areas that occupational therapists can work.

Key Points for Occupational Therapy.

• The decision to study occupational therapy is influenced by positive exposure to the profession.

• Limited information about the scope of occupational therapy may restrict people's decisions.

• Narrow knowledge and perception of the occupational therapy profession in communities continue to impact decision‐making.

1. INTRODUCTION

Occupational therapists are integral to the health‐care system, providing vital services to Australia's growing population (Department of Health, 2024) and supporting communities' health and wellbeing (Reitz et al., 2020). The demand for health services, including occupational therapy, is likely to continue to increase. Australia's population is projected to increase by an annual average of between 1.2% and 1.7% from 2022 to 2032 (Australian Bureau of Statistics, 2023). The population is ageing, there is a rise in chronic disease, and there have been reforms in aged care, mental health, and the National Disability Insurance Scheme (NDIS), all of which require more allied health workers (Department of Health, 2024). Australia's health‐care workforce has grown at both a national and a state level over the past 14 years, with Australia's registered health‐care workforce showing a growth of 37% between 2013 and 2022 (Australian Institute of Health and Welfare, 2024). Despite this growth, predictions show that the sector will struggle to meet the health‐care demands of the population (Ahpra, 2025) and that further growth is essential to meet the rising demand for health services (Department of Health, 2024). Jobs and Skills Australia's Occupation Shortage List reflects the need for more growth, showing that there has been a shortage of occupational therapists across every state since 2022 (Jobs and Skills Australia, 2026). However, there is a particular emphasis on the continued lack of growth in occupational therapists within regional and remote areas (Department of Health, Disability and Ageing, 2025).

To support overall workforce growth, the Australian Government is prioritising creating opportunities for increased participation in higher education (The Treasury, 2023), with the current government committed to ensuring that every Australian has the opportunity to benefit from further education (Department of Education, 2024). Fostering student growth is crucial not only for addressing workforce shortages, particularly in allied health fields, but also for ensuring Australia's long‐term success and prosperity as a nation (Department of Education, 2024). To support recruitment, there needs to be an understanding of why students decide to study occupational therapy within higher education and what facilitators or barriers influence their decisions.

Two previous research studies conducted within Australia provide some insights into the influences on students' decisions to study occupational therapy. Byrne (2015) focussed on the impact exposure to occupational therapy had on students deciding to study the profession. They concluded that the decision was driven by a combination of influences. These included individual influences (e.g., interest in helping others) and environmental influences, including personal exposure, professional exposure, and the influence of family, friends, and career advisors. Alternatively, a study by Boehm et al. (2017) found that the main influences on students' decisions to study occupational therapy were the long‐term intention of becoming an occupational therapist, personal experience of receiving input from occupational therapists for themselves or others, or receiving career advice. However, due to the quantitative nature of both these studies, there was limited exploration into the ways these influences impacted their decisions to study. As these research studies were conducted almost a decade or more ago (Boehm et al., 2017; Byrne, 2015), it is unclear if they remain an accurate reflection of Australia's current climate and the societal impacts on the decision to study occupational therapy.

When examining the literature internationally, three more recent research studies conducted in America over the last 5 years highlighted several influences impacting the decision to study occupational therapy. Both Ford et al. (2021) and Colaianni et al. (2022) discussed the financial barrier that occurs for minority students in America and how finance to support both the cost of the degree and the admissions process can often heavily influence a student deciding if they want and are able to pursue studying occupational therapy. Ramirez and Kiraly‐Alva's (2023) study indicated that students' decisions to study occupational therapy were heavily influenced by cultural background and exposure to the profession, with limited awareness of occupational therapy causing family members to encourage students to explore alternative, more well‐known careers.

There is a gap in our knowledge about the influences on students' decisions to study occupational therapy in the Australian context, using in‐depth qualitative analysis. Additionally, it remains unclear if experiences faced by students internationally are consistent with the Australian context and what barriers or facilitators exist when deciding to study within Australia's higher education system. The Australian health‐care context has changed in the last decade (Department of Health, 2024), so understanding current supports and strategies to improve student uptake of occupational therapy may reduce barriers to studying the profession.

1.1. Current study

We aimed to identify what influences students' decisions to study occupational therapy at a regional Australian university, as well as potential facilitators and barriers affecting these decisions. The quantitative component collected demographic information and self‐reported influences on students' decisions, and the qualitative component explored these influences in greater depth by examining how students described their experiences and the facilitators and barriers shaping their decisions. This study's research question was ‘What influences students' decisions to study occupational therapy as a course in higher education?’ In this study, course refers to the Bachelor of Occupational Therapy and Bachelor of Occupational Therapy (Honours) degrees offered at this regional university. The term course will be used throughout the article.

2. METHODS

2.1. Study design

Ethics approval was received on 13 June 2024 from Deakin University's Human Ethics Advisory Group‐Health with Project Number HEAG‐H 76_2024 before commencing participant recruitment and data collection. A data management plan was adhered to throughout the entirety of the research, and the study was designed in accordance with the Mixed Methods Reporting in Rehabilitation and Health Sciences (MMR‐RHS) guide (Tovin & Wormley, 2023).

Informed by pragmatism (Kaushik & Walsh, 2019), an explanatory sequential mixed methods design was selected to obtain data from a large number of participants while also providing insight into participants' personal experiences to obtain a deeper understanding of what and how influences affect students' decisions to study occupational therapy (Ivankova et al., 2006). The first phase involved the collection of quantitative data through an online survey. This phase was designed to provide a convenient and time‐effective way of collecting data from participants and to capture an overview of the influences on students' decisions to study occupational therapy in higher education. Additionally, it helped identify key elements for further exploration in the follow‐up interviews (Nayak & Narayan, 2019).

In the second phase, a qualitative descriptive design was used (Sandelowski, 2000). Qualitative data were collected through follow‐up semi‐structured interviews. This phase allowed the survey data to inform the interview process, enabling the qualitative data to expand upon the findings from the first phase. This method facilitated a more complete analysis and provided a more holistic understanding of the phenomenon (Toyon, 2021) that would not be achievable through a single methodological approach.

2.2. Participants and recruitment

The study was conducted at a regional Australian university with the target population of current Bachelor of Occupational Therapy and Bachelor of Occupational Therapy (Honours) students across two regional campuses, with a total of 526 enrolled students across campuses and courses at the time of recruitment. Participants were recruited for phase one through purposeful sampling using flyer advertisements and a survey link posted on online university subject sites. This method of sampling was utilised to achieve a large sample from this particular university (Else‐Quest & Hyde, 2016). The first or last 5 minutes of class seminars were attended by the first author to give a brief overview of the project, answer any questions posed, and distribute flyers to students. Flyers were also placed on tables and walls in occupational therapy spaces around the university. The inclusion criteria for phase one included that prospective participants must be currently studying occupational therapy in the pass or honours stream at the university and be over the age of 18.

Participants were recruited for phase two using a convenience sample of participants who completed the initial survey in phase one. This enabled the timely and effective recruitment of the target population (Valerio et al., 2016). Emails containing a plain language statement and a consent and withdrawal form were sent out to participants who expressed interest in completing a follow‐up interview through an additional link upon conclusion of the survey. Participants were invited to be interviewed in the order in which they expressed interest. Participants nominated either the first or second author to conduct the interview based on their preference.

For the sample size, information power was used to determine an appropriate sample size. The amount of information that the sample holds helps determine the number of participants required (Malterud et al., 2016). The more relevant and rich the information that the study sample holds, the fewer participants are required (Malterud et al., 2016). In this study, it was anticipated that the authors would need to conduct between 9 and 17 interviews to achieve information power (Hennink & Kaiser, 2022; Malterud et al., 2016). A total of 13 interviews were conducted.

2.3. Data collection tools and data gathering

2.3.1. Online survey

An original online survey was created and designed by the authors based on their previous experience deciding to study occupational therapy and a similar study exploring this topic (Ranganathan & Caduff, 2023). To enhance content validity, the survey was examined by those with knowledge of the topic, including a senior occupational therapy faculty member and two former educational staff members. The authors then made iterative changes to the survey based on this feedback to enhance the quality of the survey (Sahu, 2023). The changes made included changing the wording to be more simplistic and clear for a general audience.

The survey (Supporting Information S1) consisted of 31 questions measuring the impact of various influences on students' decisions to study occupational therapy, using 3‐point Likert scales from 1 (not at all), 2 (somewhat), to 3 (a lot); visual analogue scales; multiple‐choice questions; and questions with ‘select all that apply’ response options. Demographic questions were posed to gain a snapshot of the participating sample with an option not to respond if they were not comfortable disclosing this information. The questions sought responses to ascertain how students identified in relation to age; ethnic or cultural identity; how they identified on the neurodiversity spectrum; gender; socio‐economic status; disability identity; and previous family university attendance. To maintain student anonymity, year‐level data were not collected. Although it is acknowledged that perceptions and recall may differ between students from different year levels, it was anticipated that these differences would not significantly affect the results, and maintaining student anonymity was of the highest priority. The survey was open from June 2024 to August 2024.

2.3.2. Semi‐structured interviews

Following the survey, interviews were undertaken to deeply explore the personal influences on students' decisions to study occupational therapy, including identifying which influences acted as either facilitators or barriers in their decisions and in accepting their offers. Audio‐recorded interviews were conducted either online via Zoom or on the university campus. The semi‐structured interviews (Supporting Information S2) consisted of 10 open‐ended questions with closely related sub‐questions guided by the survey. The questions were developed to provide the opportunity for individuality of responses and allowed participants to express how and what influences affected their decisions (Kallio et al., 2016). The interview questions underwent field testing and were piloted with two occupational therapy honours students at the same university in a mock interview to confirm the relevance and coverage of the interview content. Feedback received from the students allowed the authors to refine and adjust the questions to best explore the research question and contribute to the credibility, confirmability, and dependability of the interviews conducted (Kallio et al., 2016). Overall, 11 interviews were conducted by the first author and two by the second author. Of these, four interviews were completed via Zoom, with the remaining conducted in person. Interviews ranged between 22 and 52 minutes, with interviews on average taking 37 minutes. The interviews were manually transcribed verbatim, filler words were removed, and transcripts were emailed to participants for member checking before data analysis began. Pseudonyms were used in place of participants' names in audio recordings and transcripts to protect participant confidentiality, and any identifying information was removed from the transcripts. To maintain participant anonymity, demographic details of the interview participants were not collected.

2.4. Data analysis

Quantitative data were analysed with descriptive statistics using IBM SPSS Statistics 29 (International Business Machines Corporation, 2024) software. Statistical analyses conducted included the calculation of frequencies (n) and percentages (%). The open‐ended responses provided under the ‘other’ option on selected questions were summarised for each question.

Qualitative data collected from the interview transcripts were analysed in NVivo (Lumivero, 2024) software using reflexive thematic analysis with an inductive approach (Braun & Clarke, 2022). This approach ensured the codes and themes developed were reflective of the data and meaning behind the participants' responses (Byrne, 2022). Analysis was conducted using six stages: familiarising with the dataset; coding; generating initial themes; developing and reviewing themes; refining, defining, and naming themes; and writing up (Braun & Clarke, 2022, pp. 35–36). Both authors independently coded the initial transcript to compare findings, to ensure consistency in the coding process, and to enable a comprehensive analysis. This step was conducted prior to the first author completing the coding of the remaining transcripts. Midway through the process, the second author coded an additional transcript to further assess the reliability of the coding and confirm the continued consistency of the codes across all transcripts (Natow, 2020). Themes were developed through collaboration of the authors by compiling all codes and separating them into themes.

Once data had been analysed during both quantitative and qualitative phases separately, they were analysed together using methodological triangulation, characterised by the incorporation of multiple research methods of data collection (Moon, 2019). The analysed quantitative data and qualitative interview data were viewed by both authors and were compared and contrasted before combining the information and outlining the meta‐inferences found. Meta‐inference is described as the insights, descriptions, or conclusions generated after conclusions are drawn from the individual quantitative and qualitative stages (Younas et al., 2025). This type of analysis enabled the authors to gain a comprehensive understanding of the emerging themes and underlying influences on students' decisions to study occupational therapy. Integrating and comparing the survey and interview data provided a more holistic and complete picture of the research topic, along with highlighting any similarities or differences between the quantitative and qualitative data (Moon, 2019).

2.5. Positionality statement

The first author was a fourth‐year undergraduate research honours occupational therapy student when this study was conducted. They have grown up, lived, and worked in the Geelong region on Wadawurrung country. They identify as a White female of middle class and recognise the privilege afforded to them across their lifetime. They have had recent first‐hand experience deciding to study occupational therapy as a course in higher education but acknowledge this does not mean this is reflected in other students' individual experiences.

The second author lives and works on Wadawurrung country in a regional town. They are a member of the university occupational therapy faculty. They identify as female, cisgender, heterosexual, Australian of Anglo‐Celtic heritage, neurotypical, highly educated, middle class, and without disability. They recognise the multiple elements of their identity that afford them privilege and strive to advocate for and promote the creation of more inclusive health‐care environments and practices.

There was potential for the authors' biases and preconceptions to influence the project. Several strategies were therefore used to critically examine assumptions and positionality throughout analysis. During coding and theme development, the authors engaged in regular debriefing and supervisory discussions in which early interpretations were questioned, multiple explanations were considered, and decisions were justified using the data. Reflexive journalling supported these discussions by documenting assumptions, emotional responses, and changes in interpretation over time and was used to revisit and refine decisions.

3. RESULTS

3.1. Sociodemographic characteristics of participants

As of March 2024, a total of 526 students were enrolled across the 4‐year Bachelor of Occupational Therapy and Bachelor of Occupational Therapy (Honours) Undergraduate degrees. One hundred and thirty‐four participants responded to the survey, of which 13 participated in follow‐up interviews. Overall, most participants identified as female (93.3%), aged 18–24 years (75.4%), Anglo‐Australian (76.9%), neurotypical (78.4%), without a disability (84.3%), and of middle socio‐economic status (67.2%) (see Table 1).

TABLE 1.

Sociodemographic characteristics of participants (N = 134).

Characteristic	n	%
Current age
18–24	101	75.4
25–34	16	11.9
35+	16	11.9
Prefer not to say	1	0.7
Gender identity
Female	125	93.3
Male	6	4.5
Transgender	2	1.5
Prefer not to say	1	0.7
Ethnic or cultural identity
Aboriginal or Torres Strait Islander	1	0.7
African (Ethiopian)	1	0.7
African (Somalia)	1	0.7
Anglo‐Australia (Australian of British or English descent)	103	76.9
Asian	4	3.0
Chinese	3	2.2
Lebanese	3	2.2
Multiracial or mixed ethnicity	4	3.0
Other	12	9.0
Prefer not to say	2	1.5
Neurodiversity presentation
Neurodivergent	24	17.9
Neurotypical	105	78.4
Other	2	1.5
Prefer not to say	3	2.2
Disability identification
No, I do not identify as having a disability	113	84.3
Yes, I identify as having a disability	13	9.7
Prefer not to say	5	3.7
Other	3	2.2
Current socio‐economic status
Low	26	19.4
Middle	90	67.2
High	7	5.2
Unsure	8	6.0
Prefer not to say	3	2.2
Family socio‐economic status growing up
Low	13	9.7
Middle	100	74.6
High	17	12.7
Unsure	2	1.5
Prefer not to say	2	1.5
Previous family university attendance
Yes	105	78.4
No	28	20.9
Prefer not to say	1	0.7
Pathway to university study
Deferred studies before starting university	15	11.2
Entered university directly from high school	53	39.6
Enrolled as a mature‐age student	25	18.7
Started studying another course before transferring to occupational therapy	35	26.1
Other	6	4.5
First career
Occupational therapy	105	78.4
Alternative career	29	21.6

Note: Percentages may not total 100% due to rounding.

3.2. Quantitative results

Participants selected the influences on their decision to enrol in occupational therapy at this university. Personal interest for the subject was the most frequently selected influence on decisions (80.2%), followed by recommendations to study the profession by family or friends (71.0%) (see Figure 1).

FIGURE 1.

Influences on students' decisions to enrol (N = 131). Participants could select more than one response; therefore, the total sum will equal greater than 100%. Three missing participant responses.

The most frequently selected motivations for becoming an occupational therapist were making a positive impact on people's lives (83.2%), desire to work in a health‐care field (77.1%), and the opportunity to help people (72.5%) (see Figure 2).

FIGURE 2.

Motivations for becoming an occupational therapist (N = 131). Participants could select more than one response; therefore, the total sum will equal greater than 100%. Three missing participant responses.

Table 2 highlights how participants were exposed to occupational therapy, with 49.3% hearing about the profession through family or friends and 48.5% knowing a friend or family member studying occupational therapy prior to deciding to study themselves. Participants were least likely to have heard about the profession through colleagues (3.7%) and attending university open days (4.5%). Despite participants having heard about occupational therapy from multiple sources, 80.6% felt they did not have a good understanding of the role and scope of occupational therapy practice prior to studying.

TABLE 2.

Students' exposure to occupational therapy (N = 134).

Variable	n	%
Age of first hearing about occupational therapy
Under 10	8	6.0
11–17	62	46.3
18–24	47	35.1
25–34	11	8.2
35+	6	4.5
First heard of occupational therapy from
Colleague	5	3.7
Family member	41	30.6
Friend	25	18.7
Personal experience seeing an occupational therapist themselves or with someone else	18	13.4
Online advertisement/interest search	8	6.0
School career advisor	19	14.2
University open day	6	4.5
Other	12	9.0
Personal experience seeing an occupational therapist
Yes, had seen an occupational therapist themselves	10	7.5
Yes, had accompanied someone who saw an occupational therapist	36	26.9
No, had not seen an occupational therapist	92	68.7
Know friends or family studying occupational therapy prior to choosing to study themselves
Yes	65	48.5
No	69	51.5

Note: Sum will equal greater than 100% for ‘personal experience seeing an occupational therapist’ because four participants selected both ‘yes’ response options (seeing an occupational therapist themselves and accompanying someone to see an occupational therapist). Percentages for other questions may not total 100% due to rounding.

Participants indicated the extent to which certain considerations influenced their decisions to study occupational therapy using a 3‐point Likert scale with response options: not at all, somewhat, and a lot (see Figure 3). Location of the university was a main consideration in students' decisions (74.6%). Participants somewhat considered academic results (61.9%), study commitments (47.0%), and the application process (47.0%). Additionally, 67.2% of participants did not consider part‐time options in their decisions.

FIGURE 3.

Students' considerations when deciding to study (N = 134). OT, occupational therapy.

Participants selected the influences that supported their decision to study occupational therapy (see Figure 4). HECS (Higher Education Contribution Scheme) loan was selected by 81.3% of participants, followed by part‐time or casual employment (78.4%).

FIGURE 4.

Influences supporting students' decisions to study (N = 134). Participants could select more than one response; therefore, the total sum will equal greater than 100%. HECS, Higher Education Contribution Scheme.

3.3. Qualitative results

Five themes influencing students' decisions to study occupational therapy were identified from the interviews: (1) value of personal networks and connections to occupational therapy; (2) attraction of occupational therapy; (3) appeal of early and consistent practical experiences; (4) impact of narrow societal knowledge and perception of occupational therapy; and (5) importance of the environment on decisions.

3.3.1. Value of personal networks and connections to occupational therapy

Participants noted the importance of personal connections to learn about occupational therapy, with Carol stating, ‘I feel like it's one of those jobs in the health field that you don't know a lot about unless you know someone in the role’. Initial exposure often came through family or friends, leading to further personal research or providing the opportunity for direct conversations with occupational therapists. These discussions helped participants better understand the profession and clarify what they read online. Positive feedback from occupational therapists, coupled with observing therapists' satisfaction and fulfilment in the job, strongly influenced participants' decisions to pursue the career. As Naomi noted, ‘You could see how happy they were in their jobs and how fulfilling it was’.

3.3.2. Attraction of occupational therapy

Occupational therapy attracted participants in a variety of different ways, influencing their decisions to study the profession in higher education.

Sub‐theme: Occupational therapy aligned with personal values, skills, and roles

As participants learned more about occupational therapy, they recognised how the profession aligned with their personal values, skills, and roles that they desired within their future career. Many were motivated by the desire to build relationships, make a positive impact, and see tangible results, with Susan stating, ‘I wanted to be able to implement things that actually made a change—and you could see that change’. Participants chose the profession based on how it matched their core values, with Olof explaining, ‘I think it probably comes down to my values. And what is important to me and then choosing a career path that aligns with those values’. Lucy noted that the occupational therapy role and skillset ‘resonated and aligned’ with them, which influenced their decision to study the profession.

Sub‐theme: Further career development and flexibility

Occupational therapy offered a variety of specialisation areas for participants, with one participant stating, ‘there's room for that change in development while still remaining in the same sphere of occupational therapy as a profession’ (Grace). This ability to move between different areas within the field offered a variety of opportunities, as highlighted by Molly: ‘you can move around a bit; you can explore, and you can grow with it, instead of being stuck in an area.’ Lucy added, ‘I think as an OT [occupational therapist], it's such a foundational position to be in to then—you could add on extra things afterwards’. Participants valued how occupational therapy could afford further career development and flexibility not only once they graduated but also that it could lead to further study, with Sandra stating, ‘I could be doing occupational therapy and then have all these other doors open to me’.

Sub‐theme: Graduating with an accredited qualification

Obtaining an accredited qualification upon completion of the course was identified by many participants as an influence in their decision to study occupational therapy, highlighted in Abby's response, ‘I think the Ahpra [Australian Health Practitioner Regulation Agency] registration was also important—like knowing that it did feed into that professional registration’. Maverick highlighted how knowing exactly how many years they were required to study to gain a qualification provided a level of security within their chosen career, as opposed to deciding on a course that required additional study, stating ‘rather than doing a Bachelor of Science and still being on the road with it, and not really having a job afterwards’.

The qualification additionally allowed participants to feel confident in pursuing further study, knowing they had something to fall back on. Grace described the advantage upon finishing the degree, ‘if I get to the end of my degree and decide—actually I do want to do medicine. You can transfer into it from OT [occupational therapy], but you still have a degree behind you for work …’. Another participant viewed the qualification as giving them security:

OT [occupational therapy] became sort of like—whatever I want to do after, OT [occupational therapy] acts as like a—I can fall back on it. I can come back to it. I will always have my licence. I will always be a registered OT [occupational therapist]. (Maverick)

3.3.3. Appeal of early and consistent practical experiences

The presence of early placement opportunities within the course was a significant appeal. Gaining practical experiences straight away was important, particularly among participants who learned best through applying their knowledge. When considering their options, participants perceived having access to placement in their first year as providing early confirmation they made the right decisions and reassurance that they were not committing to years of study they might not enjoy. One participant stated, ‘I figured the placement would help me know if OT [occupational therapy] was for me, and if I needed to change courses or anything like that …’ (Carol). The spread of placements across the course also influenced participants' decisions, as they valued the ample hands‐on practice available to grow confidence in their clinical skills:

I think it's just so much more beneficial for my learning, and for making me feel prepared for when I inevitably work. So I thought that that was a really nice thing, even in terms of choosing OT [occupational therapy] as a field, the fact that we have so much placement. (Naomi)

Alternatively, several participants stated placement was only a consideration once they had commenced the course and that timing and length of placements did not have an impact on their decision. Participants were aware of the placement expectations and had the mindset of acceptance in doing what was necessary to obtain the degree, stating ‘I wouldn't say it influenced me entering the course, it was like a factor and it's part of the course’ (Ashley) and ‘I was totally accepting of whatever I had to do to get the degree’ (Sandra).

3.3.4. Impact of narrow societal knowledge and perception of occupational therapy

Many participants noted that occupational therapy is still a relatively unknown profession among family, peers, and within broader communities. Some described the challenge of overcoming misconceptions about the profession and its opportunities:

I didn't realise there's so many occupational therapy fields you can go into … children, primary school, aged care. That's all I've ever been told we could do. But there is so much more you can do, and I just feel like we are not made aware of it. (Kate)

The lower recognition of occupational therapy compared to other allied health fields made it more difficult for participants to commit to studying it:

I didn't have a really good grasp maybe on what it was. Whereas nursing is quite familiar to the general public … people understand—you know, you can work in a hospital, you can work in the community, you're kind of very hands on with the patients or the clients. Whereas occupational therapy was more of a leap of faith, I guess, and just into the unknown. (Naomi)

Participants felt they would not have explored occupational therapy if not for personal motivation, as the profession was not presented as a career option at high school. Career counsellors were not aware of how occupational therapy would fit with the participants' desired attributes, with Stella stating, ‘I feel like I had to go searching for it. It wasn't something that when we were going to the career's person in high school, it's not something they were like, “what about OT [occupational therapy]?”’

3.3.5. Importance of the environment on decisions

Participants' decisions to initiate studying occupational therapy were impacted by a variety of environmental influences. Encouragement, open‐mindedness, and positive feedback from others, who recognised the participants' skills and personalities as a strong fit for the profession, helped foster confidence in their decisions:

It's just that mental support of … you mentioned it to people and they're like, ‘that sounds really good. Oh, that sounds up your alley’. And it just gives you a little spur on to do it … I found that I only ever came across positive things … there's no one that was like, ‘what are you bothering with that for?’ (Sandra)

This positive feedback and encouragement was reflected in other participants' experiences, with comments such as ‘OT [occupational therapy] just seems to really fit you well’ (Grace), ‘I think you'd be great at it’ (Susan), ‘I can see you doing that’ (Carol), ‘I think you could do well in that’ (Sandra), and ‘you would be a great OT [occupational therapist]’ (Lucy).

Additionally, logistical support from friends, family, fellow students, career counsellors, and university supports from student advisors and admissions staff played a key role in enabling participants to initiate and successfully complete the application process:

… the student advisors were absolutely amazing …. He would set out the course map for me … I kind of told him I was like—‘oh, I'm feeling a little bit like this is a big workload’. He's like—‘alright, well you can do just three units in this year and three units in this year’. So he was very understanding, very approachable. (Naomi)

Participants were able to decide to study occupational therapy due to various financial supports available to assist in the financial obligations involved in the course. Financial supports from family included assisting with rent, contributing to placement expenses, and providing accommodation within the family home located close to the university. Personal savings allowed participants to make their decision to study occupational therapy knowing they had money to support them throughout the course. However, this often came with personal sacrifice, with Ashley stating, ‘I'm going to have to stop work—rely on family savings budget’. Financial supports also included having sufficient and flexible employment in place around their study obligations. Government supports were a major facilitator in participants' decisions to study occupational therapy, with systems such as the provision of government interest‐free study loans (HECS) and government income support (Centrelink) providing additional financial support.

3.4. Integration of results

Table 3 displays the integration of key results with qualitative themes, providing further insights into the results. A meta‐interference has been presented to enhance the results, showing several key insights. It was evident that various financial supports played a crucial role in supporting participants' decisions to study occupational therapy, with the primary motivation being that it aligned with personal values, skills, and roles. Participants relied on personal networks and connections to the profession to gain information about the scope and role. It is possible that the narrow societal knowledge and perception of occupational therapy meant many participants reported a limited understanding of the role and broad scope of the profession.

TABLE 3.

Joint display table.

Quantitative scores	Qualitative themes	Meta‐inferences
Influences supporting decisions to study	Importance of the environment on decisions	Financial supports influenced participants' decisions to study occupational therapy, with family members or relatives contributing to living costs and course‐related expenses. Part‐time and casual employment required flexibility around course commitments, and HECS allowed participants to delay paying course expenses.
HECS loan (81.3%)
Part‐time or causal employment (78.4%)
Financial support from family or relatives (62.7%)
Motivations for becoming an occupational therapist	Attraction of occupational therapy Sub‐theme: Occupational therapy aligned with personal values, skills, and roles	Occupational therapy aligned with participants' personal values. The profession enabled them to work in health care in a role that afforded the opportunity to work across a broad range of areas and have greater development opportunities, while remaining within the sphere of occupational therapy.
Making positive impact on people's lives (83.2%)
Desire to work in the healthcare field (77.1%)
Opportunity to help people (72.5%)
Variety of work settings/opportunities (68.7%)
Understanding of the role and scope of occupational therapy practice	Impact of narrow societal knowledge and perception of occupational therapy	Narrow societal knowledge and perception of occupational therapy resulted in participants gaining a limited understanding of the broad scope and role of occupational therapy from others.
Participants felt they did not have a good understanding (80.6%)
Considerations when deciding to study	Importance of the environment on decisions	Participants preferred attending a university that allowed them to save financially by living at home. Support from family and the university made applying easier. University entry was made easier with strong prior academic results, particularly if receiving course credits for prior study. Part‐time options were not considered as participants did not want to lengthen the course duration. Additional financial supports or costs were not considered due to the available supports from their family and the government.
A lot
Location of the university (74.6%)
Somewhat
Academic results (61.9%)
Application process (47.0%)
Not at all
Part‐time options (67.2%)
Availability of scholarships or financial aid supports (57.5%)
Costs of studying occupational therapy compared with other courses (48.5%)
First heard of occupational therapy from	Value of personal networks and connections to occupational therapy	Family members or friends had personal connections to people in the profession that enabled them to inform participants about occupational therapy as a career.
Family member (30.6%)
Friend (18.7%)
Influences on decisions to enrol	Attraction of occupational therapy Sub‐theme: Occupational therapy aligned with personal values, skills, and roles Sub‐theme: Further career development and flexibility	Participants were interested in occupational therapy as a subject due to how it aligned with their values and skillset. The opportunities for further professional growth and obtaining an accredited qualification upon completion of the course afforded participants greater career prospects within the profession.
Personal interest/passion for the subject (80.2%)
Recommendations from friends or family (71.0%) Career prospects/job market demand (67.2%)	Value of personal networks and connections to occupational therapy	Personal connections to the profession through recommendations from family and friends influenced participants to further research the profession online to gain a deeper understanding.
Guidance counsellor/advisor recommendations (26.7%) Influence of a particular professor or academic advisor (13.7%) Grade 12 university information day (11.5%)	Impact of narrow societal knowledge and perception of occupational therapy	Narrow societal knowledge and perception of occupational therapy caused participants to not gain information on the profession from other avenues.

Abbreviation: HECS, Higher Education Contribution Scheme.

4. DISCUSSION

The aim of this study was to identify what influences students' decisions to study occupational therapy at a regional Australian university, as well as potential facilitators and barriers affecting these decisions. The key findings suggest that students' decisions were heavily influenced by personal connections that afforded them positive exposure to occupational therapy, allowing students to discover how the profession aligned with their values, skills, and roles. Financial supports were a major facilitator in allowing students to decide to study occupational therapy, whereas narrow societal knowledge and perceptions of occupational therapy were a barrier for students, affecting the amount of information and understanding they had of the role and scope of the profession.

Previous studies have highlighted that personal connections through family or friends are the primary way students are introduced to occupational therapy (Bowman, 2007; Leadley et al., 2023). This study expanded on these findings, identifying that such connections often involved family or friends with networks in the profession, leading to direct interactions with occupational therapists. These connections helped students confirm how the profession aligned with the characteristics they were looking for in a future career. In contrast, other studies found that initial exposure came through personal treatment or accompanying a family member to an occupational therapist (Byrne, 2015; Collins & Carr, 2018). In this study, most students had not personally seen an occupational therapist. This highlights that although avenues of exposure may vary, positive experiences and interactions with occupational therapists are crucial. Thus, for those without access to occupational therapists, they may be less likely to hear about the profession. This finding suggests a potential barrier for prospective students lacking such connections.

The variety of possible future work settings and opportunities was a key influence impacting students' decisions to study occupational therapy. Previous studies had concluded that variety within a profession influenced students' decisions. However, they provided limited insight into the ways variety appealed to students when making their decision to study occupational therapy (Craik et al., 2001; Craik & Napthine, 2001; Craik & Zaccaria, 2003; Leadley et al., 2023). A more recent study highlighted the appeal of a profession that offered career development without having to change professions (Tétreault et al., 2020). Our study confirmed that occupational therapy not only provides opportunities for career development within the profession but also offers students an accredited qualification. This qualification enables students to take on a range of roles and responsibilities within their job, without the need to change careers or pursue additional qualifications. This highlights the value students place on a career that encompasses a variety of opportunities, all within a single field, without requiring further formal education or credentials.

Although variety and opportunity appealed to students when making their decision to study occupational therapy, there was a perceived lack of exposure and knowledge of the profession within society. Students were unsure about deciding to study occupational therapy due to this lack of knowledge about the profession and being unaware of the variety of areas and opportunities it offers. This is consistent with Greenwood et al. (2005), who found that occupational therapy was not seen to offer the same opportunities as more familiar careers.

Environmental influences played a role in students' decision‐making, particularly the availability of financial support. Although Ford et al. (2021) highlighted the need for financial assistance, the authors did not specify the types of support required by American students within America's educational system. However, our study explored the specific financial supports Australian students rely on that included assistance from family members or partners for rent, placement expenses, and general living costs. Australian government support was also crucial in allowing students to delay course expenses. Both family and government support were essential, whereas American students from diverse backgrounds (including people from under‐represented gender, ethnic, and racial groups) reported that interviews, admission costs, and institutional barriers prevented them from entering the course (Colaianni et al., 2022). This may reflect differences in financial and educational systems that allow or prevent students from pursuing study in higher education. However, as our study primarily consisted of White, middle‐class students, further research is needed to determine whether these findings are representative of the broader student experience.

4.1. Limitations

There were several limitations in this study. The reliability and validity of the survey and interview questions could have been comprehensively tested prior to use in this study among current occupational therapy students, across a variety of geographical areas and institutions. However, due to project timing and resource restraints, this was not feasible as part of this study. The sample of participants was predominantly White, female, and between 18 and 25 years of age. This has implications for the generalisability of the findings to students from different cultural backgrounds, genders, and ages. This study was open to all students currently completing a Bachelor of Occupational Therapy and Bachelor of Occupational Therapy (Honours) students across two regional university campuses. It is possible that international students were among those who participated. However, specific international student demographic data were not identified or discussed. It is acknowledged that their experience and challenges may differ from those of domestic students. Participants were currently studying occupational therapy; thus, any barriers potential students might have found in accessing the course have not been well evaluated. Additionally, although the findings may be applicable in similar contexts, the results may not apply more broadly to other educational institutions, geographical regions, or disciplines because the study was conducted at a singular regional Australian university.

4.2. Future directions

To address the lack of exposure to the profession, a grassroots approach to occupational therapy promotion is required. This could occur through community‐led initiatives and be supported by professional associations. These initiatives could include online campaigns, clinician visits to local high schools and community events, and broader education strategies in communities, particularly with populations currently under‐represented in the occupational therapy profession. Strategies should be evaluated and shared.

Further research via co‐production (Dingelstad et al., 2025) is required to determine what information students want and need to support their decisions. Students should be involved in the co‐production of these inclusive resources, with the aim of reaching prospective students from diverse backgrounds.

Future research should examine how recent policy changes, including the introduction of paid placements for certain disciplines (teaching, nursing, midwifery, and social work) in Australia, may influence students' decisions to study a particular profession, including occupational therapy (Australian Government Department of Education, 2025). Although occupational therapy was not included in this policy, and the payment scheme was introduced after data were collected for this study, such initiatives may influence perceptions of certain study pathways and warrant investigation in future studies.

5. CONCLUSION

The aim of this study was to identify influences on students' decisions to study occupational therapy at a regional Australian university, as well as potential facilitators and barriers affecting these decisions. The key findings showed the influence of personal networks in course decision‐making, in addition to a narrow societal knowledge and perception of occupational therapy. This suggests that there is a need for greater opportunity for diverse exposure to the occupational therapy profession, with more information provided to prospective students about the scope of occupational therapy practice. Students' decisions were impacted by external supports, indicating the need to gain more information around resources for students who do not have access to these same support systems.

AUTHOR CONTRIBUTIONS

All authors contributed to the study design, instrument creation, and analysis of all data collected across the duration of the research study. Author two formulated the overarching research goal and aims of the study. All authors contributed to the development of the survey and interview questions.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

DECLARATION OF USE OF ARTIFICIAL INTELLIGENCE

Generative Artificial Intelligence has not been used at any stage in this research project or in preparing this manuscript.

Supporting information

Data S1. Supporting Information.

Data S2. Supporting Information.

Kleindienst, E. , & Wanklyn, T. (2026). Influences on students' decisions to study occupational therapy at a regional Australian university: A mixed methods study. Australian Occupational Therapy Journal, 73(4), e70110. 10.1111/1440-1630.70110

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.