PURPOSE: We observed novice case presentations to identify the opportunities optometry students have to learn about balancing patient and professional agendas.

METHODS: Eight optometry students and 6 faculty optometrists were audio-recorded during 31 case presentations. Four students and 4 optometrists from the field observations were interviewed. We analyzed the data using a grounded theory method.

RESULTS: Students encountered patient and professional agendas that were both compatible (these instances typically involved appointment purpose and treatment options) and incompatible (these instances typically involved patient consent and 'guideline adherence).

CONCLUSIONS: Ideally through explicit instruction, optometrists facilitated the student's ability to negotiate these tensions by articulating the logic behind their actions.