ORIGINAL RESEARCH

Determinants of undergraduate nursing students' satisfaction with the academic experience

Aline Marcelino Ramos^I; Jamila Geri Tomaschewski-Barlem^II; Valéria Lerch Lunardi^III; Edison Luiz Devos Barlem^IV; Laurelize Pereira Rocha^V; Bruna Ruoso da Silva Neutzling^VI

^I Nurse. Ph.D. student in the Graduate Program in Nursing, Federal University of Rio Grande. Brazil. E-mail: aline-ramos-@hotmail.com
^II Nurse. Ph.D. Adjunct Professor, School of Nursing, Federal University of Rio Grande. Rio Grande do Sul, Brazil. E-mail: jamila_tomaschewski@hotmail.com
^III Ph.D. in Nursing, Professor of the Graduate Program in Nursing, Federal University of Rio Grande. Rio Grande do Sul, Brazil. E-mail: vlunardi@terra.com.br
^IV Nurse. Ph.D. Professor, Federal University of Rio Grande. Rio Grande do Sul, Brazil. E-mail: ebarlem@gmail.com
^V Nurse. Ph.D. Adjunct Professor, School of Nursing, Federal University of Rio Grande. Rio Grande do Sul, Brazil. E-mail: Laurelize@gmail.com
^VI Nurse. Federal University of Rio Grande, Member of the Studies and Research Center in Nursing and Health. Rio Grande do Sul, Brazil. E-mail: bruna.sho@hotmail.com

DOI: http://dx.doi.org/10.12957/reuerj.2016.9555

ABSTRACT

Objective: to learn the factors that determine satisfaction with the academic experience among undergraduate nursing students. Method: in this qualitative, descriptive study of 27 undergraduate nursing students at a public university in southern Brazil, data were collected through semi-structured interviews in February and March 2013 and analyzed using textual discourse analysis. This study complied with the recommendations of National Health Council Resolution 466/12 and was approved by the local research ethics committee (Opinion 59/2012). Results: three categories of determinants emerged regarding academic satisfaction - academic and curricular determinants, institutional determinants and social determinants. Students were generally found to be satisfied in the three dimensions examined. Conclusion: it is expected that recognition of the determinants of academic satisfaction can contribute to the planning and implementation of strategies to inform these students' training.

Keywords: Nursing students; staff satisfaction; nursing education; nursing.

INTRODUCTION

Brazilian universities have undergone important transformations over time, both in teaching structures and in social position and sense, leading to essential adjustments in curriculum content and teaching-learning dynamics, so scientific, social advances and the perspectives of university students would be possible to follow who want to play an active role in society^{1, 2}.

In recent years, there has been a significant increase in the university population, with very different characteristics, such as social class, gender, goals, expectations, previous academic experience, age group, among others, making visible the need for the Universities to prepare them for greater recognition of the specificities of students entering higher education³.

The educational institution has shown to be important for the student´s intellectual and vocational development, for offering the sharing of ideas and new experiences at a theoretical and practical level, interaction with other students, teachers, employees and community, instigating students to better understand the process of interaction between the undergraduate and its academic, and to the changes provoked as a result of this interaction⁴. Thus, one of the results of the interaction between the student, the undergraduate course, and the educational institution refers to academic satisfaction.

The need to measure academic satisfaction is not a recent task, considering that the first investigations about this subject were made in the 1960s, from studies on occupational satisfaction³. It can be understood as a variable that involves the subjective experience of the student and his perception of the value of this educational experience throughout his academic trajectory, being a dynamic process, since it can be affected by the characteristics of the students and also by the educational experiences in the undergraduate course⁵.

Academic satisfaction also plays an important role in the nursing context, with essential knowledge about how undergraduate students experience satisfaction with the course, since when they are not satisfied, sources of suffering and stress can be identified, with possible repercussions in their academic life, their professional future, in the environment and in the work relationships, with the different subjects that will come to interact, and for the care provided⁶.

Some research with nursing students have already verified that the dissatisfaction with the undergraduate course seems to be related to the dichotomy between theory and practice, to the difficulty in delimiting the actions of the nurse´s competence in the professional practice, to the perception of being permanently in the process of evaluation by the teachers, the lack of autonomy in performing practical activities and internships, recognition of the devaluation and subalterns of the profession and the apparent lack of autonomy of the nurse⁷.

Thus, academic satisfaction research is fundamental for the planning and consequent improvement of the institutional programs and services assigned to students, qualifying the educational process, wand justifying the accomplishment of this research.

Given these considerations, the following research question emerged: what factors determine the academic satisfaction among undergraduate nursing students during their educational trajectory? Thus, the objective was to know the factors that determine satisfaction with the academic experience among undergraduate students in nursing.

LITERATURE REVIEW

Academic satisfaction is the subjective evaluation of all experience associated with education, defined as a psychological state resulting from the confirmation or not of the student´s expectations with the academic reality⁸. It also includes specific aspects related to the quality of teaching, curriculum, relationship with teachers and colleagues, administration, facilities, and resources of the institution of higher education, also providing the student´s perception of the academic and intellectual environment of the institution⁹.

Some factors are more prominent as determinants of academic satisfaction, such as university environment; relationship between student and teacher; involvement in at least one academic activity, such as monitoring, scientific initiation, internships, events, fundamental for greater identification with the course and optimism with the chosen profession; social recognition of the future profession and good performance in some subjects¹.

Also, there are some factors that may negatively influence academic satisfaction, such as: unfavorable labor market; dissatisfaction with the course regarding frustrations with certain subjects, teachers (regarding didactics and involvement with students), high quantity of hours, insufficient practical activities, low development opportunity such as extracurricular activities, lack of support from the course´s administration².

When the student who is not satisfied with his or her course may have a lack of learning and lack of interest, also having an impact on their health and the relationships they establish. Therefore, understanding the factors that generate students´ satisfaction or not, evaluating their interests, methods of teaching in the institution, curriculum and course´s organization, is a way of contributing to the satisfaction of students´ needs, as well as the institution that chooses to search quality of services^1,5.

METHODOLOGY

This is a qualitative research, of the descriptive type, carried out in a Nursing Undergraduate Course of a public university in the South of Brazil. Twenty-seven undergraduate nursing students enrolled from the first to the ninth grade of the course were respondents. The inclusion criteria were: to be a student of the Undergraduate Nursing Course, to have availability and interest in participating in the research.

Data were collected in February and March of 2013, in classrooms of the studied course, reserved for this purpose, using semi-structured, recorded interviews with an average duration of 30 minutes. The script contained closed questions, for the characterization of the participants, and open questions, focusing on possible determining factors for academic satisfaction. It should be noted that a minimum of three students per series was established to save the representativeness of the different moments of the course.

The data were analyzed according to a discursive textual analysis, understood as a self-organized process of construction and understanding, in which new understandings emerge from a cycle of analysis composed of three components: unitarization, the establishment of relationships and communication¹⁰.

As recommended in Resolution 466/12 of the National Health Council, this study was approved by the Local Research Ethics Committee (Opinion Nº 59/2012). Asserting the ethical precepts, the participants agreed to participate voluntarily and were identified by the letter S (student), followed by a sequential number (for example, S1, S2).

RESULTS AND DISCUSSION

From the characterization of the 27 participants, there was a predominance of the age group between 18 and 25 years old, 24 of the participants were female, 21 were single, and 23 did not have children, 14 lived with relatives, nine with spouses and four with colleagues. It was possible to confirm the nursing profile as a predominantly female profession, corroborating the findings in other studies, which mention the historical origin of nursing^11-13.

Evidence from another study based on the quality of life of nursing students, also obtained a similar age range, ranging from 18 to 30 years old, and the predominance of single students. In Brazilian society, it is becoming increasingly common for young people to opt for vocational training first, and then to decide on their future marital life¹⁴.

From the analysis of the data, three categories related to academic satisfaction emerged according to the open questions: academic and curricular determinants; institutional determinants; and social determinants.

Academic and Curricular determinants

It was possible to show that students were satisfied with the subjects learned and methodologies that make up the Undergraduate Nursing Course, but they were dissatisfied with the organization of the subjects in the curriculum and with their insufficient workload, which may hinder the development of their potential:

Regarding the organization of the course subjects, it was possible to show a certain dissatisfaction among nursing students with teaching didactics and their duration, especially in the initial series of the course, possibly due to the difficulty in perceiving the applicability of contents developed in the subjects of the courses. Biological Sciences of Health, Social Human Sciences and in delimiting the actions of nurse competence in professional practice^8,15.

The subjects of the Undergraduate Nursing Course are influenced by a dynamic context, in which there is a growing and cumulative incorporation of knowledge and technologies that need to be related to contemplate technical-scientific knowledge that will enable students and future professionals according to the social and health needs of the population¹⁶.

About students´ satisfaction, it is considered a dynamic process, since it can be modified throughout the educational experience. This is verified in some studies that identify greater enthusiasm and satisfaction as the student progresses in the course series, which must be associated with greater contact with nursing subjects, and contributing to the knowledge of the work of nurses, in the different health institutions, favoring the perception of the applicability of their studies^4,8,17. Thus, as they approach the end of the course, they glimpse the possibility of insertion in the job market and possible career stability¹⁸.

Nursing students, who are involved in at least one extracurricular activity, are more likely to be satisfied with the undergraduate course, which may be associated with greater identification with the chosen profession, given the opportunities for development in the training environment:

Extracurricular activities were mentioned as determinants of academic satisfaction, as they allowed greater involvement in the activities of the course and an important channel of access to reality, favoring the recognition and relevance of their actions, which are fundamental for greater identification with the course and optimism with the chosen profession^13,19.

In this perspective, it was evidenced that when getting involved in the activities of the course, the students perceive the conditions for entry into the professional curricular area as positive, confirming that the satisfaction with the course and the opportunities for the development of the career have a considerable weight in the strengthening the trajectory of academic experience. Such experiences favor entering the world of work and professional life¹³. In this sense, the student´s dedication to educational activities, inside or outside the classroom, contributes to his personal learning and development, resulting in academic success^17,18.

As for the relationship established with the teachers, they are satisfied, emphasizing the importance of the teacher-student relationship as a basis for the teaching and learning the process, especially in the exchange of knowledge. It was also highlighted the importance of teacher recognition and counseling, which may instigate greater academic involvement:

The study participants showed how satisfactory is the good relationship between the teacher-student binomial, especially regarding the recognition of the effort and involvement of student, being a motivational determinant ^12,16. On the other hand, an investigation directed at supervised internships in the hospital context has identified that students expect a flexible attitude of the teacher when dealing with their potentialities and limitations. Otherwise, they feel dissatisfied and unmotivated when they perceive the teacher as a threat⁴.

A determinant aspect of dissatisfaction by some students was the insufficient adequacy between the tasks required of the course and the time established by the teachers for their accomplishment:

Overloading of activities, short-term assignments, and lack of time for extracurricular activities were also mentioned as determinants of dissatisfaction, which may be associated with the difficulty of reconciling daily academic tasks with extracurricular activities, hindering the better use of teaching in the course^14,17.

Faced with the activities in Nursing Undergraduate Courses, the time and effort dedicated, still relate to the traditional pedagogical conception, which is directed to a curriculum in which the contents are isolated and follow a hierarchy of their own, and sometimes disintegrated from reality. Moreover, the teacher is the sole holder of knowledge¹⁹.

The Law on the Guidelines and Bases of National Education emphasizes that higher education aims to stimulate students´ reflective thinking, as well as to train individuals capable of acting in the different professional areas, contributing to the social, cultural and scientific development, as well as constant improvement²⁰. Therefore, it is important to highlight the growing need for teacher-student articulation in the teaching-learning process, since the mismatch of both makes teaching and learning insufficient. It is necessary to establish a reciprocal relationship, in which each one knows its limits and responsibilities^21-23.

Institutional determinants

It was possible to show that students perceive the conditions of the structures of the university environment as unfavorable to their professional formation, often hindering learning and academic achievement:

The students expressed some dissatisfaction with the structure of the university environment - discomfort in the physical area of the institution, insufficient infrastructure of classrooms and the long distances traveled between their homes and the different campuses of the university. Studies have revealed that such factors determined the dissatisfaction of students from different undergraduate courses, interfering negatively in the learning process^2,12. In this way, the quality of services provided in the context of higher education institutions has also become an essential element for its consolidation, to become an educational reference^21,22.

As for the support services of the institution, the students were satisfied, since the conditions of the course are maintained to personal development and the professional future of the university environment.

In agreement with the finding, it is possible to reflect that in admitting and encouraging the democratization of higher education, educational institutions also need to be prepared to receive students, who present varying socioeconomic conditions, since the support services sometimes become a conditional on staying in the course²³.

The attendance offered by the institution´s employees, including the library, secretary, and other sectors, was satisfactorily explained, converging to the findings of other studies, which relate the interaction between students/employees positively, with emphasis on the feelings of welcome and safety in the teaching environment^7,12.

Social determinants

The students also expressed the quality of the interpersonal relationships they establish with their colleagues as a determinant of academic satisfaction, which allows the balance of personal life with the period of professional formation:

Among the factors that favor academic satisfaction, the students highlighted the bonds of friendship established with their colleagues and the importance of performing leisure activities. This finding corroborates other studies that highlight the importance of leisure as a therapeutic activity since students perceive more satisfied when there is time available for personal life, temporarily detaching from the stressful environment, which allows a relief of their tensions of training^15,16.

Also, the students expressed dissatisfaction with the lack of social events and leisure opportunities offered by the institution, which may constitute factors determining the satisfaction of students of different undergraduate courses^2,12.

It should be emphasized that since it is a subjective assessment, the academic satisfaction is a difficult task to understand, since it involves all the training experience and also more specific aspects related to the quality of teaching, curriculum of the course, facilities and resources^{9, 22}.

CONCLUSION

The results obtained provide a better understanding of the level of satisfaction experienced by nursing students throughout the professional training process, also showing the efficiencies and deficiencies of the undergraduate and university courses as opportunities for personal and academic development.

Thus, it is expected that the recognition of student satisfaction and dissatisfaction can contribute to the establishment of strategies aimed at qualifying learning, especially in the three dimensions addressed: academic and curricular determinants, institutional determinants and social determinants. Certain reports of dissatisfaction have emerged, indicating the importance of actions aimed at strengthening the identity with the profession to meet the students´ needs.

In this perspective, the recognition of the factors that interfere in the students´ satisfaction in the educational environment can help in the planning of actions that reduce the feelings of dissatisfaction, through programs and services of attendance to the students and, even, strategies of improvement of the pedagogical project of the course, to ensure their active participation in their training process and to ensure student/professional and institutional success.

This study had as limitations, its accomplishment in a specific population of students of a public university in the south of Brazil, being not possible the generalization of its results.

REFERENCES

1.Dennison S, Masri EM. Development and psychometric assessment of the undergraduate nursing Student academic satisfaction scale. J nurs meas. 2012; 20(2):75-89.

2.Chen HS, Lo HS. Development and psychometric testing of the nursing student satisfaction scale for the associate nursing programs. J Nurs Educ Pract. 2012;2(3):25-37.

3.Schleich AL, Polydoro SA, Santos AAA. Escala de satisfação com a experiência acadêmica de estudantes do ensino superior. Aval psicol. 2006; 5(1):11-20.

4.Oliveira EB, Costa SLT, Guimarães NAL. O trabalho do acadêmico de enfermagem no hospital geral: riscos psicossociais. Rev enferm UERJ. 2012; 20(3):317-22.

5.Jaradeen N, Jaradat R, Safi AB, Tarawneh FA. Students satisfaction with nursing program. Bahrain Med Bull. 2012; 34(1):1-6.

6.Barlem JGT, Lunardi VL, Bordignon SS, Barlem ELD, Lunardi Filho WD, Silveira RS, Zacarias CC. Opção e evasão de um curso de graduação em enfermagem: percepção de estudantes evadidos. Rev Gaúcha Enferm. 2012;33(2):132-8.

7.Silva VLS, Chiquito NC, Andrade RPO, Brito MFP, Camelo SHH. Fatores de estresse no último ano do curso de graduação em enfermagem: percepção dos estudantes. Rev enferm UERJ. 2011; 19(1):121-6.

8.Tomaschewski-Barlem JG. Lunardi VL, Ramos AM, Silveira RS, Barlem ELD, Ernandes CM. Manifestações da síndrome de burnout entre estudantes de graduação em enfermagem. Texto Contexto - Enferm. 2013; 22(3):754-62.

9.Tessema MT, Ready K, Yu WC. Factors affecting college students' satisfaction with major curriculum: evidence from nine years of data. Int J Humanit Soc Sci. 2012; 2(2):34-44.

10.Moraes R, Galiazzi MC. Análise textual discursiva. 2ª ed. rev. Ijuí (RS): Ed. Unijuí; 2011.

11.Astin AW. Student Involvement: a developmental theory for higher education. J Coll Student Person.1984; 40(15):518-29.

12.Forattini CD, Lucena C. Adoecimento e sofrimento docente na perspectiva da precarização do trabalho. Laplage em Revista (Sorocaba). 2015; 1(2):32-47.

13.Pires AS, Souza NVD, Pennal LH, Tavares KF, Brecht CAF, OliveiraV et al. A formação de enfermagem na graduação: uma revisão integrativa da literatura. Rev enferm UERJ. 2014; 22(5):705-11.

14.Oliveira JLC, Papa MAF, Wisniewski D, Inoue KC, Costa MAR, Matsuda LM. Qualidade do cuidado: concepções de graduandos de enfermagem. Rev Min Enferm. 2015; 19(1):29-35.

15.Hirsch CD, Barlem EL, Tomaschewski-Barlem JG, Lunardi VL, Oliveira AC. Preditores do estresse e estratégias de coping utilizadas por estudantes de enfermagem. Acta Paul Enferm. 2015; 28(3):224-9.

16.Carvalho ACO, Soares JR, Maia ER, Machado MFAS, Lopes MS, Sampaio KJAJ. Teacher planning: report on methods of assets used in nursing education. Rev enferm UFPE on line. 2016; 10(4):1332-8.

17.Lee CY, White B, Hong YM. Comparison of the clinical practice satisfaction of nursing students in Korea and the USA. Nurs Health Sci. 2009; 11(1):10-6.

18.Yildirim Y, Kilic SP, Akyol AD. Relationship between life satisfaction and quality of life in Turkish nursing school students. Nurs Health Sci. 2013; 15(4):415-22.

19.Pires AS, Souza NVD, Pennal LH, Tavares KF, Brecht CAF, OliveiraV et al. A formação de enfermagem na graduação: uma revisão integrativa da literatura. Rev enferm UERJ. 2014; 22(5):705-11.

20.Ministério da Educação e Cultura [site de internet]. Lei 9.394/96. Lei de Diretrizes e Bases da Educação Nacional. Brasília (DF): MEC; 1996. [cited 2016 Apr 2]. Available from: http://www.mec.gov.br

21.Acioli S, Correia LM, Souza NVD, Pereira SLF, Ferraccioli P, Ferreira VA. Avaliação do processo educativo na graduação de enfermagem. Rev enferm UERJ. 2014; 22(6):801-7.

22.Chicharo SCR, Florêncio MV, Alves SZSP, Cortez EA, Andrade M, Valente GSC. Fatores facilitadores do ensino-aprendizagem na formação do enfermeiro: uma revisão integrativa. Rev pesqui cuid fundam. (Online) 2016; 8(2):4099-108.

23.Coelho MP, Menezes HF, Rosas AMTF, Rosa AF, Pinto ACS, Saraiva RJ. O ensino do cuidado nos cursos de graduação em enfermagem do Brasil: revisão integrativa. Rev enferm UFPE on line. 2016;10(2):647-56.