Satisfaction with academic experience among undergraduate nursing students

Satisfacción con experiencia académica entre estudiantes universitarios en enfermería

Abstracts

To analyze satisfaction with the academic experience and its relationship with sociodemographic variables among undergraduate nursing students from a public university in southern Brazil. Quantitative study, conducted with 170 students with the application of the Academic Experience Satisfaction Scale. Descriptive statistics, analysis of variance and linear regression analysis were used for data analysis. Students were neither satisfied nor dissatisfied with the course or with the institution and the opportunity of development. The aspect "satisfaction with the course" obtained the highest mean; younger students who carried out leisure activities had greater satisfaction with the course and with the opportunity of development. It is expected that learning the possible satisfaction or dissatisfaction of students can contribute to the development of strategies aimed at qualifying students' learning.

Nursing students; Personal satisfaction; Nursing education; Nursing

Analizar la satisfacción con la experiencia académica y su relación con variables sociodemográficas en estudiantes de pregrado de enfermería de una universidad pública del sur de Brasil. Estudio cuantitativo, realizado con 170 estudiantes mediante la aplicación de la Escala de Satisfacción con la experiencia académica. Se utilizó estadística descriptiva, análisis de varianza y análisis de regresión lineal para el análisis de datos. Se encontró que los estudiantes se mostraron ni satisfechos/insatisfechos con el curso o la institución y las oportunidades para el desarrollo y la dimensión de satisfacción con el curso tuvo el promedio más alto del instrumento; los estudiantes más jóvenes y la realización de actividades de tiempo libre tener una mayor satisfacción con el curso y la oportunidad de desarrollo. Se espera que el reconocimiento de las posibles satisfacciones e insatisfacciones de los estudiantes puede contribuir al desarrollo de estrategias dirigidas a calificar el aprendizaje de los estudiantes.

Estudiantes de enfermería; Satisfacción personal; Educación en enfermería; Enfermería

O objetivo foi analisar a satisfação com a experiência acadêmica e sua relação com as variáveis sociodemográficas entre estudantes de graduação em enfermagem de uma universidade pública do Sul do Brasil. Estudo quantitativo, realizado com 170 estudantes de graduação em enfermagem, mediante aplicação da Escala de Satisfação com a Experiência Acadêmica. Utilizou-se a estatística descritiva, análise de variância e análise de regressão linear para análise dos dados. Constatou-se que os estudantes se mostraram nem satisfeitos/nem insatisfeitos com o curso, a instituição e a oportunidade de desenvolvimento, sendo que a dimensão Satisfação com o Curso apresentou a maior média do instrumento; estudantes mais jovens e que realizavam atividades de lazer apresentaram maior satisfação com o curso e com a oportunidade de desenvolvimento. Espera-se que o reconhecimento das possíveis satisfações e insatisfações dos estudantes possa contribuir para o estabelecimento de estratégias que visem qualificar a aprendizagem dos estudantes.

Estudantes de enfermagem; Satisfação pessoal; Educação em enfermagem; Enfermagem

INTRODUCTION

Students' entry to higher education brings about a series of changes at personal, cognitive, professional, affective and social levels, besides resulting in a series of expectations regarding the chosen undergraduate course. These expectations very often come with anxiety, fear and doubts concerning academic performance and professional training. Therefore, the undergraduate course will be the students' new learning environment, which can positively or negatively affect their growth as academics and their professional future.¹

Academic institutions have proved to be important for the intellectual and vocational development of students, as they offer the opportunity to share ideas and experiences at theoretical and practical levels, to interact with other students, professors, employees and the community as a whole, and they also encourage students to better understand the process of interaction between undergraduate course and scholars, as well as changes resulting from this interaction.¹ In this sense, we should point out that one of the results obtained from the interaction between the student and the undergraduate course is related to academic satisfaction.

The first investigations on academic satisfaction were conducted in the 1960s and originated from studies on occupational satisfaction.¹ Academic satisfaction refers to the subjective evaluation of the whole educational experience, and it is defined as a psychological state that results from the confirmation or not of the students' expectations regarding their academic reality.^{2 - 3}

Academic satisfaction is strongly related to the quality of students' learning, and it is a dynamic process that can be affected by the institution's characteristics within its educational context, and by the way students themselves perceive and understand their learning environment.^{2 , 4 - 5}

In addition, ratings of academic satisfaction include the institutional context as a whole, and consider the quality of the course, the relationship between theory and practice, the quality of teaching, the evaluation system, contact with professors and colleagues, curricular content, management of the university and its facilities and resources.^{5 - 6} A successful higher education institution is the one that is constantly seeking to improve and develop its ability to meet the needs and expectations of students and professors.⁷

In the context of nursing, it is essential to understand how students experience their undergraduate course, since feelings of suffering and stress can be identified in students who are dissatisfied, which can affect their academic lives, their professional future, their working environment and relationships, as well as people with whom they will interact and the care services they will provide.⁸

In this sense, nursing students' satisfaction with their undergraduate program is essential and can serve as an instrument of assessment of institutional effectiveness and success. Also, students need to find ways to achieve professional fulfillment by acquiring new knowledge that brings benefits in the course of their careers.^{9 - 10}

Moreover, the study on nursing students' academic satisfaction is based on the assumption that this variable has a direct influence on these students performance and may affect both their professional training and their social interaction, and possibly result in the desire to withdraw from the course, which in turn will result in financial loss, as well as in physical and psychological damage.

In Brazilian literature, there is a lack of research on the matter, whereas in foreign literature it is possible to find studies that investigated this variable in the context of undergraduate nursing students.^{2 - 4 , 7} Therefore, the starting point of this study is the lack of information about satisfaction with the academic experience among undergraduate nursing students at a public university in southern Brazil.

The authors considered that the investigation on academic satisfaction is essential for planning and for the consequent improvement of institutional services and programs oriented toward students, which qualify the educational process, thus justifying this study.

Hence, the acknowledgment of possible degrees of students' satisfaction or dissatisfaction can contribute to the establishment of strategies with the aim to qualify students' learning and development by identifying their needs, bringing improvements to professors and the coordination staff, making efforts to obtain students' satisfaction so as to reduce a possible discrepancy between their expectations and what the institution actually delivers.^{1 , 5}

The aim of this study was to analyze the degree of satisfaction of undergraduate nursing students with their academic experience at a public university in southern Brazil.

METHOD

This is a quantitative, exploratory and descriptive study, with cross-sectional design,¹¹ conducted in the nursing undergraduate course of a public university in southern Brazil. The program has a total course load of 4,055 hours, distributed in compulsory disciplines, practical classes, internships and complementary activities.

The present study was conducted with a sample of 170 students enrolled from the 1^st to the 9^th semester, and the following inclusion criteria were adopted: being a student of the nursing undergraduate course and being present in the classroom at the time of data collection. The sample size was defined by a specific mathematical formula,¹² whose objective was to estimate the minimum sample size needed for the development of specific statistical procedures, thus ensuring the reliability of the study. After the application of this formula¹² to the total population of 242 students, a minimum number of 150 participants was found.

Data were collected in the classrooms between February and March of 2013. The instrument was handed out to students, after a previous authorization from professors, and then collected, along with a Free and Informed Consent Form duly signed.

The data collection instrument was the Academic Experience Satisfaction Scale (AESS), which was proposed and validated in a previous study with higher education students.¹ This scale, composed of 35 items, investigated the degree of academic satisfaction of higher education students, and included three aspects: satisfaction with the course, opportunity of development and satisfaction with the institution; these aspects were measured by means of a five-point Likert scale, which was represented by (1) "Totally dissatisfied", (2) "Little satisfied", (3) "Not dissatisfied/not satisfied", (4) "Satisfied" and (5) "Totally satisfied".¹ The instrument also had an initial part with the characterization of subjects and included sociodemographic and academic characteristics.

For data analysis, the Statistical Package for the Social Sciences (SPSS) version 17.0 was used, which made the organization process easier through the use of spreadsheets that allowed for a better presentation and interpretation of results.

Data were submitted to three different analyses: descriptive statistics, with the use of means and frequency distribution of constructs and their indicators; analysis of variance (ANOVA) between different groups of respondents, according to sample characteristics, in order to assess possible significant differences between groups of respondents; linear regression analysis, in order to identify which factors have stronger effects on nursing students' perception on satisfaction with the academic experience. In order to perform the ANOVA, the following variables were considered: gender, age, current occupation, aid from the institution, school year/semester, extra-curricular activities, experience in another institution and intention to withdraw from the course.

In compliance with Resolution 196/96, this study was submitted to the local Research Ethics Committee for evaluation and obtained a favorable opinion (number 59/2012).

RESULTS

Regarding the sociodemographic data of the studied sample, a total of 170 participants was obtained, of which most individuals were female (88.8%), aged 24.9 years in average, with the mean age of 1^st to 4^th semester students being 24.7, and the mean age of 5^th to 9^th semester students being 25.1 years old. Most students were single (77.1%), did not work (73.5%), had their studies funded by their families (66.5%), and carried out leisure activities (75.9%). Students who lived with their parents prevailed (40.6%).

Regarding academic characteristics, the first semester classroom had a higher number of students (18.2%), who reported to have only basic information concerning the nursing undergraduate course before their entry to university (45.3%). Most subjects stated they had chosen nursing as their first option (80%) and had not attended another higher education institution (77.1%).

Besides, most individuals reported carrying out extra-curricular activities (67.6%), were granted a scholarship, a research grant or an extension grant (52.4%), and 58.8% were not granted any aid by the institution. Those who considered they had a suitable place to study were 83.5%; those who had a computer were 94.4%; who had easy access to internet, 97.1%; who had a printer, 72.4%; and who had free access to up-to-date books, 85.3%. Most students did not express, or had not expressed before, their intention to withdraw from the course (65.9%).

As for the results of the assessment of the degree of academic satisfaction of nursing students (Table 1), the descriptive analysis showed that the aspect "satisfaction with the course" had the highest mean (3.62), which indicated neither satisfaction nor dissatisfaction with their relationship with professors. For the aspect "opportunity of development", the corresponding mean was 3.54, which shows that students were not satisfied neither dissatisfied with personal and professional development provided by the course and the institution. Within this aspect, the question "diversity of extra-curricular activities offered by the institution" obtained the lowest mean (3.35).

Table 1 -
Degree of academic satisfaction experienced by students. Rio Grande, Rio Grande do Sul, 2013

Factors	n	Degree of satisfaction
Satisfaction with the institution q*-04 Resources and audio-visual equipment available at the institution q-06 Social events offered by the institution q-15 Equipment and software offered by the computer lab q-16 Quality of service and information provided by the library staff q-20 Physical infrastructure of classrooms q-21 Institution’s commitment with quality of teaching q-22 Institution’s physical infrastructure q-29 Services provided by the library q-30 Comfort of the institution’s facilities q-32 Location of the institution’s different sectors	170 170 169 170 169 168 169 169 170 170 169	(3.36) 3.50 2.93 3.04 4.25 2.65 3.70 3.12 4.08 2.89 3.45
Satisfaction with the course q-01 Relationship with professors q-12 Interest of professors in helping students during class q-13 Knowledge of professors of the content they teach q-14 Recognition by professors of my commitment with my education q-25 Evaluation proposed by professors q-28 Professors’ class strategies q-31 Relevance of contents q-33 Professors’ availability to help students outside class hours q-34 Contents suitability	170 170 170 170 169 170 170 170 169 170	(3.62) 3.84 3.80 3.78 3.60 3.46 3.54 3.63 3.57 3.61
Opportunity of development q-02 Diversity of extra-curricular activities offered by the institution q-10 Support services or programs offered by the institution q-11 Conditions offered for professional development q-23 Financial support program offered by the institution q-24 Opportunity of development offered by the institution q-26 Match between financial investment required and quality of teaching provided	170 170 169 170 170 169 170	(3.54) 3.35 3.60 3.58 3.49 3.55 3.68

• ^*
  refers to the question number found in the instrument.

The aspect "satisfaction with the institution" had a mean of 3.36, making it evident that students were neither dissatisfied nor satisfied. However, students showed little satisfaction with social events offered by the institution (2.93), with the comfort of its facilities (2.89), and with the physical infrastructure of the classrooms (2.65).

ANOVA (Table 2) enabled us to analyze the possible existence of differences in means of nursing students' academic satisfaction, considering their sociodemographic and academic characteristics. Concerning the relationship between academic satisfaction and sociodemographic variables, significant differences were found regarding the variables "age" and "leisure activities". Younger students who had leisure activities were more satisfied with the course and with the opportunity of development.

Table 2 -
Relationship between the aspects of satisfaction and sociodemographic and academic variables. Rio Grande, Rio Grande do Sul, 2013

Aspects		Institution		Course		Opportunity of development
	n	M	P	M	P	M	P
Gender Female Male	151 19
		3.34 3.52	.301	3.62 3.68	.684	3.53 3.58	.803
Age ≤ 25 yrs > 25 yrs	115 55	3.41 3.25	.211	3.70 3.46	.025*	3.63 3.34	.039*
Working Yes No	45 125	3.16 3.43	.023*	3.51 3.67	.148	3.20 3.66	.003*
Aid from institution Yes No	69 100	3.34 3.38	.714	3.65 3.61	.708	3.65 3.46	.139
Develops leisure activities Yes No	129 41	3.41 3.17	.084	3.73 3.30	.001*	3.66 3.17	.001*
Current school semester 1st-4th 5th-9th	85 85	3.30 3.41	.342	3.52 3.73	.029*	3.44 3.63	.676
Extra-curricular Yes No	115 55	3.26 3.55	.014*	3.64 3.60	.665	3.58 3.45	.291
Attended another institution Yes No	39 131	3.32 3.37	.724	3.59 3.64	.696	3.41 3.57	.306
Intention to withdraw from the course Yes No	58 112	3.16 3.46	.015*	3.43 3.72	.006*	3.32 3.65	.013*

• ^*
  Significant difference at 5%.

A significant difference was also found between the variable "work" and the three aspects of academic satisfaction, showing that students who worked and studied were less satisfied with the institution, with the course and with the opportunity of development, thus being less satisfied than those who only studied.

In the relationship between the three aspects of academic satisfaction and the academic variables, it was found that students from the early years were less satisfied with the course than those who were reaching the end of the course. It was also found that students who carried out extra-curricular activities were less satisfied with the institution. In addition, students who intended to withdraw from the course were dissatisfied with the institution, the course and the opportunity of development.

In the assessment of the effects of the three constructs regarding the perception of satisfaction with the academic experience, by means of linear regression and asking the question "generally speaking, how satisfied are you with your academic experience?" as a dependent variable, results showed a significant relationship at 5% in two constructs, with exception to the aspect "satisfaction with the institution". The construct that had greater effect on students' satisfaction with their academic experience was "satisfaction with the course" (Table 3). The test had an adjusted coefficient of determination (R2) of 0.21, which represents 21% of satisfaction with the academic experience based on the questionnaire.

Table 3 -
Linear regression analysis of constructs. Rio Grande, Rio Grande do Sul, 2013

Variable	B	P
Satisfaction with the institution	.063	.588
Satisfaction with the course	.342	.027*
Opportunity of development	.268	.035*

• ^*
  Significant difference at 5%.

DISCUSSION

Concerning the degree of satisfaction with the academic experience of the studied sample, and considering the frequency scale of 1 to 5, undergraduate nursing students were neither dissatisfied nor satisfied with the institution, the course and the opportunity of development. Therefore, there may be a lack of involvement in the institution's activities and course, and since this involvement is understood as students' active participation in the learning process, the lack of it can make it difficult for students to have a clear perception of their satisfaction with the academic experience.^{5 , 13}

However, it is crucial that students be satisfied, as they need to find, in the institution and in the course, ways to achieve professional success by acquiring new knowledge that bring an added value to their training.^{9 - 10} In this sense, a study on the determining factors of general satisfaction of students highlighted the importance of satisfaction as an essential element in motivation and academic involvement, which affects their learning performance and consequently their proficiency in the work market.¹³

Furthermore, students showed little satisfaction with social events promoted by the institution, as well as with the comfort and physical infrastructure of classrooms, which can be critical factors in the satisfaction of students from different undergraduate courses.^{2 , 13 - 14}

Students who developed leisure activities had a higher degree of satisfaction with the course and with the opportunity of development, which confirms other studies that highlight the importance of carrying out leisure activities as therapeutic activities, since students are more satisfied when they have free time for their personal lives and have the possibility of temporarily staying away from a stressful environment, thus relieving tensions that are specific to the academic life.^{15 - 16}

Besides, younger students also had a higher degree of satisfaction with the course and with the opportunity of development, as they might idealize the university environment and have positive expectations about professional training and personal development, as well as expectations of new friendships or even affectional bonds, which all result in a desire to be effectively involved in the course activities.¹⁷ Another aspect observed was that the age group under 25 is less committed to housing or family matters,¹⁷ which makes them more likely to be involved in the course and in activities related to the opportunity of development.

Combining work and studies had negative results in nursing students' satisfaction, which influenced their satisfaction with the course, the institution and the opportunity of development. This is in line with other studies found in the literature, which expressed in a negative way the conditions of students who work, as this makes it more difficult for them to learn and be involved in academic activities.¹⁸

Keeping a job along with the undergraduate course can lead students to an intense and consuming life, with symptoms of depression as a result, due to the physical and emotional weariness.^{18 - 19} In addition, financial needs can very often lead students to give up activities that are particular to their area of training, which makes it even more difficult to be effectively involved in academic activities.

Students of early years were less satisfied with the course than those who were reaching the end. However, some studies point out that beginners in higher education had a higher degree of satisfaction with the course when compared to students who were in the second half of the course.^{19 - 20}

As far as nursing is concerned, students' satisfaction seems to be lower in the early semesters of the course, possibly because of the difficulty of perceiving the practical application of contents studied in biological, human and social sciences, and the difficulty of defining the competences of nursing in professional practice.²¹

The highest degree of satisfaction with the course among students of late semesters can be associated with a closer contact with nursing sciences discipline, which contributes to understand nurses' work in different health institutions and can improve their perception of the importance and practical application of their academic training.²¹

Furthermore, the diversity of experiences over the course makes it possible for late semester students to confirm or contradict some of their initial idealizations regarding the course, which helps to overcome difficulties and frustrations, and may result in more satisfaction.²⁰

Students who carried out extra-curricular activities were satisfied with the institution, which can be associated with the difficulty of conciliating academic tasks with extra-curricular activities and thus not making a good use of the institution's facilities. In a previous study, the participation of students in extra-curricular activities was considered simply as a contribution to the curriculum or a way to fulfill the complementing hours required by the course, and it was also seen as an obligation.²²

However, the participation in extra-curricular activities during professional training enables students to see and be an integral part of reality, which is full of conflicts and contradictions, and it also encourages them to take part in activities related to their professional choice and to appreciate the importance of their actions.²³

In addition, it was also found that students who intended to withdraw from the course had a lower degree of satisfaction with the program, the institution and the opportunity of development. When students express their dissatisfaction with the course, they probably do not realize the meaning and the reward for the effort put in the performance of training activities, which results in an increased weariness in the performance of tasks and the consequent desire to leave the course.^{8 , 21}

The desire to withdraw from the course may be directly related to the lack of commitment and interest from students, and it can be deduced that they do not have projects for the future nor interest in knowing the services offered by the institution, neither have they the intention to be involved in the learning-teaching process.^{1 , 8}

Regarding the construct that had the strongest effect on nursing students' academic satisfaction, "satisfaction with the course" obtained the highest mean score, followed by "opportunity of development", which confirms that both can have a significant role in the perception of the academic experience in the context of higher education, and create favorable conditions for entering the work market.¹³

Students who are dissatisfied with their course can have their health and relationships affected, besides suffering from a learning deficit and lack of interest. Therefore, understanding the factors that result or not in students' satisfaction, by assessing their interests, the institution's teaching methods, curriculum and course organization is a way to contribute to meet students' needs and to help the institution, which seeks continuous improvement of the services provided.^{1 , 13 - 14}

FINAL CONSIDERATIONS

The limitations of this study included its performance with a specific population of a public university in southern Brazil, which did not allow for a generalization of results. The research makes it clear that other studies on nursing students' academic satisfaction are necessary, with special attention to their environment and training.

We highlight the association found between the variable "intention to withdraw from the course" and the aspects "satisfaction with the institution", "satisfaction with the course" and "opportunity of development", which require follow-up actions oriented toward the strengthening of the identification with the profession and the needs of students, who are in a situation in which they question themselves about their professional choice.

Different paths can be followed in order to promote academic satisfaction, among which, the importance of an undergraduate course being oriented toward nursing students' needs, by respecting and listening to them, by making use of strategies that prepare them to deal with the events of academic and professional life, as well as by offering a broad psychological and pedagogical support, especially to those who expressed some dissatisfaction.

Understanding the meaning of satisfaction and its factors, which can positively or negatively affect satisfaction with the academic trajectory, is important for the relationship between the institution and the quality of the professional-to-be that will enter the work market, since students of today will be the professionals of tomorrow, and subsequently, these students tend to reproduce the experiences lived during the course in their future professional practice.

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Publication Dates

• Publication in this collection
  Jan-Mar 2015

History

• Received
  07 Oct 2013
• Accepted
  15 Jan 2014