The Role of School Environment and Social Interaction in Predicting Student Nurses' Satisfaction with Academic Programmes: Insights from Two Nursing Training Colleges in Eastern Ghana

A quantitative study of 241 student nurses in Eastern Ghana reveals that the school environment and social interaction are significant predictors of their overall satisfaction with academic programmes, highlighting the need for institutional interventions in these areas.

The Gist

Imagine a nursing school not just as a building with classrooms, but as a garden. The students are the young plants, the teachers are the gardeners, the lessons are the sunlight, and the school's facilities are the soil and water.

This research paper is like a report from a gardener who went to two specific nursing schools in Eastern Ghana to answer one big question: "What makes these young nurse-students truly happy and satisfied with their education?"

Here is the story of what they found, broken down into simple terms:

1. The Big Problem

In the past, people mostly asked students, "How was your time in the hospital practicing?" (Clinical learning). But they rarely asked, "How do you feel about the whole school experience?" (The classrooms, the teachers, the friends, and the buildings). This study wanted to fix that blind spot.

2. The Experiment

The researchers asked 237 student nurses (mostly women, aged 19–33) to fill out a survey. Think of this survey as a "Happiness Thermometer." They asked the students to rate four main things:

• The Curriculum: Is the lesson plan like a good recipe?
• The Faculty: Are the teachers like helpful, friendly gardeners?
• Social Interaction: Do the students and teachers get along like a happy family?
• The School Environment: Is the "soil" (buildings, labs, library) rich and healthy, or is it rocky and dry?

3. The Surprising Findings

The researchers used some math (statistics) to see which of these four things mattered the most. Here is what they discovered:

🏆 The Winner: The School Environment (The "Soil")

This was the most important factor.

• The Metaphor: Imagine trying to grow a beautiful flower in a pot filled with concrete. No matter how good the gardener is, the plant will struggle.
• The Reality: If the classrooms are broken, the library is empty, or the labs lack equipment, students feel unhappy. The study found that fixing the physical school (better buildings, working computers, clean labs) had the biggest impact on making students happy. It was the single strongest predictor of satisfaction.

🤝 The Runner-Up: Social Interaction (The "Water")

This was the second most important factor.

• The Metaphor: Even with good soil, a plant needs water to thrive. Social interaction is the water.
• The Reality: When teachers are friendly, listen to students, and when students feel they belong to a community, satisfaction goes up. It's not just about what is taught, but how people treat each other. A supportive relationship between a tutor and a student acts like a safety net, making students feel brave enough to ask questions and learn.

📚 The "Good, But Not Enough" Factors: Teachers and Curriculum

• The Teachers (Faculty): Students loved having good teachers. In the initial check, happy students had happy teachers. However, when the researchers looked at the whole picture (including the broken buildings), the teachers' influence became slightly less dominant than the physical environment. It's like having a world-class chef (teacher) trying to cook in a kitchen with no stove (environment); the chef is great, but the results are still limited.
• The Lessons (Curriculum): Students wanted relevant lessons. While they agreed that a good curriculum is important, it wasn't the main reason they were happy or unhappy. They were willing to overlook a slightly boring lesson plan if the school building was nice and the teachers were kind.

4. The Takeaway (The "So What?")

The study concludes that if you want to make nursing students happy and successful, you can't just focus on the textbooks or hire more teachers. You have to fix the garden first.

The Recipe for Success:

1. Fix the Infrastructure: Pour money into buildings, libraries, and labs. Make the "soil" fertile.
2. Foster Friendship: Create programs where teachers and students hang out, mentor each other, and build trust.
3. Update the Menu: Keep the lessons fresh and relevant, but know that this works best after the environment is fixed.

In a Nutshell

If you are a nursing student in Ghana, this study is telling you: "Your happiness depends heavily on having a nice place to study and feeling like you belong."

If you are a school administrator, the message is: "Don't just buy new textbooks; fix the leaking roof, buy new computers, and tell your teachers to smile more. That is the secret sauce to a successful nursing program."

Technical Summary

1. Problem Statement

While student satisfaction is a critical metric for evaluating higher education institutions, existing research on nursing education in Ghana has predominantly focused on clinical learning experiences. There is a significant gap in literature regarding student nurses' satisfaction with the academic programme as a whole (encompassing curriculum, faculty, environment, and social dynamics). This lack of data impedes the ability of educational administrators to formulate evidence-based strategies for improving programme delivery, student retention, and the overall quality of healthcare workforce preparation.

2. Methodology

• Study Design: A quantitative, cross-sectional study design.
• Setting: Two public Nursing and Midwifery Training Colleges (NMTCs) in the Eastern Region of Ghana offering the Registered General Nursing (RGN) programme.
• Population & Sampling:
  • Target Population: 485 student nurses (2nd and 3rd years).
  • Sample Size: Calculated using Yamane's formula (219), adjusted by 10% for non-response, resulting in a target of 241 respondents.
  • Technique: Systematic random sampling was employed to select participants from the 2nd and 3rd-year cohorts.
  • Final Sample: 237 valid responses were analyzed (95.7% response rate).
• Instrument: The Nursing Student Satisfaction Scale (NSSS), a validated instrument based on the Curriculum, Faculty, Social Interaction, and Environment (CFSE) model.
  • Subscales: Curriculum (9 items), Faculty (8 items), Social Interaction (6 items), Learning Environment (7 items).
  • Measurement: 6-point Likert scale (1 = Not satisfied at all to 6 = Very satisfied).
  • Reliability: The instrument demonstrated high internal consistency (Cronbach's $\alpha$ = 0.96).
• Data Analysis:
  • Software: SPSS Version 27.
  • Correlation: Spearman's Rho was used to assess associations between variables due to ordinal data.
  • Regression: Hierarchical multiple linear regression was used to predict overall satisfaction, controlling for the specific school attended.
  • Assumptions: Linearity, homoscedasticity, and multicollinearity (VIF < 10) were met. Although normality of residuals was violated, the large sample size (>200) justified the robustness of the regression coefficients.

3. Key Contributions

• Contextual Gap Filling: This is one of the first studies in Ghana to specifically investigate predictors of satisfaction with the academic programme rather than just clinical placements.
• Model Application: It applies the CFSE model to the Ghanaian nursing education context, validating its relevance in a developing nation setting.
• Predictive Hierarchy: The study identifies a hierarchy of influence, revealing that while all factors correlate with satisfaction, School Environment and Social Interaction are the primary independent predictors, whereas Curriculum and Faculty roles, while correlated, did not remain significant predictors in the multivariate regression model.

4. Key Results

• Demographics: The sample was predominantly female (85.7%), with a mean age of 22.47 years. 53.2% were in their second year of study.
• Correlation Analysis: All independent variables showed strong, significant positive correlations ($p < 0.001$) with overall satisfaction:
  • Social Interaction ($r = 0.680$)
  • Faculty Role ($r = 0.650$)
  • Curriculum ($r = 0.583$)
  • School Environment ($r = 0.670$)
• Regression Analysis (Predictors):
  • Model 1 (School only): Explained 15.3% of the variance.
  • Model 2 (Full Model): Explained 55.5% of the total variance in satisfaction ($R^2_{adj} = 0.551$).
  • Significant Predictors: After controlling for the school, only two variables remained statistically significant:
    1. School Environment: ($\beta = 0.354, p = 0.000$) – The strongest predictor.
    2. Social Interaction: ($\beta = 0.291, p = 0.001$).
  • Non-Significant Predictors: Curriculum ($\beta = 0.078, p = 0.286$) and Faculty Role ($\beta = 0.119, p = 0.176$) did not significantly predict overall satisfaction in the multivariate model, suggesting their influence is mediated by the environment and social dynamics.

5. Significance and Implications

• Infrastructure is Paramount: The finding that the School Environment is the highest predictor suggests that physical infrastructure (libraries, laboratories, classrooms, emergency exits) and resource availability are foundational to student satisfaction. Without these, other pedagogical improvements may fail to yield satisfaction.
• Social Dynamics: The significance of Social Interaction highlights the critical role of the tutor-student relationship, peer support, and a democratic, non-hostile learning atmosphere.
• Policy Recommendations:
  • Funding: Nursing training colleges require increased funding to upgrade physical infrastructure and learning materials.
  • Mentorship: Institutions should implement structured mentorship programs and group activities to foster positive social interactions.
  • Holistic Review: While curriculum review is necessary, administrators must prioritize the "ecosystem" of the school (environment + social relations) to effectively boost student satisfaction and, by extension, academic performance and retention.
• Clinical Impact: Improved student satisfaction is linked to better academic performance and reduced burnout, ultimately leading to a more competent and motivated nursing workforce and improved patient care outcomes.