Causes of Academic Failure among Nursing Students

Background: Education is the most hopeful discipline which provide pathway for a purposeful and productive life. The progress in any filed is achieved through education. Education is a complex process. Academic failure is the one of the main challenges which students face during academic years. Current study was conducted to identify the causes of academic failure among the nursing students and determine the correlation between these causes. Materials and Methods: A quantitative descriptive cross-sectional study design used to explore the causes of academic failure among the nursing students and correlation between these variables. A convenient sampling technique use to collect the data. Questionnaire distributed in 134 participants. SPSS version 24 was used for data analysis. Results: The mean score of question related to teacher behavior was 2.62 and the overall mean score was 2.62 ± 0.20. Lack of commitment to study was 2.23 and the overall mean score was 2.23 ± 0.22. Problem with learning environment mean 2.61 and the overall mean score 2.61 ± 0.26. The mean score of courses content and examination problem 2.52 and the overall mean score was 2.52 ± 0.32. The unsatisfying relation with family mean score 3.27 and the overall mean score was 3.27 ± 0.30. The future concerns related chosen field mean score was 2.64 and the overall mean score was 2.64 ± 0.20. Conclusion: Causes of student’s failure are the unsatisfied relation with the family and psychological problems of the students. There was positive correlation between all variables except the unsatisfied relation with family and future related concern to the chosen field of study.


Introduction
Education is the most hopeful discipline which provide pathway for a purposeful and productive life (1). The progress in any filed is achieved through education. Education is a complex process. A student faces many challenges during educational process. Academic failure is the one of the main challenge which students face during academic years (2). The academic achievements of student play important role to improve the quality of education. The students good perform in their studies produce quality graduates. So in future they took part in development of the country and become leader of that county (3). The academic performance can affect by absenteeism. The absence of students' nurses from classes and clinical areas has a bad impression on their performance and increases the studying length (4). Teacher behavior play very important role in the educational environment. It is the key component that contributes in the educational plans. Teacher behavior involves creating an environment for the learners and engaging them into study, so that they can able study specific things (5). It is observed that the teacher negative attitude is the cause of students' lower achievements. (6). Commitment is very important factor for students in their study. The individuals who are non-committed and disengaged with their work are always face failure there is research evidences that how the non-committed and careless individuals become unproductive and useless in future. (7). The academic achievements of the students are directly related to the parents. The parents provide support to their children which help them in their studies. The students which don't have a caring family or negative relation with family faces academic failure (8). The modern time is called the time of anxiety because of the challenges, lack of opportunities and over compaction. The students have anxiety and worries about their future. This causes the students to be overburdened (9). The study will provide opportunity to the institution to make policies and implement them which will help students to improve their academic performance. This study is important for the nursing profession as well as it verify that academic achievements are as important in nursing profession as skills. Nothing is more important for a student than paying attention to study and get a bright future. This study will help the nursing students to assess reason which causes the hurdle in the academic achievement. The assessment of the causes which lead the students to failure, important because it can help the students to minimize these issues. Investigating the failure causes of nursing students will help the nursing

Significance:
Education is the most hopeful discipline which provide pathway for a purposeful and productive life. The progress in any filed is achieved through education. Education is a complex process. Academic failure is the one of the main challenges which students face during academic years.

Causes of Academic Failure
students to modify their pattern of studying and selfanalysis to identify the causes of their academic failure. It will help the nursing students to assess their weakness which are responsible for their poor academic performance. This study will also beneficial for the instructor to analyze those factors which causes the low achievements of the students. Aim of this study was to identify the causes of academic failure among the nursing students and determine the correlation between these causes.

Materials and Methods
A quantitative descriptive cross-sectional study design was used for this study. Study was conducted in Lahore School of Nursing, The University of Lahore, Pakistan. Target population was students of Lahore School of Nursing, The University of Lahore. The BSN and Post-RN BS nursing students were included in this study. The Likert scale questionnaire adopted from Dr. Ferda Aysan, Dr. G UInur Tannagen, and Dr. Abdurrahman Tanridgen, was used to collect the data. The questionnaire consists of close ended 68 questions. Pilot study was done to check reliability of instrument. The questionnaire was filled by 15 respondents. Reliability was 0.96. A convenient sampling technique was used to collect the data. Questionnaire distributed in 134 participants. SPSS version 24 was used for data analysis.

Results
Descriptive statistics such as percentages and frequencies were calculated to assess the causes and Pearson correlation test applied for assess correlation among variables. The data is summarized in terms of frequency and percentage. Table 1 elaborates the percentage and frequencies of demographic characteristics of the participants. Gender of the participants involved in the study were male n = 22 (16.4%) and female n = 112 (83.6%). The frequency of female is higher than male in this study. Out of 134 participants, majority of respondent was belong to the age group of 22-26. 25.4% n= 34 majority of participant 52.2% 2 nd year (BSN+ Post-RN) students. 29% n=40 chose nursing profession on parent and elder suggestion 8.2% due to job security and nobility of profession and 23% did not get admission other course while 38% n=52 had other reasons. The question related to teacher behavior give results that majority of respondent 41% (n=55) participants neutral about question that teacher's attitude is usually negative and 20.1% (n=27) were disagreed. 56% (n=75) participants agreed/strongly agreed that teacher are not trust worthy. 29.1% (n=39) disagreed about it. The 33.6% (n=45) participants neutral and 37.3% (n=50) agreed/ strongly agree that teacher are not democratic. 56.3% (n=76) respondent agreed/ strongly agreed and 27.6% (n=37) disagreed that there are no consistency between what they say and what they do. The future concerns related chosen field show that 54.8% (n=74) participants were agreed/strongly agreed that they not able to get honorable status in the society after graduation and 10.4% (n=14) disagreed. The 26.1I% (n=35) agreed/strongly agreed, 58.2% (n=78) respondents were neutral that they worried about future and 15.6% (n=21) disagreed/strongly disagreed. The 51.2% (n=70) participants were agreed/strongly agreed that there's no guarantee to find job after graduation while 16.4% (n=22) disagreed. The 66.4% (n=89) participants were agreed that they won't be able to get high economic status after graduation and 17.9% (n=24) disagreed. The 44.8% (n=66) participants were agreed that they don't have definite career plans for the future and 20.8% (n=28) disagreed/strongly disagreed.

Discussion
The aim of the study was determine the causes of academic failure of nursing students and assess the correlation between these causes. In the current study the 16.4% (n=22) participants were male nursing students and 83.6% (n=112) participants were female students. Female ratio is greater than male ratio. The similar result was funded in another study which was conducted to assess the academic performance of the undergraduate nursing students. In that study the female participants 80.0% while the male participants were 20.0%. So female ratio was greater than male (10). To determine the correlation between the variables the Pearson Product moment correlations were used. The results of the test show that there was significant relationship between most of variables. Only few variables were non-significant. The first variable in the table is the teaching behavior (TB) positively correlated with the other variables such as the lack of commitment to the study (LC), problem with learning environment (PLE), positively related with the problem with content subject and examination (PCSE), psychological problem of students (PS). But it did no correlated to the unsatisfying relation with the family (URF) and Future concern related to chosen field of study (FCF). Problem with the learning environment (PLE) was positively correlated to the all other variable but it is negatively correlated with the variable unsatisfying relation with the family (URF). The problem with learning environment (PLE) is highly correlated with the variable future concern to the chosen field of study (FCF). The Psychological problems of the students (PS) were positively correlated with all other variables. The variable unsatisfied relation with the family (URF) negatively correlated to the teaching behavior (TB), problem with learning environment (PLE). The last variable future concern related to chosen field of study (FCF) was positively related to the all the variable except the teaching behavior (TB). The future concern to the chosen field of study was negatively related to the Teaching behavior. Another study gives the similar results were the all variables have positively correlated with each other only two factor the problem with the learning environment and the unsatisfied relation with the family were having no relation. Similarly there is no significant relation between the teaching behavior and the future concern related to chosen field of study (11). The study show that the unsatisfying relation with family was the highest cause of academic failure of students with mean score 3.27 and the overall mean score was 3.27 ± 0.30. Another study gives the similar results that family related problem are the highest causes of the academic failure of the students (8).
The Psychological problems of the students was the second highest causes of students failure with the mean score 2.81 and the overall mean score was 2.81 ± 0.19. The similar results obtained in another study in which the psychological problems of the students are the cause of students' lower achievements with the mean score 3.54 ± 0.86. The psychological problems of the students directly affect the students study outcomes (6). The third leading causes of the academic failure were problem with learning environment and teaching behavior with the mean score of 2.62 and 2.61 the overall mean score was 2.62 ± 0.20 and 2.62± 0.26. In another study results show that the student having the problem in their learning environment and the attitude of the instructor lead to ward the academic failure of students (12). The other causes includes future concerns related chosen field with the mean score 2.60 and the overall mean score was 2.60 ± 0.20. A study show the similar results that future concern about the selected filed causes the anxiety and failure in the students the total mean score was 2.06 ± 0.87 (9). The least causes of the academic failure related to lack of commitment to study was with mean 2.23 and the overall mean score was 2.23 ± 0.22 and the problem with content subject and examination was 2.42 and the overall mean score was 2.42 ± 0.23. The similar results show in another study that these factor have lower effect on students study outcomes (13).

Conclusion
This study was conducted to determine causes of academic failure among nursing students and the correlation among these variables. The study shows that the overall main causes of students' failure are the unsatisfied relation with the family and psychological problems of the students. There is positive correlation between the all variables except the unsatisfied relation with family, future related concern to the chosen field of study.