1. Background

The educational environment (EE) refers to everything that surrounds an educational institution that represents the climate within the classrooms, department, and even the institution in general [1]. It contains learners’ viewpoints about infrastructures, learning opportunities, faculty skills, attitudes, and their peer’s socialization [1–5]. It has a crucial role in enhancing students’ growth, competency, critical thinking, independence, sense of mental wellbeing, and self-confidence [3]. Students’ satisfaction, academic success, and effective curriculum and instructors are the major indicators of teaching and learning quality and are related to several outcomes [4–6]. Besides EE influences how, why, and what students learn, which is vital in the success of the educational program [7].

A qualitative study conducted in Canada showed that confidence and competencies of educators, nursing students’ clinical experiences, subjectively evaluating the students’, poorly qualified instructors who lacked knowledge, skill, and teaching experience, poor relationships among instructors, staff nurses, and students’ were reported as the main challenges in nursing students’ in the clinical setting [8, 9]. A similar study done at Iranian University in 2015 showed that students’ perception about their theoretical education and clinical skills needs careful attention to the selection and recruitment of practical instructors by controlling their educational performances and clinical skills, and availing teaching equipment and facilities. It also revealed that the knowledge of instructors was not up to date and unskilled instructors were assigned for practical courses [10, 14].

Another qualitative study from a Norwegian University showed a shortage of teaching and learning tools, infrastructures, facilities, equipment, and standard procedures. The study also showed that expectations, feedback, and relationships as well as poor resources in the faculty and organization of the curriculum were known as factors that affect the students’ perception of their clinical skill learning environment [11].

In Sub-Saharan Africa, more reforms are needed to increase the capacity of educators and mentors responsiveness of curricula, strong regulatory frameworks, and availability of infrastructures and resources. Universities are responsible for the dissemination and transferring of knowledge, and providing specialized human resources [12, 13].

In Ethiopia, the role of higher education is the backbone for the country’s development efforts towards eradication of poverty and improving the vision of quality and employability of the university graduates. Thus, changing attention to quality, lead to change the schools into honest learning environments like quality-focused school supervision, internal school governance, increased students’ involvement, and school-community partnerships are among the priority focus [14]. There may be cultural and other determinants of how individuals view different qualitative aspects of a given EE, but perceived ratings report their perceptions [15].

The educational climate in nursing schools affects the quality and effectiveness of education [16]. Many qualitative studies have shown that there is a discrepancy between the views of students for class lectures and clinical attachments. It also appears unsupportive for their learning, mostly because of their teachers’ behavior [17]. The challenges and solutions in nursing education are common within the countries. There is a recognized association between positive EE and the development of learning capabilities of students’, performance and satisfaction [16, 18].

The goals of nursing education are mainly to equip nursing students with the required knowledge, attitude, skills, and professional ethics that will help them to solve health and health-related problems of the communities. Students’ comments’ are very important for the success of the educational environment [19]. Teachers play a vital role in promoting any educational system. Learning in the clinical teaching environment is considered to be central to the nursing education curriculum and for enabling nursing students to integrate their theoretical education into clinical practices. Therefore EE must be standardized to help nursing students’ to realize this combination [20]. While many studies were conducted in many countries in the world, currently little is known about nursing students’ perception towards their EE in Ethiopia. Thus, the present study was conducted to explore nursing students’ perception towards their EE in governmental Universities of southwest Ethiopia.

2. Materials and methods

An institution-based qualitative case study design was employed for this study seeks to provide a rich understanding of the study phenomenon contextually by researchers work. It is a better approach to understand the deep insight into the phenomenon of interest in the context of the case. In-depth investigation of small number of units at a point in time were done. Accordingly, a total of 8 participants(4 males and 4 females) were selected from Southwest Government Universities (two from Jimma University, two from Mizan Tepi University, two from Welkitie University and two from Mettu University) were selected purposively. Twelve class representatives from each university were contacted through the representative of students union and selected as key informants assuming that they had adequate information about the educational environment because of their closeness to university and department affairs. Using a convenient sampling technique, the sample size were determined by data saturation. Also we had considered resource constraints. All of the participants were year four students, and age groups between 21 to 33. Data was collected by four experienced interviewers from April 9 to 23/2019 through face-to-face in-depth interviews in the silent and private rooms. A semi-structured interview guide, digital recorder, and field note were used to capture interview data. An initial probe during the first interview was primarily directed to the respondent to expand or explain some of his/ her answers as appropriate to the flow of the interview. The time needed for each interview session was between forty-five minutes and an hour.

Interview data were transcribed and translated from local languages to English verbatim on daily basis, to guide the subsequent interviews. Field notes were summarized daily in English to prepare for coding. Data were analyzed using the conventional content analysis approach. Accordingly, to identify the topics, codification of the text, emerge codes, and creation of the categories, each text was read again and again carefully to advance a common understanding of the vital statements. Then, meaning units about participants’ experiences of nursing education, existing problems, and challenges were extracted from the transcriptions. The meaning units were abstracted by summarizing the vital statements’ and labeled as codes. The respondents’ speeches and secret concepts were used for coding, and then the codes were compared for matches and differences. Accordingly, the classification of codes was carried out. Finally, four themes were emerged based on the results. Experts were also asked to review the themes to reach a mutual agreement on related codes and the classifications of the data. Finally, the interview result was written by compiling memos, quotes, and analyzed data, and presented with narrative descriptions.

The ethical clearance with reference number GHRPGD/501/2019 was obtained from the Institutional Review Board (IRB) of Jimma University, Institute of Health, and submitted to the concerned bodies. Informed verbal consent was obtained for the digital recording of an interview before beginning any formal interview. The Code of participants was used for all participants in data records (field notes, interview transcripts, and translated data). The transcripts were devoid of real names or places thereby ensuring the complete anonymity of the participants. Hard data (printed, translated, transcripts, and field notes) were stored in a private room. Electronic versions of these documents were stored on password-protected computers.

3. Results

The perception of the educational environment was explored by the experience of the respondents. The main themes that emerged from the qualitative analysis of nursing students’ perception of their educational environment were related to curriculum, instructors, organizations, and students’ (S1 Table). The results for various categories within the themes were presented and illustrate the findings with citations from the interviews.

4. Discussion

The educational environment is the cornerstone for the better productivity of higher educational institutions. A less conducive educational environment reduces the performance of students and a reason for the poor quality of education. Currently, throughout the world, there is limited information about nursing students’ perception of their educational environment [6, 7]. Thus the present study explored nursing students’ opinions towards their educational environment in governmental Universities of southwest Ethiopia (S1 Table).

This study showed that the contents of the current nursing curriculum inadequately addressed the need of the profession and it is not to the standard. Some courses are redundant and unrelated to the nursing profession like civics. The participants believed that hours given for the theory were more than the hours allotted for clinical practice. Besides, the study showed a lack of uniformity with block and semester-based delivery of courses. The curriculum was haphazardly implemented during a block-based system. Thus, the participants recommended shifting all the block courses to the semester-based delivery system and the pressing need for nursing curriculum revision. This study had similar findings with studies conducted at the Kuate University of Saud Arabia, a Private University of Malaysia, and a qualitative study conducted in Iran [5, 10, 11].

The current study also revealed that students felt nursing instructors had inadequate knowledge and skills to teach nursing students, particularly in the clinical area. The majority of respondents reported that some instructors are unethical, biased in students’ evaluation, preparing examinations out of the learning objectives especially from the internet, and had not respected their students’. The result also showed that most instructors were using one-way teaching methods; merely relied on projectors or LCD and they did not use alternative teaching aids in the event of power failure. Moreover, participants also reported that some instructors are authoritarian; they did not follow the course syllabus or give reading materials on time, or show the students’ assessment results. The result of this study was different from a study conducted in three Countries including Aga khan university medical college of Karachi in Sweden, Pakistan in Shifa College of Nursing, and Addis Ababa University, Ethiopia [4, 12, 17]. The possible explanation of the discrepancies might be due to differences in the level of instructors teaching knowledge and skills, behaviors, and characteristics. Also, the difference might be due to a lack of close follow-up and supportive supervision from concerned bodies for those instructors who had inadequate knowledge and skill and harsh behavior.

The result also exposed the lack of teaching and learning facilities/instructional materials like smart classes, desktop computers, LCD, learning videos, manuals, whiteboard markers, and flip charts. Also, the study brought to light poor infrastructure in the study areas like poor internet access, inadequate lecture halls, tutorial classes, and an insufficient support system for needy students’. Lack of support was described as inadequate medications in the clinic, poor transportation, and lack of support system in the hospital practices. These findings are contrary to the study conducted in four Countries namely, University College of Southeast Norway, Students’ perception of the educational environment of medical schools in Korea, Iran, and Addis Ababa University, Ethiopia [5, 7, 8, 17]. The discrepancy might be due to differences like medical students’ perceptions of their educational environments compared to nursing students’. It might also be due to the nursing profession is more reliant on skills that demand many skill learning equipment and materials that expose them to a higher expectation. Moreover, the availability of well-established infrastructures and teaching-learning materials are directly associated with the development of countries and regions. Thus, in a developed country like Korea, these kinds of problems may not exist.

The result of the present study showed that lack of motivation to learn from many students’, unethical behaviors in some students, low academic performance, and disinterest in the profession. The participants recommended that students’ should be motivated for learning new things, studying hard to attain high grades and love, and respect their profession. These results are in line with many studies conducted in different countries in the world [4–10, 13, 17, 21].

5. Conclusion

Even though the participants were optimistic about their educational environment, most of them rated it as not conducive for teaching and learning. The study also revealed that there was poor implementation practice of the curriculum, poor institutions students support system, inadequate skill, and knowledge in some instructors, scarce instructional materials or teaching aids and infrastructures, scarcity of equipment’s for practicing in skill development lab and clinical settings, and lack of motivation from the students’. Thus, Universities should design follow-up and supportive supervision mechanisms for instructors who have knowledge and skill gap and misbehaving towards their students’. In addition monitoring and evaluation of curriculum implementation practices, enhancing the University infrastructures and instructional materials, creating conducive practical areas, improving the motivation of students’ and about adequate students’ support system are important. Also, the Minister of Science and Higher Education of Ethiopia should consider curriculum revision from a block-based to a semester-based approach.

Supporting information

Acknowledgments

We would like to acknowledge Jimma University, Mettu University, Wolkite University and Mizan Tepi University for their permission to undertake the study. Our heartfelt thanks go to the study participants who gave valuable information.