Career Aspirations and Motivations: Perceptions of Nursing and Midwifery Students at Kpembe Nursing and Midwifery Training College, Savannah Region

Career Aspirations and Motivations: Perceptions of Nursing and Midwifery Students at Kpembe Nursing and Midwifery Training College, Savannah Region | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Career Aspirations and Motivations: Perceptions of Nursing and Midwifery Students at Kpembe Nursing and Midwifery Training College, Savannah Region John Kwame Agbenyeavu, Yahaya Mohammed Sadat, Yaw Appiah Sarkodie This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7425909/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Nursing and midwifery are critical to health system performance, particularly in regions with limited resources and persistent workforce shortages. Students’ motivations, career aspirations, and perceived barriers strongly influence retention and professional satisfaction. In Ghana’s Savannah Region, these dynamics are shaped by cultural and socioeconomic constraints. This study explored the factors influencing students’ career choices at Kpembe Nursing and Midwifery Training College to inform workforce development strategies. Methods An explanatory sequential mixed-methods study was conducted. A cross-sectional survey of 307 first-year students established prevalent trends. Subsequent in-depth interviews with 14 purposively selected students explained these trends. Quantitative data were analyzed using descriptive statistics; qualitative data underwent thematic analysis, with integration occurring at the interpretation stage. Results Career satisfaction was high, with over 91% of students reporting satisfaction and 82.7% indicating they would choose their career again. Passion for patient care (46.0%) was the strongest motivator. Despite reporting substantial barriers, including financial constraints (41.5%) and lack of career guidance (22.5%), students demonstrated high resilience. Qualitative data revealed that this paradox was sustained by strong intrinsic motivation, altruism, and robust peer and spiritual support systems. Career aspirations centered on hospital practice (39.7%) and specialization (36.6%), with 94.5% intending to remain in the profession. Conclusion The study reveals a resilient cohort of students whose strong intrinsic motivation and protective support systems buffer against significant systemic barriers. To sustain this resilience and reduce attrition, institutional strategies must move beyond addressing financial hardship alone. Fostering robust mentorship, formalizing peer support, and integrating resilience-building into the curriculum are critical to developing a motivated and future-ready health workforce for the region. Career motivation Aspiration perceptions Nursing and Midwifery Career Choice in Healthcare Ghana Figures Figure 1 Figure 2 Background The nursing and midwifery professions are cornerstone pillars of healthcare systems worldwide. They contribute significantly to patient care, public health outcomes, and the overall quality of healthcare delivery within communities (Hassmiller & Wakefield, 2022 ). The perceptions, motivations, and career aspirations of individuals pursuing these careers not only shape their personal trajectories but also influence the sustainability and effectiveness of the healthcare workforce (Mentag, 2020 ). In an era marked by workforce shortages, an aging population, and evolving disease burdens, understanding the aspirations of nursing and midwifery students has become increasingly relevant for building a competent and committed workforce (Jones & Dolsten, 2024 ). In contexts such as the Savannah Region of Ghana, students’ decisions to pursue nursing and midwifery are often shaped by a complex interplay of cultural, societal, and economic factors. Personal motivations, such as a genuine desire to help others and improve community health, are commonly reported drivers (Kakyo et al., 2024 ; Haaland et al., 2023 ). At the same time, external influences, including family expectations, societal perceptions of the profession, and economic incentives, can significantly impact career choices (Stadnicka & Zarzycka 2023 ; Ait Ali et al., 2024 ). In regions where cultural norms strongly shape professional aspirations, it is crucial to examine how these dynamics influence students’ decisions and expectations (Alanazi et al., 2024 ). The Kpembe Nursing and Midwifery Training College plays a vital role in preparing future healthcare providers in the Savannah Region. However, there is limited evidence on the motivations and career aspirations of its students, despite the college attracting a diverse cohort with varied backgrounds and life experiences. Understanding these aspirations is essential because students’ career goals often extend beyond immediate employment to include specialization, leadership, or community health roles (Taylor et al., 2019 ; Zhang et al 2022 ). If such aspirations are not aligned with training opportunities and workforce needs, the result could be dissatisfaction, attrition, or underutilization of skills within the health system (Hu et al 2022 ). Family support, gender expectations, and societal attitudes further complicate students’ career pathways. In some communities, traditional gender roles may constrain perceptions of nursing and midwifery as respected professions, while in others, societal recognition may enhance their appeal (Prosen, 2022 ). Moreover, the rapid evolution of healthcare, driven by technological advancements and changing patient needs, demands that training programs equip students with both clinical competence and adaptive skills to thrive in multidisciplinary teams (Prosen, 2022 ; WHO, 2020 ). Against this backdrop, the problem addressed by this study is the lack of systematic evidence on the motivations, perceptions, and career aspirations of nursing and midwifery students at Kpembe Nursing and Midwifery Training College in the Savannah Region. Without such evidence, it is difficult for policymakers, educators, and healthcare leaders to design curricula and support systems that both meet students’ professional goals and respond to the pressing workforce needs of the region. This study therefore seeks to explore the motivations, aspirations, and external influences shaping the career choices of nursing and midwifery students at Kpembe. By filling this gap, the findings aim to inform educational planning and workforce development strategies that foster student satisfaction, reduce attrition, and ultimately strengthen the delivery of quality healthcare in the Savannah Region. The questions that guide this study are: How satisfied are nursing and midwifery students with their career choice? What motivational factors influence nursing and midwifery students’ career aspirations and professional development? What barriers affect students’ pursuit of nursing and midwifery career aspirations, and what are their implications for education and workforce retention? Methods Study design This study employed an explanatory sequential mixed methods design (Creswell & Plano Clark, 2017). In this design, the quantitative method was the primary priority and was implemented first. A descriptive cross-sectional survey was administered to 307 first-year students to map the prevalence and patterns of motivational factors influencing their career aspirations. This was followed sequentially by a qualitative phase, where in-depth interviews were conducted with a purposively selected subsample of 14 participants. The purpose of this design was to use the qualitative data to elaborate on and explain the initial quantitative results. This approach was chosen because the survey could identify what factors influenced students and their prevalence, but could not adequately explain why these factors were important or how students experienced them. Study area The study was conducted at the Nursing and Midwifery Training College, Kpembe (See Fig. 1). Nursing and Midwifery Training College, Kpembe is one of the Nursing and Midwifery Training Colleges in the Savannah Region established in December 2008 as one of the Ministry of Health Training Institutions to train Nurses and Midwives. The school is located in Kpembe, a community located 2 kilometres East of the Salaga Municipality. Academic activities started in February, 2008 with only the Nurse Assistant, Clinical (NAC) programme. In 2012, the Post-NAC/NAP midwifery program was introduced to complement the NAC program. This was followed by the introduction of Registered General Nursing in 2013, and Registered Midwifery in 2014. This brought the full complement of the academic program in the school to four, and gave true meaning to the current name of the school, “Nursing and Midwifery Training”. The school has recently added two (2) Bachelor of science programs to the list of programmes to be run by the school. This has made the Kpembe Nursing and Midwifery Training school the only training school within the Northern enclave running Bachelor of Science in Nursing and Public Health Nursing. the school currently have a total students’ population of 2,500. From a very humble beginning, the school is now considered one of the best nursing training colleges in the country with enviable infrastructure, human resource, and a very good track record of success in the licensing exams. At the end of the 2023/2024 academic year, the school demoted and sacked a number of students due to poor academic performance. Study Population and Sampling The target population consisted of all nursing and midwifery students enrolled in the 2024/2025 academic year. Eligibility criteria included being a registered student at the college, having completed at least one semester of training, and willingness to provide informed consent. Students on leave of absence were excluded. Two levels of sampling method were employed. First of all, each class was considered as a homogeneous stratum within and a heterogeneous stratum across. The proportion allocated to each stratum were sampled using systematic random sampling where the students in the class were ordered based on their siting position. An interval was calculated based on the proportion of the class and the sampling was done using the skip method. The study sampled a total of 307 students into the study. For the qualitative phase, a purposive subsample of survey respondents (n = 14) was selected for in-depth interviews to elaborate on key themes identified in the survey. Sampling continued until data saturation was achieved. According to Guest et al (2006), data saturation is typically achieved with approximately 12 to 15 participants in in-depth interviews. Data Collection Method Quantitative Data A structured self-administered questionnaire (Appendix 1) was developed based on existing literature on healthcare career motivations and contextualized to the Ghanaian nursing/midwifery training context. The tool covered demographic characteristics, initial motivations, challenges faced, and career aspirations. Face and content validity were established through pre-testing with 15 students from the same training college, who assessed the tool for clarity, relevance, and comprehensiveness. The questionnaire was pretested with this group to assess reliability and internal consistency. Qualitative Data An interview guide (Appendix 2) was used to conduct semi-structured in-depth interviews. The guide was informed by the quantitative findings to explore nuances behind survey responses, focusing on motivations, challenges, evolving perceptions, and career vision. Interviews were conducted face-to-face in a private setting within the college premises, lasting 30–45 minutes. With consent, interviews were audio-recorded and later transcribed verbatim. Data collection instruments The data collection instrument for this study consisted of two main components: a structured survey and semi-structured interview guides. The structured survey included Likert-scale questions to quantitatively assess the career aspirations and motivations of first-year nursing and midwifery students. It captured demographic information and specific perception metrics. The semi-structured interview guides facilitated in-depth qualitative discussions, allowing participants to share personal insights and experiences related to their career goals. This mixed-methods approach ensures a comprehensive understanding of students' perspectives, combining numerical data with rich qualitative narratives. Data Integration in the Explanatory Sequential Design This study employed an explanatory sequential mixed-methods design (Creswell & Clark, 2017 ). The core purpose of this design is to use the in-depth qualitative data to elaborate on, contextualize, and explain the initial quantitative results. Integration was systematically achieved through the following steps: Connecting (Instrument Development) : The quantitative survey data were analyzed to identify predominant trends and surprising results. These findings directly informed the development of the semi-structured interview guide , ensuring it probed into the reasons and lived experiences behind the key statistical trends. This connects the two phases at the point of instrument design for the qualitative phase. Building (Analysis) : Following the thematic analysis of the qualitative data, the findings were built upon the quantitative results. The qualitative themes were actively mapped onto the quantitative findings to seek explanation. For instance, we explored how and why students remained highly satisfied (a quantitative finding) despite facing significant financial constraints (another quantitative finding). Interpreting (Discussion) : The final, integrated interpretation is presented in the Discussion section. In this section, the qualitative evidence is explicitly used to interpret and explain the initial quantitative results, providing a more complete and nuanced understanding of the research problem. Data Processing and Management Quantitative data were coded and entered into SPSS version 27 for analysis. Descriptive statistics (frequencies, percentages, means, and standard deviations) were computed to summarize student characteristics and motivational factors. The internal consistency (reliability) of the scale items was assessed using Cronbach's alpha. Associations between demographic variables and motivational patterns were tested using chi-square tests at a 95% confidence interval. The qualitative data were analyzed using reflexive thematic analysis, following the systematic six-phase approach outlined by Braun and Clarke ( 2006 , 2022). This process was iterative and involved moving back and forth between the phases as our understanding of the data deepened. The analysis was conducted manually and involved the following phases: Familiarizing with the data : The research team repeatedly read the interview transcripts while listening to the audio recordings to ensure accuracy and immersion. Initial analytical notes and ideas were recorded during this phase. Generating initial codes : Two researchers independently conducted the initial coding on a subset of transcripts to enhance trustworthiness. Meaningful segments of data relevant to the research questions were systematically identified and labeled with descriptive codes. The researchers then met to compare their codes, discuss discrepancies, and refine a unified coding framework. This framework was then applied to the entire dataset. Searching for themes : The collated codes were analyzed and sorted into potential overarching themes. This involved organizing codes into clusters based on shared patterns of meaning that captured something important about the data in relation to the research questions. Mind maps and thematic maps were used to visualize the relationships between codes and candidate themes. Reviewing themes : This phase involved a two-level check. At Level 1, the candidate themes were reviewed against the coded data extracts to ensure they formed a coherent pattern. At Level 2, the validity of the candidate thematic map was reviewed in relation to the entire dataset, ensuring the themes accurately reflected the meanings evident in the data as a whole. This process led to the refinement, splitting, combining, or discarding of themes. Defining and naming themes : A detailed analysis was conducted for each theme to determine its core essence and significance. Clear definitions and concise, informative names were developed for each theme to immediately convey its core idea to the reader. Producing the report : The final step involved weaving the analytic narrative together, selecting vivid and compelling data extracts to illustrate each theme, and contextualizing the analysis within the existing literature. This process resulted in the five major themes reported in the findings. Ensuring Trustworthiness in the Qualitative Component The rigor and credibility of the qualitative findings were ensured by adhering to the framework of trustworthiness proposed by Lincoln and Guba ( 1985 ). The following strategies were employed throughout the research process: Credibility (Internal Validity) : To ensure the findings are an accurate representation of the participants' experiences, several strategies were utilized. Prolonged engagement with the data was achieved through repeated reading of transcripts and immersion in the audio recordings. Peer debriefing was conducted through regular discussions among the research team to challenge assumptions and refine interpretations of the emerging codes and themes. Furthermore, member checking was performed by sharing a summary of the initial themes with a subset of participants, who confirmed that the findings resonated with their experiences. Dependability (Reliability) : To ensure the research process was logical, traceable, and documented, an audit trail was maintained. These included records of raw data, transcripts, field notes, and the iterative versions of the codebook and thematic maps, providing a transparent record of the analytical decisions made from the data to the findings. Confirmability (Objectivity) : To demonstrate that the findings were shaped by the participants and not researcher bias, reflexivity was practiced. The researchers maintained a reflexive journal to acknowledge and bracket preconceptions. Additionally, investigator triangulation was achieved through the independent coding of transcripts by two researchers, with discrepancies resolved through consensus, ensuring the analysis was grounded in the data. Transferability (External Validity) : To enable readers to assess the potential transferability of the findings to other contexts, thick, rich description is provided in the findings section, using direct and vivid quotes from participants. The specific context of the study, the characteristics of the participants, and the data collection process are also detailed. Findings Quantitative Findings This section provides details of the findings from this work including the socio-demography of participants, students’ satisfaction with career choices, Key motivational factors for choosing career, Barriers to pursuing career, Career aspirations in nursing practice and Motivation to stay in the healthcare profession. Table 1 Socio-demographic of the participants Variable Frequency (n = 307) Percentage Age in years 17–21 149 48.50% 22–26 150 48.80% 27–31 8 2.60% Gender Male 73 23.80% Female 234 76.20% Marital Status Single 298 97.10% Married 8 2.60% Divorced 1 0.30% Religion Islam 195 63.50% Christianity 112 36.50% Programme of Study RGN 75 24.40% Midwifery 74 24.10% NAC 52 16.90% Public Health Nurse 49 16.00% Degree Nurse 57 18.60% Previous family members pursuing nursing Yes 186 60.60% No 121 39.40% Family member in health profession Yes 174 56.70% No 133 43.30% The table 1 above summarizes the demographic characteristics of participants. As seen, majority of participants were between the ages of 17–26 years, with 48.5% aged 17–21 and 48.8% aged 22–26. Only small proportion (2.6%) were aged 27–31 years. In terms of gender, females predominated, making up 76.2% of the sample, while males constituted 23.8%. Regarding marital status, nearly all participants were single (97.1%), with very few married (2.6%) or divorced (0.3%). The religious composition showed that 63.5% identified as Muslims and 36.5% as Christians. Participants were enrolled in various programmes: 24.4% were Registered General Nursing (RGN) students, 24.1% in Midwifery, 18.6% in Degree Nursing, 16.9% in Nurse Assistant Clinical (NAC), and 16.0% in Public Health Nursing. A majority of participants (60.6%) reported having a family member who previously pursued nursing, and 56.7% indicated having a family member currently in the health profession. Table 2 Descriptive statistics, scale and item reliability test of study constructs Construct No. of Items Mean Responses Standard Deviation Mean values under 95% confidence interval Cronbach’s alpha Study Scale Items 11 2.25 0.47 [2.20–2.31] 0.701 Table 2 summarizes the descriptive statistics and reliability of the study constructs. The 11 scale items in the questionnaire, produced a mean response of 2.25 (SD = 0.47), with values ranging between 2.20 and 2.31 at the 95% confidence interval. The internal consistency of the scale was acceptable, as indicated by a Cronbach’s alpha of 0.701. This result confirms the instrument demonstrated sufficient reliability for assessing students’ career motivations and aspirations in this context. Table 3 Students’ satisfaction with career choice Variable Frequency Percent Satisfaction with career choice Very dissatisfied 3 1% Dissatisfied 6 2% Neutral 18 5.9% Satisfied 140 45.6% Very satisfied 140 45.6% Choosing career again Yes 254 82.7% No 32 10.4% Not Sure 21 6.8% Table 3 above presents the summary of career satisfaction among participants. As shown, majority of students expressed a high level of satisfaction with their chosen career. Specifically, 45.6% reported being very satisfied and another 45.6% indicated they were satisfied , while only 5.9% were neutral . A small proportion were either dissatisfied (2%) or very dissatisfied (1%). When asked if they would choose the same career again, 82.7% responded yes , 10.4% said no , and 6.8% were not sure . These findings suggest a strong overall satisfaction and commitment to their chosen career path among the students. Key Motivational Factors Table 4: Key motivational factors for choosing career Variable Frequency Percent Motivation for choosing career Personal interest 125 31.3% Family influence 39 9.8% Job security 23 5.8% Financial stability 29 7.3% Passion for patient care 184 46.0% Influence of factors on career decision 1 - NI 2 - N 3 - HI Mean SD N(%) N(%) N(%) Personal interest 98(31.9) 100(32.6) 109(35.5) 2.04 0.82 Family encouragement 123(40.1) 91(29.6) 93(30.3) 1.90 0.83 Financial incentives 191(62.2) 65(21.2) 51(16.6) 1.54 0.76 Career progression opportunities 102(33.2) 106(34.5) 99(32.2) 1.99 0.81 Societal perception 189(61.6) 71(23.1) 47(15.3) 1.54 0.75 Source: Field Data (2025) [1 – NI = Not Influential; 2 – N = Neutral ; 4 – I = Influential; 3 – HI = Highly Influential; SD – Standard Deviation] Table 4 outlines the main factors shaping respondents’ career choices. Passion for patient care emerged as the most frequently reported motivator (46.0%), followed by personal interest (31.3%). Other factors, such as family influence (9.8%), financial stability (7.3%), and job security (5.8%), were less prominent. Mean scores further contextualize these findings. Personal interest recorded the highest mean rating (M = 2.04, SD = 0.82), underscoring its strong influence on decision-making. Opportunities for career progression (M = 1.99, SD = 0.81) and family encouragement (M = 1.90, SD = 0.83) were also rated as important. Conversely, extrinsic considerations such as financial incentives (M = 1.54, SD = 0.76) and societal perception (M = 1.54, SD = 0.75) carried relatively lower weight. Together, these results highlight that, intrinsic motivations, such as passion and personal interest, were stronger drivers than external or material considerations. Barriers to pursuing Career The table 5 below describes the Barriers to pursuing Career among participants, majority of participants (68.4%) reported encountering challenges when choosing their career, while 31.6% did not face any challenges. The most commonly cited barrier was financial constraints (41.5%), followed by lack of career guidance (22.5%). Other reported challenges included limited opportunities for specialization (14.7%), work-life balance concerns (12.4%), and societal stigma (8.9%). Despite these barriers, 73.0% of participants indicated they received adequate support in pursuing their career. However, 17.9% reported no support , and 9.1% were unsure about the level of support they received. These findings suggest that while many students face significant challenges, a strong support system plays a crucial role in enabling them to pursue their chosen career path. Table 5 : Barriers to pursuing career Variable Frequency Percent Presence of challenges in choosing career Yes 210 68.4% No 97 31.6% Challenges in choosing career Financial constraints 107 41.5% Societal stigma 23 8.9% Lack of career guidance 58 22.5% Limited opportunities for specialization 38 14.7% Work-life balance concerns 32 12.4% Presence of adequate support Yes 224 73.0% No 55 17.9% Not Sure 28 9.1% Source: Field Data (2025) Table 6: Career aspirations in nursing practice Variable Frequency Percent Future aspirations with career choice Specialisation 119 36.6% Teaching 21 6.5% Research 25 7.7% Hospital practice 129 39.7% Community practice 31 9.5% Future in present career Yes 290 94.5% No 3 1.0% Not Sure 14 4.6% Source: Field Data (2025) Table 6 highlights participants’ career aspirations. The most common aspiration was hospital practice (39.7%), followed closely by specialization (36.6%). Smaller proportions of students aspired to community practice (9.5%), research (7.7%), and teaching (6.5%). When asked about their long-term outlook, the vast majority (94.5%) expressed their intention to continue in nursing, with only 1.0% stating they did not envision a future in the field. A small proportion (4.6%) remained uncertain. These findings indicate that most participants are not only clear about their professional trajectories but also demonstrate strong commitment to building sustainable careers within the health sector. Factors Motivating Career Retention Among Nursing and Midwifery Students Table 7 : Motivation to stay in the healthcare profession Theme Frequency (n) Percentage (%) Clarification/Examples 1. Passion for Patient Care 81 26.4% "Saving lives," "Love for humanity," "Joy in recovery." 2. Financial Support 61 19.9% Tuition help, salary increases, fee reduction. 3. Professional Growth 46 15.0% Career advancement, specialization, skill development. 4. Supportive Work Environment 37 12.1% Mentorship, teamwork, institutional support. 5. Recognition & Respect 31 10.1% Appreciation from patients/society, respect for the profession. 6. Family/Social Encouragement 25 8.1% Parental wishes, family support, role models. 7. Academic Success 15 4.9% Passing exams, self-confidence, hard work. 8. Work-Life Balance 8 2.6% Manageable schedules, mental health prioritization. 9. Ethical Practice 7 2.3% Confidentiality, compassionate care. 10. Systemic Improvements 6 2.0% Fair pay, policy changes, employment opportunities. 11. Nothing 5 1.6% Nothing will encourage me 12. Faith-based 4 1.3% Allah’s blessing 13. Job Security 3 1.0% Employment after graduation Others (Unique/Diverse) 12 3.9% "The dressing," "Comparisons to seniors" Source: Field Data (2025) Table 7 summarizes the factors motivating nursing and midwifery students to remain in the healthcare profession. The most frequently reported motivation was a passion for patient care (26.4%), with participants describing fulfillment from “saving lives,” “love for humanity,” and “joy in recovery.” This underscores the intrinsic value students attach to caregiving and the emotional satisfaction derived from patient outcomes. Financial support followed as the second most cited motivator (19.9%), including desires for tuition assistance, fair remuneration, and fee reduction. These findings reflect the economic challenges faced by students and highlight the importance of financial incentives in sustaining workforce commitment. Professional growth (15.0%) was another key factor, with students emphasizing career advancement, specialization, and skill development as essential for long-term engagement. A supportive work environment (12.1%) and recognition and respect (10.1%) were also frequently mentioned, demonstrating the role of mentorship, teamwork, and social appreciation in promoting job satisfaction and retention. Additional motivators included family and social encouragement (8.1%), academic success (4.9%), and work–life balance (2.6%). A few respondents mentioned ethical practice (2.3%), systemic improvements (2.0%), and faith-based motivation (1.3%), while a small number (1.6%) reported that “nothing” would encourage them to remain in the profession. Qualitative Findings The qualitative phase explored the lived experiences, motivations, and challenges shaping the career aspirations of nursing and midwifery students at Kpembe Nursing and Midwifery Training College. Thematic analysis yielded five major themes and corresponding sub-themes, illustrating how personal, institutional, and sociocultural factors intersect to influence students’ professional journeys. (See Figure 2) Theme 1: Initial Motivations and Career Choice Drivers Students’ motivations for pursuing nursing and midwifery were deeply rooted in personal encounters, empathy, and early professional exposure. Personal and Family Health Experiences: Many participants described how personal or family health experiences inspired their career choice. Witnessing illness, childbirth, or inadequate healthcare within their communities awakened a desire to help. One student shared, “Honestly, I chose nursing after my grandmother got very sick. I saw how the nurses cared for her, and it really touched me. I wanted to be that person for someone else.” (P1). Another reflected, “When I was in SHS, my elder sister gave birth at home because the midwife wasn’t available. I felt helpless. That day, I promised myself I would become a midwife so I can help other women.” (P2). Altruistic Values and Compassionate Calling: Intrinsic compassion and the drive to serve humanity were dominant motivators. Students repeatedly emphasized “saving lives” and “helping others” as central to their professional identity. One respondent stated, “I believe every woman deserves a safe birth. That’s something I truly value… …saving lives, especially of mothers and babies.” (P2). Early Clinical Exposure Impact: Experiential learning during internships strengthened students’ career commitment. For some, these encounters were transformative: “During our clinical at the district hospital, I helped an elderly woman with her wound dressing. She was scared, but I reassured her. Later she thanked me and said I reminded her of her daughter. That moment stayed with me.” (P1). Others noted that such interactions confirmed their calling and fostered a sense of belonging in the profession. Theme 2: Evolving Professional Identity and Aspirations As students progressed, their career goals evolved toward specialization and community impact. Shift Toward Specialization: Several respondents expressed aspirations beyond general practice. Some desired to specialize in pediatrics, trauma, or public health nursing. “I came in wanting to be a general nurse, but now I am fascinated by mental health nursing and want to pursue that.” (P11). “My goal is to specialize in oncology nursing. I feel a strong pull to support patients and families through that journey.” (P13) Preference for Clinical Practice: A strong preference for hands-on clinical work emerged, with students viewing direct patient care as the most rewarding aspect of their training. "I love working directly with people. Research or academic teaching feels less immediate." (P9). Community Service Orientation: A commitment to serving underserved populations was a recurring theme. Participants emphasized a desire to work in rural areas, reflecting both moral obligation and awareness of community needs. "My long-term goal is to return to my village and be the nurse I wished we had when my cousin was sick." (P14). Theme 3: Structural Challenges and Barriers Despite high motivation, students faced several systemic and personal challenges. Financial Constraints: Economic hardship was the most pervasive barrier. Participants described difficulty affording study materials, transportation, and accommodation. "It has been tough. Sometimes I worry about paying school fees or buying supplies. It makes focusing on studies difficult." (P9). Academic and Clinical Workload: Students found the demands of training physically and emotionally taxing. "I didn't expect it to be so demanding. The long hours, the emotional stress, it's not easy." (P1). Another added, "The combination of academic pressure and clinical responsibilities is overwhelming at times." (P10). Societal Stigma and Gender Stereotypes: Cultural perceptions of nursing and midwifery as low-status or female-oriented careers were also noted. A male student remarked, “ Yes, especially as a male nursing student. Some people think nursing is just for women. I just try to educate them... ” (P1). Others faced community pressure to abandon their studies for marriage or different professions. Theme 4: Support Systems and Coping Mechanisms Support networks, both social and institutional, played a critical role in sustaining students’ motivation and resilience. Family and Peer Support Networks: Emotional encouragement and occasional financial assistance from family members were frequently cited. "We form study groups, and that's my support system. We cry together and we push each other." (P10). "My uncle supports(me sometimes... I also talk to my classmates; we encourage each other." (p1) Spiritual Resilience and Personal Faith: Religious faith and prayer provided psychological comfort. Participant acknowledged praying as offering a lot of help. “Praying helps me a lot,” (P2), while another said, I believe God called me to do this work. On hard days, I hold onto that." (P11). Institutional Support Systems: Tutors and mentors provided moral guidance, even in informal capacities. One participant noted "The encouragement from one particular tutor has been invaluable. She believes in me more than I believe in myself sometimes." (P12). Others acknowledged external assistance, such as church support or scholarships, that alleviated some burdens. Theme 5: Educational and Institutional Support Needs Students provided thoughtful recommendations to enhance their academic and professional experiences. Enhanced Mentorship and Career Guidance: Participants emphasized the need for structured mentorship and exposure to diverse nursing career paths. "Especially mentorship. It's hard to know where you're heading without guidance." said one student (P1). Financial Aid and Resource Access: Requests for expanded financial support and improved access to learning resources were consistent. "More financial aid would help. Also... better accommodation, we live far from campus." (P2). "Access to a reliable internet connection for research would make a huge difference in our learning." (P10). Curriculum and Practical Training Enhancement: Students advocated for a more practice-oriented curriculum and mental health support. As one participant noted: "I think more practical exposure... would help. Also, the curriculum could focus more on specializations..." one stated (P1). Another emphasized, "More mental health support is needed. Many students are stressed but don't talk about it." (P4). The qualitative findings reveal a complex but hopeful narrative. Students’ career motivations are primarily altruistic, strengthened by real-life experiences and faith. However, their progress is challenged by financial and institutional barriers. The presence of strong social and spiritual support systems fosters resilience, yet students call for improved mentorship, curriculum relevance, and financial assistance. Collectively, these insights underscore the importance of holistic educational reform and sustained institutional investment to nurture a motivated, skilled, and resilient nursing and midwifery workforce in Ghana’s Savannah Region. Discussion This study provides novel evidence on the motivations, barriers, and aspirations of nursing and midwifery students in the Savannah Region of Ghana by employing an explanatory sequential mixed-methods design. While previous research has often examined student career motivations in urban settings, this study delves into the realities of a rural, low-resource context, using qualitative insights to explain the quantitative trends. The integrated findings reveal a narrative of strong intrinsic motivation that is both challenged by systemic barriers and sustained by remarkable resilience, with significant implications for health workforce planning in sub-Saharan Africa. Explaining the Drivers of Career Choice and Satisfaction The quantitative data established an overwhelmingly high level of career satisfaction (91.2%) and a strong desire to choose the same career again (82.7%). The qualitative findings provide the crucial explanation for this commitment, revealing that it is deeply rooted in formative, personal experiences rather than abstract ideals. The survey identified 'passion for patient care' as the dominant motivator (46.0%), and the interviews gave life to this statistic. Participants described pivotal moments, such as witnessing a grandmother's care ("I wanted to be that person for someone else" - P1) or a sister's traumatic birth ("I felt helpless... I promised myself I would become a midwife" - P2). This suggests that the high quantitative satisfaction scores are underpinned by a powerful, empathetic calling forged in personal and family health experiences, which also explains the strong influence of having family members in healthcare (60.6%). Resolving the Paradox of Barriers and Sustained Commitment A central quantitative finding was the paradoxical coexistence of high satisfaction with significant reported barriers, most notably financial constraints (41.5%). The qualitative data are essential to resolve this paradox, as they uncover the active resilience strategies students employ, which the survey alone could not capture. While participants confirmed the pervasive financial strain, stating, "It has been tough. Sometimes I worry about paying school fees..." (P9) , they simultaneously described robust coping mechanisms. These included relying on peer support networks ("We form study groups... We cry together and we push each other" - P10) and spiritual faith ("Praying helps me a lot" - P2; "I believe God called me to do this work" - P11). This integration demonstrates that the quantitative measure of high satisfaction is maintained not in the absence of barriers, but through the presence of dynamic, protective support systems that buffer against adversity, aligning with resilience theory (Garcia-Dia et al., 2013 ; Thomas & Revell, 2016 ). Contextualizing Career Aspirations and Institutional Gaps The survey clearly mapped students' future trajectories, showing strong aspirations for hospital practice (39.7%) and specialization (36.6%), with minimal interest in research (7.7%) or teaching (6.5%). The qualitative findings powerfully corroborated and explained this clinical preference. Participants expressed a direct desire for hands-on work, with one noting, "I love working directly with people. Research or academic teaching feels less immediate" (P9) . Furthermore, the qualitative data illuminated the real-world consequences of the quantitative finding that 22.5% lacked career guidance. Students explicitly called for "structured mentorship" (P1) and lamented that "it's hard to know where you're heading without guidance," directly explaining how the lack of guidance quantified in the survey manifests as uncertainty and a constrained view of potential career paths. Implications for Policy and Practice Taken together, these integrated findings underscore the need for support strategies that are as multifaceted as the students' experiences. While expanding financial aid is critical to address the primary barrier of affordability, this must be paired with interventions that bolster the identified resilience factors. Formalizing peer support networks and integrating resilience-building into the curriculum can sustain motivation. Furthermore, establishing structured mentorship programs is essential to address the identified gap in career guidance, helping students navigate their clear aspirations for specialization and clinical practice. Strengths and Limitations The primary strength of this study is its explanatory sequential mixed-methods design, which used qualitative data to explain quantitative trends, providing a nuanced understanding of student experiences. However, the cross-sectional design precludes causal inference, and the single-site focus may limit generalizability, though it offers valuable insights for similar rural contexts. A potential limitation of the sequential design is that the quantitative survey was fixed prior to the qualitative inquiry, though this was mitigated by designing the qualitative phase explicitly to explain the initial results. Future longitudinal studies are recommended to track the evolution of motivations and their impact on career retention. Conclusion This study reveals that nursing and midwifery students in the Savannah Region are a resilient cohort. Their journey is not defined by an absence of challenges, but by a powerful sense of purpose that is activated and sustained through personal support systems and spiritual faith. By using qualitative evidence to explain quantitative trends, this study moves beyond simply identifying barriers and satisfaction to explaining how they coexist. The findings provide a robust evidence base for developing holistic educational and policy interventions aimed at sustaining this resilience and building a motivated, future-ready health workforce for Ghana and similar contexts. Declarations Ethics approval and consent to participate The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki (2013 revision) . Ethical approval was sought from the Ghana Health Service Ethics Review Committee (GHS-ERC); the application is currently under review (Protocol ID: Pending). Administrative permission was granted by the Kpembe Nursing and Midwifery Training College. All participants provided written and oral informed consent after the study's objectives, procedures, benefits, and minimal risks were thoroughly explained. Participation was entirely voluntary, with no impact on academic standing. Participants retained the right to withdraw at any time without penalty. To ensure confidentiality, all electronic data are stored on password-protected devices, and paper records were securely destroyed after data compilation. The researchers affirm that all procedures were conducted with utmost regard for participant welfare and data protection standards while awaiting the final ethical clearance. Consent for publication Not applicable Availability of data and materials No datasets were generated or analysed during the current study. Competing interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors received no financial support for the research, authorship, and/or publication of this article. Authors' contributions Conceptualization, JKA; formal analysis, investigation, and data curation, JKA, YMS and YSA; formal data analysis and results interpretation, SAY and JK; writing and original draft preparation SAY, JKA and YMS; and writing, review, and editing JKA, YMS and YSA. All authors have read and agreed to the published version of the manuscript. Acknowledgements The authors acknowledge Mr. Adomako-Asare Gabriel of the Department of Health Information Management, University of cape Coast Ghana. We are appreciating the efforts of all the respondents and also the staff and management of Kpembe Nursing Training College. References Ait Ali, D., Ncila, O., Ouhhamou, S., Rizzo, A., Chirico, F., & Khabbache, H. (2024). Motivations Driving Career Choices: Insights From a Study Among Nursing Students. SAGE Open Nursing , 10 . https://doi.org/10.1177/23779608241255876 Alanazi, S., Wiechula, R., & Foley, D. (2024). Perceptions of followership among nurses: A qualitative study. International Journal of Nursing Studies Advances , 7 (September 2023), 100222. https://doi.org/10.1016/j.ijnsa.2024.100222 Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology , 3 (2), 77-101. Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. Creswell, J. W., & Clark, V. L. P. (2017). Designing and conducting mixed methods research . Sage publications. Garcia-Dia, M. J., DiNapoli, J. M., Garcia-Ona, L., Jakubowski, R., & O'Flaherty, D. (2013). Concept analysis: resilience. Archives of psychiatric nursing , 27 (6), 264-270. Glerean, N., Hupli, M., Talman, K., & Haavisto, E. (2019). Perception of nursing profession – focus group interview among applicants to nursing education. Scandinavian Journal of Caring Sciences , 33 (2), 390–399. https://doi.org/10.1111/scs.12635 Haaland, G. H., Øygarden, O., Storm, M., & Mikkelsen, A. (2023). Understanding registered nurses’ career choices in home care services: a qualitative study. BMC Health Services Research , 23 (1), 1–12. https://doi.org/10.1186/s12913-023-09259-0 Hassmiller, S. B., & Wakefield, M. K. (2022). The Future of Nursing 2020–2030: Charting a path to achieve health equity. Nursing Outlook , 70 (6), S1–S9. https://doi.org/10.1016/j.outlook.2022.05.013 Hu, H., Wang, C., Lan, Y., & Wu, X. (2022). Nurses’ turnover intention, hope and career identity: the mediating role of job satisfaction. BMC Nursing , 21 (1), 1–11. https://doi.org/10.1186/s12912-022-00821-5 Jones, C. H., & Dolsten, M. (2024). Correction to: Healthcare on the brink: navigating the challenges of an aging society in the United States (npj Aging, (2024), 10, 1, (22), 10.1038/s41514-024-00148-2). Npj Aging , 10 (1), 41514. https://doi.org/10.1038/s41514-024-00153-5 Kakyo, T. A., Xiao, L. D., & Chamberlain, D. (2024). The role of motivation in the initiation and maintening mentoring relationships among nurses and midwives. International Nursing Review , October 2023 . https://doi.org/10.1111/inr.12977 L. N., M., J. M, K., M, Y., & B. M, N. (2014). ICT-Integration in Higher Education and Student Behavioral Change: Observations at University of Arusha, Tanzania. American Journal of Educational Research , 2 (11A), 30–38. https://doi.org/10.12691/education-2-11A-5 LINCOLN, Y., & Guba, E. (1985). Naturalistic Inquiry. [sl] Sage Publications. Maurud, S., Børøsund, E., & Moen, A. (2022). Gender and ethnicity’s influence on first-year nursing students’ educational motivation and career expectations: A cross-sectional study. Nursing Open , 9 (3), 1667–1678. https://doi.org/10.1002/nop2.1191 Mbalinda, S. N., Najjuma, J. N., Gonzaga, A. M., Livingstone, K., & Musoke, D. (2024). Understanding and barriers of professional identity formation among current students and recent graduates in nursing and midwifery in low resource settings in two universities: a qualitative study. BMC Nursing , 23 (1), 1–10. https://doi.org/10.1186/s12912-024-01795-2 Mentag, N. M. (2020). NSUWorks The Lived Experiences of Thriving Nursing Students . 85 . Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: Meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences , 7 (2), 41–52. https://doi.org/10.3390/admsci7020017 Prosen, M. (2022). Nursing students’ perception of gender-defined roles in nursing: a qualitative descriptive study. BMC Nursing , 21 (1), 1–11. https://doi.org/10.1186/s12912-022-00876-4 Stadnicka, S. K., & Zarzycka, D. (2023). Perception of the professional self-image by nurses and midwives. Psychometric adaptation of the Belimage questionnaire. BMC Nursing , 22 (1), 1–14. https://doi.org/10.1186/s12912-023-01564-7 Taylor, S., Iacobelli, F., Luedke, T., Matthews, P. A., Monge, M., Cooper, J., Moreira, J., Grippo, P., Girotti, J., Molina, Y., Yanez, B., & Simon, M. A. (2019). Improving health care career pipeline programs for underrepresented students: Program design that makes a difference. Progress in Community Health Partnerships: Research, Education, and Action , 13 (Special Issue), 113–122. https://doi.org/10.1353/cpr.2019.0044 Thomas, L. J., & Revell, S. H. (2016). Resilience in nursing students: An integrative review. Nurse education today , 36 , 457-462. WHO. (2020). State of the World’s Nursing . Who Publications. Yarbrough, S., Martin, P., Alfred, D., & McNeill, C. (2017). Professional values, job satisfaction, career development, and intent to stay. Nursing Ethics , 24 (6), 675–685. https://doi.org/10.1177/0969733015623098 Zhang, J., Shields, L., Ma, B., Yin, Y., Wang, J., Zhang, R., & Hui, X. (2022). The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study. BMC Medical Education , 22 (1), 1–9. https://doi.org/10.1186/s12909-022-03609-y Additional Declarations No competing interests reported. Supplementary Files Appendix1.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 30 Jan, 2026 Reviews received at journal 30 Jan, 2026 Reviewers agreed at journal 05 Jan, 2026 Reviews received at journal 11 Dec, 2025 Reviewers agreed at journal 02 Dec, 2025 Reviewers agreed at journal 13 Nov, 2025 Reviewers invited by journal 21 Oct, 2025 Submission checks completed at journal 10 Oct, 2025 First submitted to journal 10 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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2","display":"","copyAsset":false,"role":"figure","size":191448,"visible":true,"origin":"","legend":"\u003cp\u003eSummary of qualitative findings\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eSource:\u003c/strong\u003e\u003c/em\u003e Authors Analysis (2025)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7425909/v1/9c0666e487a6fc218520bd6c.png"},{"id":94990515,"identity":"75ae46c3-39d4-4839-9406-e20bedee957b","added_by":"auto","created_at":"2025-11-03 07:17:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2623687,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7425909/v1/09fdf78a-aca3-4818-8122-2757e2dadb5e.pdf"},{"id":94874684,"identity":"0bbfe428-a89b-459e-89af-5ffedaa6d7e1","added_by":"auto","created_at":"2025-10-31 15:32:31","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":20133,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7425909/v1/387af9cb4e18a96bb4cfc17a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eCareer Aspirations and Motivations: Perceptions of Nursing and Midwifery Students at Kpembe Nursing and Midwifery Training College, Savannah Region\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eThe nursing and midwifery professions are cornerstone pillars of healthcare systems worldwide. They contribute significantly to patient care, public health outcomes, and the overall quality of healthcare delivery within communities (Hassmiller \u0026amp; Wakefield, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). The perceptions, motivations, and career aspirations of individuals pursuing these careers not only shape their personal trajectories but also influence the sustainability and effectiveness of the healthcare workforce (Mentag, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In an era marked by workforce shortages, an aging population, and evolving disease burdens, understanding the aspirations of nursing and midwifery students has become increasingly relevant for building a competent and committed workforce (Jones \u0026amp; Dolsten, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn contexts such as the Savannah Region of Ghana, students\u0026rsquo; decisions to pursue nursing and midwifery are often shaped by a complex interplay of cultural, societal, and economic factors. Personal motivations, such as a genuine desire to help others and improve community health, are commonly reported drivers (Kakyo et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Haaland et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). At the same time, external influences, including family expectations, societal perceptions of the profession, and economic incentives, can significantly impact career choices (Stadnicka \u0026amp; Zarzycka \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Ait Ali et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). In regions where cultural norms strongly shape professional aspirations, it is crucial to examine how these dynamics influence students\u0026rsquo; decisions and expectations (Alanazi et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe Kpembe Nursing and Midwifery Training College plays a vital role in preparing future healthcare providers in the Savannah Region. However, there is limited evidence on the motivations and career aspirations of its students, despite the college attracting a diverse cohort with varied backgrounds and life experiences. Understanding these aspirations is essential because students\u0026rsquo; career goals often extend beyond immediate employment to include specialization, leadership, or community health roles (Taylor et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Zhang et al \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). If such aspirations are not aligned with training opportunities and workforce needs, the result could be dissatisfaction, attrition, or underutilization of skills within the health system (Hu et al \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eFamily support, gender expectations, and societal attitudes further complicate students\u0026rsquo; career pathways. In some communities, traditional gender roles may constrain perceptions of nursing and midwifery as respected professions, while in others, societal recognition may enhance their appeal (Prosen, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Moreover, the rapid evolution of healthcare, driven by technological advancements and changing patient needs, demands that training programs equip students with both clinical competence and adaptive skills to thrive in multidisciplinary teams (Prosen, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; WHO, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAgainst this backdrop, the problem addressed by this study is the lack of systematic evidence on the motivations, perceptions, and career aspirations of nursing and midwifery students at Kpembe Nursing and Midwifery Training College in the Savannah Region. Without such evidence, it is difficult for policymakers, educators, and healthcare leaders to design curricula and support systems that both meet students\u0026rsquo; professional goals and respond to the pressing workforce needs of the region.\u003c/p\u003e\u003cp\u003eThis study therefore seeks to explore the motivations, aspirations, and external influences shaping the career choices of nursing and midwifery students at Kpembe. By filling this gap, the findings aim to inform educational planning and workforce development strategies that foster student satisfaction, reduce attrition, and ultimately strengthen the delivery of quality healthcare in the Savannah Region. The questions that guide this study are:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eHow satisfied are nursing and midwifery students with their career choice?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat motivational factors influence nursing and midwifery students\u0026rsquo; career aspirations and professional development?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat barriers affect students\u0026rsquo; pursuit of nursing and midwifery career aspirations, and what are their implications for education and workforce retention?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy design\u003c/h2\u003e\u003cp\u003eThis study employed an explanatory sequential mixed methods design (Creswell \u0026amp; Plano Clark, 2017). In this design, the quantitative method was the primary priority and was implemented first. A descriptive cross-sectional survey was administered to 307 first-year students to map the prevalence and patterns of motivational factors influencing their career aspirations. This was followed sequentially by a qualitative phase, where in-depth interviews were conducted with a purposively selected subsample of 14 participants. The purpose of this design was to use the qualitative data to elaborate on and explain the initial quantitative results. This approach was chosen because the survey could identify \u003cem\u003ewhat\u003c/em\u003e factors influenced students and their prevalence, but could not adequately explain \u003cem\u003ewhy\u003c/em\u003e these factors were important or \u003cem\u003ehow\u003c/em\u003e students experienced them.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy area\u003c/h3\u003e\n\u003cp\u003eThe study was conducted at the Nursing and Midwifery Training College, Kpembe (See Fig.\u0026nbsp;1). Nursing and Midwifery Training College, Kpembe is one of the Nursing and Midwifery Training Colleges in the Savannah Region established in December 2008 as one of the Ministry of Health Training Institutions to train Nurses and Midwives. The school is located in Kpembe, a community located 2 kilometres East of the Salaga Municipality. Academic activities started in February, 2008 with only the Nurse Assistant, Clinical (NAC) programme. In 2012, the Post-NAC/NAP midwifery program was introduced to complement the NAC program.\u003c/p\u003e\u003cp\u003eThis was followed by the introduction of Registered General Nursing in 2013, and Registered Midwifery in 2014. This brought the full complement of the academic program in the school to four, and gave true meaning to the current name of the school, \u0026ldquo;Nursing and Midwifery Training\u0026rdquo;. The school has recently added two (2) Bachelor of science programs to the list of programmes to be run by the school. This has made the Kpembe Nursing and Midwifery Training school the only training school within the Northern enclave running Bachelor of Science in Nursing and Public Health Nursing. the school currently have a total students\u0026rsquo; population of 2,500.\u003c/p\u003e\u003cp\u003eFrom a very humble beginning, the school is now considered one of the best nursing training colleges in the country with enviable infrastructure, human resource, and a very good track record of success in the licensing exams.\u003c/p\u003e\u003cp\u003eAt the end of the 2023/2024 academic year, the school demoted and sacked a number of students due to poor academic performance.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\n\u003ch3\u003eStudy Population and Sampling\u003c/h3\u003e\n\u003cp\u003eThe target population consisted of all nursing and midwifery students enrolled in the 2024/2025 academic year. Eligibility criteria included being a registered student at the college, having completed at least one semester of training, and willingness to provide informed consent. Students on leave of absence were excluded.\u003c/p\u003e\u003cp\u003eTwo levels of sampling method were employed. First of all, each class was considered as a homogeneous stratum within and a heterogeneous stratum across. The proportion allocated to each stratum were sampled using systematic random sampling where the students in the class were ordered based on their siting position. An interval was calculated based on the proportion of the class and the sampling was done using the skip method. The study sampled a total of 307 students into the study.\u003c/p\u003e\u003cp\u003eFor the qualitative phase, a purposive subsample of survey respondents (n\u0026thinsp;=\u0026thinsp;14) was selected for in-depth interviews to elaborate on key themes identified in the survey. Sampling continued until data saturation was achieved. According to Guest et al (2006), data saturation is typically achieved with approximately 12 to 15 participants in in-depth interviews.\u003c/p\u003e\n\u003ch3\u003eData Collection Method\u003c/h3\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eQuantitative Data\u003c/h2\u003e\u003cp\u003eA structured self-administered questionnaire (Appendix 1) was developed based on existing literature on healthcare career motivations and contextualized to the Ghanaian nursing/midwifery training context. The tool covered demographic characteristics, initial motivations, challenges faced, and career aspirations. Face and content validity were established through pre-testing with 15 students from the same training college, who assessed the tool for clarity, relevance, and comprehensiveness. The questionnaire was pretested with this group to assess reliability and internal consistency.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eQualitative Data\u003c/h2\u003e\u003cp\u003eAn interview guide (Appendix 2) was used to conduct semi-structured in-depth interviews. The guide was informed by the quantitative findings to explore nuances behind survey responses, focusing on motivations, challenges, evolving perceptions, and career vision. Interviews were conducted face-to-face in a private setting within the college premises, lasting 30\u0026ndash;45 minutes. With consent, interviews were audio-recorded and later transcribed verbatim.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData collection instruments\u003c/h3\u003e\n\u003cp\u003eThe data collection instrument for this study consisted of two main components: a structured survey and semi-structured interview guides. The structured survey included Likert-scale questions to quantitatively assess the career aspirations and motivations of first-year nursing and midwifery students. It captured demographic information and specific perception metrics. The semi-structured interview guides facilitated in-depth qualitative discussions, allowing participants to share personal insights and experiences related to their career goals. This mixed-methods approach ensures a comprehensive understanding of students' perspectives, combining numerical data with rich qualitative narratives.\u003c/p\u003e\n\u003ch3\u003eData Integration in the Explanatory Sequential Design\u003c/h3\u003e\n\u003cp\u003eThis study employed an explanatory sequential mixed-methods design (Creswell \u0026amp; Clark, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The core purpose of this design is to use the in-depth qualitative data to elaborate on, contextualize, and explain the initial quantitative results. Integration was systematically achieved through the following steps:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eConnecting (Instrument Development)\u003c/b\u003e: The quantitative survey data were analyzed to identify predominant trends and surprising results. \u003cb\u003eThese findings directly informed the development of the semi-structured interview guide\u003c/b\u003e, ensuring it probed into the reasons and lived experiences behind the key statistical trends. This connects the two phases at the point of instrument design for the qualitative phase.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eBuilding (Analysis)\u003c/b\u003e: Following the thematic analysis of the qualitative data, the findings were built upon the quantitative results. The qualitative themes were actively mapped onto the quantitative findings to seek explanation. For instance, we explored \u003cem\u003ehow\u003c/em\u003e and \u003cem\u003ewhy\u003c/em\u003e students remained highly satisfied (a quantitative finding) despite facing significant financial constraints (another quantitative finding).\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eInterpreting (Discussion)\u003c/b\u003e: The final, integrated interpretation is presented in the Discussion section. In this section, the qualitative evidence is explicitly used to interpret and explain the initial quantitative results, providing a more complete and nuanced understanding of the research problem.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eData Processing and Management\u003c/h2\u003e\u003cp\u003eQuantitative data were coded and entered into SPSS version 27 for analysis. Descriptive statistics (frequencies, percentages, means, and standard deviations) were computed to summarize student characteristics and motivational factors. The internal consistency (reliability) of the scale items was assessed using Cronbach's alpha. Associations between demographic variables and motivational patterns were tested using chi-square tests at a 95% confidence interval.\u003c/p\u003e\u003cp\u003eThe qualitative data were analyzed using reflexive thematic analysis, following the systematic six-phase approach outlined by Braun and Clarke (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2006\u003c/span\u003e, 2022). This process was iterative and involved moving back and forth between the phases as our understanding of the data deepened. The analysis was conducted manually and involved the following phases:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eFamiliarizing with the data\u003c/b\u003e: The research team repeatedly read the interview transcripts while listening to the audio recordings to ensure accuracy and immersion. Initial analytical notes and ideas were recorded during this phase.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eGenerating initial codes\u003c/b\u003e: Two researchers independently conducted the initial coding on a subset of transcripts to enhance trustworthiness. Meaningful segments of data relevant to the research questions were systematically identified and labeled with descriptive codes. The researchers then met to compare their codes, discuss discrepancies, and refine a unified coding framework. This framework was then applied to the entire dataset.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eSearching for themes\u003c/b\u003e: The collated codes were analyzed and sorted into potential overarching themes. This involved organizing codes into clusters based on shared patterns of meaning that captured something important about the data in relation to the research questions. Mind maps and thematic maps were used to visualize the relationships between codes and candidate themes.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eReviewing themes\u003c/b\u003e: This phase involved a two-level check. At Level 1, the candidate themes were reviewed against the coded data extracts to ensure they formed a coherent pattern. At Level 2, the validity of the candidate thematic map was reviewed in relation to the entire dataset, ensuring the themes accurately reflected the meanings evident in the data as a whole. This process led to the refinement, splitting, combining, or discarding of themes.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDefining and naming themes\u003c/b\u003e: A detailed analysis was conducted for each theme to determine its core essence and significance. Clear definitions and concise, informative names were developed for each theme to immediately convey its core idea to the reader.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eProducing the report\u003c/b\u003e: The final step involved weaving the analytic narrative together, selecting vivid and compelling data extracts to illustrate each theme, and contextualizing the analysis within the existing literature. This process resulted in the five major themes reported in the findings.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eEnsuring Trustworthiness in the Qualitative Component\u003c/h2\u003e\u003cp\u003eThe rigor and credibility of the qualitative findings were ensured by adhering to the framework of trustworthiness proposed by Lincoln and Guba (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e1985\u003c/span\u003e). The following strategies were employed throughout the research process:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eCredibility (Internal Validity)\u003c/b\u003e: To ensure the findings are an accurate representation of the participants' experiences, several strategies were utilized. \u003cb\u003eProlonged engagement\u003c/b\u003e with the data was achieved through repeated reading of transcripts and immersion in the audio recordings. \u003cb\u003ePeer debriefing\u003c/b\u003e was conducted through regular discussions among the research team to challenge assumptions and refine interpretations of the emerging codes and themes. Furthermore, \u003cb\u003emember checking\u003c/b\u003e was performed by sharing a summary of the initial themes with a subset of participants, who confirmed that the findings resonated with their experiences.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDependability (Reliability)\u003c/b\u003e: To ensure the research process was logical, traceable, and documented, an \u003cb\u003eaudit trail\u003c/b\u003e was maintained. These included records of raw data, transcripts, field notes, and the iterative versions of the codebook and thematic maps, providing a transparent record of the analytical decisions made from the data to the findings.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eConfirmability (Objectivity)\u003c/b\u003e: To demonstrate that the findings were shaped by the participants and not researcher bias, \u003cb\u003ereflexivity\u003c/b\u003e was practiced. The researchers maintained a reflexive journal to acknowledge and bracket preconceptions. Additionally, \u003cb\u003einvestigator triangulation\u003c/b\u003e was achieved through the independent coding of transcripts by two researchers, with discrepancies resolved through consensus, ensuring the analysis was grounded in the data.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eTransferability (External Validity)\u003c/b\u003e: To enable readers to assess the potential transferability of the findings to other contexts, \u003cb\u003ethick, rich description\u003c/b\u003e is provided in the findings section, using direct and vivid quotes from participants. The specific context of the study, the characteristics of the participants, and the data collection process are also detailed.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Findings","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003cdiv id=\"Sec14\" class=\"Section3\"\u003e\u003ch2\u003eQuantitative Findings\u003c/h2\u003e\u003cp\u003eThis section provides details of the findings from this work including the socio-demography of participants, students\u0026rsquo; satisfaction with career choices, Key motivational factors for choosing career, Barriers to pursuing career, Career aspirations in nursing practice and Motivation to stay in the healthcare profession.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic of the participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;307)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge in years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u0026ndash;21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e22\u0026ndash;26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48.80%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e27\u0026ndash;31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.60%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23.80%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e234\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76.20%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e298\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e97.10%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.60%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.30%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReligion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIslam\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e195\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChristianity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e112\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36.50%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProgramme of Study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRGN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.40%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMidwifery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.10%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNAC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.90%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePublic Health Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.00%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDegree Nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.60%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrevious family members pursuing nursing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e186\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60.60%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39.40%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily member in health profession\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56.70%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43.30%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe table 1 above summarizes the demographic characteristics of participants. As seen, majority of participants were between the ages of 17\u0026ndash;26 years, with 48.5% aged 17\u0026ndash;21 and 48.8% aged 22\u0026ndash;26. Only small proportion (2.6%) were aged 27\u0026ndash;31 years. In terms of gender, females predominated, making up 76.2% of the sample, while males constituted 23.8%.\u003c/p\u003e\u003cp\u003eRegarding marital status, nearly all participants were single (97.1%), with very few married (2.6%) or divorced (0.3%). The religious composition showed that 63.5% identified as Muslims and 36.5% as Christians.\u003c/p\u003e\u003cp\u003eParticipants were enrolled in various programmes: 24.4% were Registered General Nursing (RGN) students, 24.1% in Midwifery, 18.6% in Degree Nursing, 16.9% in Nurse Assistant Clinical (NAC), and 16.0% in Public Health Nursing.\u003c/p\u003e\u003cp\u003eA majority of participants (60.6%) reported having a family member who previously pursued nursing, and 56.7% indicated having a family member currently in the health profession.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDescriptive statistics, scale and item reliability test of study constructs\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConstruct\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo. of\u003c/p\u003e\u003cp\u003eItems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003cp\u003eResponses\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStandard\u003c/p\u003e\u003cp\u003eDeviation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMean values under\u003c/p\u003e\u003cp\u003e95% confidence interval\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCronbach\u0026rsquo;s\u003c/p\u003e\u003cp\u003ealpha\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudy Scale Items\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e[2.20\u0026ndash;2.31]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.701\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;2 summarizes the descriptive statistics and reliability of the study constructs. The 11 scale items in the questionnaire, produced a mean response of 2.25 (SD\u0026thinsp;=\u0026thinsp;0.47), with values ranging between 2.20 and 2.31 at the 95% confidence interval. The internal consistency of the scale was acceptable, as indicated by a Cronbach\u0026rsquo;s alpha of 0.701. This result confirms the instrument demonstrated sufficient reliability for assessing students\u0026rsquo; career motivations and aspirations in this context.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStudents\u0026rsquo; satisfaction with career choice\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercent\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSatisfaction with career choice\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVery dissatisfied\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDissatisfied\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSatisfied\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVery satisfied\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eChoosing career again\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e254\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e82.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot Sure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;3 above presents the summary of career satisfaction among participants. As shown, majority of students expressed a high level of satisfaction with their chosen career. Specifically, 45.6% reported being \u003cem\u003every satisfied\u003c/em\u003e and another 45.6% indicated they were \u003cem\u003esatisfied\u003c/em\u003e, while only 5.9% were \u003cem\u003eneutral\u003c/em\u003e. A small proportion were either \u003cem\u003edissatisfied\u003c/em\u003e (2%) or \u003cem\u003every dissatisfied\u003c/em\u003e (1%).\u003c/p\u003e\u003cp\u003eWhen asked if they would choose the same career again, 82.7% responded \u003cem\u003eyes\u003c/em\u003e, 10.4% said \u003cem\u003eno\u003c/em\u003e, and 6.8% were \u003cem\u003enot sure\u003c/em\u003e. These findings suggest a strong overall satisfaction and commitment to their chosen career path among the students.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eKey Motivational Factors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 4: Key motivational factors for choosing career\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"677\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMotivation for choosing career\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 216px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003ePersonal interest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 216px;\"\u003e\n \u003cp\u003e31.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eFamily influence\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 216px;\"\u003e\n \u003cp\u003e9.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eJob security\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 216px;\"\u003e\n \u003cp\u003e5.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eFinancial stability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 216px;\"\u003e\n \u003cp\u003e7.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003ePassion for patient care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 216px;\"\u003e\n \u003cp\u003e46.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfluence of factors on career decision\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1 - NI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2 - N\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3 - HI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003ePersonal interest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e98(31.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e100(32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e109(35.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eFamily encouragement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e123(40.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e91(29.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e93(30.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eFinancial incentives\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e191(62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e65(21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e51(16.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eCareer progression opportunities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e102(33.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e106(34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e99(32.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eSocietal perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e189(61.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e71(23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e47(15.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSource:\u003c/em\u003e\u003c/strong\u003e Field Data (2025)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e[1 \u0026ndash; NI\u003c/strong\u003e = Not Influential; \u003cstrong\u003e2 \u0026ndash; N\u0026nbsp;\u003c/strong\u003e= Neutral\u003cstrong\u003e; 4 \u0026ndash; I\u003c/strong\u003e = Influential; \u003cstrong\u003e3 \u0026ndash; HI\u0026nbsp;\u003c/strong\u003e= Highly Influential; \u003cstrong\u003eSD \u0026ndash;\u0026nbsp;\u003c/strong\u003eStandard Deviation]\u003c/p\u003e\n\u003cp\u003eTable 4 outlines the main factors shaping respondents\u0026rsquo; career choices. Passion for patient care emerged as the most frequently reported motivator (46.0%), followed by personal interest (31.3%). Other factors, such as family influence (9.8%), financial stability (7.3%), and job security (5.8%), were less prominent.\u003c/p\u003e\n\u003cp\u003eMean scores further contextualize these findings. Personal interest recorded the highest mean rating (M = 2.04, SD = 0.82), underscoring its strong influence on decision-making. Opportunities for career progression (M = 1.99, SD = 0.81) and family encouragement (M = 1.90, SD = 0.83) were also rated as important. Conversely, extrinsic considerations such as financial incentives (M = 1.54, SD = 0.76) and societal perception (M = 1.54, SD = 0.75) carried relatively lower weight. Together, these results highlight that, intrinsic motivations, such as passion and personal interest, were stronger drivers than external or material considerations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBarriers to pursuing Career\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe table 5 below describes the Barriers to pursuing Career among participants, majority of participants (68.4%) reported encountering challenges when choosing their career, while 31.6% did not face any challenges. The most commonly cited barrier was \u003cem\u003efinancial constraints\u003c/em\u003e (41.5%), followed by \u003cem\u003elack of career guidance\u003c/em\u003e (22.5%). Other reported challenges included \u003cem\u003elimited opportunities for specialization\u003c/em\u003e (14.7%), \u003cem\u003ework-life balance concerns\u003c/em\u003e (12.4%), and \u003cem\u003esocietal stigma\u003c/em\u003e (8.9%).\u003c/p\u003e\n\u003cp\u003eDespite these barriers, 73.0% of participants indicated they received \u003cem\u003eadequate support\u003c/em\u003e in pursuing their career. However, 17.9% reported \u003cem\u003eno support\u003c/em\u003e, and 9.1% were \u003cem\u003eunsure\u003c/em\u003e about the level of support they received. These findings suggest that while many students face significant challenges, a strong support system plays a crucial role in enabling them to pursue their chosen career path.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Barriers to pursuing career\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of challenges in choosing career\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e68.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e31.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChallenges in choosing career\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eFinancial constraints\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e41.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eSocietal stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e8.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eLack of career guidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e22.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eLimited opportunities for specialization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e14.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eWork-life balance concerns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e12.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of adequate support\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e73.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e17.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 293px;\"\u003e\n \u003cp\u003eNot Sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 141px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e9.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSource:\u003c/em\u003e\u003c/strong\u003e Field Data (2025)\u003c/p\u003e\n\u003cp\u003eTable 6: Career aspirations in nursing practice\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFuture aspirations with career choice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eSpecialisation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e36.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eTeaching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e6.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eResearch\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eHospital practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e39.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eCommunity practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e9.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFuture in present career\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e94.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eNot Sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e4.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSource:\u003c/em\u003e\u003c/strong\u003e Field Data (2025)\u003c/p\u003e\n\u003cp\u003eTable 6 highlights participants\u0026rsquo; career aspirations. The most common aspiration was hospital practice (39.7%), followed closely by specialization (36.6%). Smaller proportions of students aspired to community practice (9.5%), research (7.7%), and teaching (6.5%).\u003c/p\u003e\n\u003cp\u003eWhen asked about their long-term outlook, the vast majority (94.5%) expressed their intention to continue in nursing, with only 1.0% stating they did not envision a future in the field. A small proportion (4.6%) remained uncertain. These findings indicate that most participants are not only clear about their professional trajectories but also demonstrate strong commitment to building sustainable careers within the health sector.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors Motivating Career Retention Among Nursing and Midwifery Students\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Motivation to stay in the healthcare profession\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"722\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTheme\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClarification/Examples\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1. Passion for Patient Care\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e26.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003e\u0026quot;Saving lives,\u0026quot; \u0026quot;Love for humanity,\u0026quot; \u0026quot;Joy in recovery.\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2. Financial Support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e19.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eTuition help, salary increases, fee reduction.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3. Professional Growth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e15.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eCareer advancement, specialization, skill development.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4. Supportive Work Environment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e12.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eMentorship, teamwork, institutional support.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5. Recognition \u0026amp; Respect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e10.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eAppreciation from patients/society, respect for the profession.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6. Family/Social Encouragement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e8.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eParental wishes, family support, role models.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7. Academic Success\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e4.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003ePassing exams, self-confidence, hard work.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e8. Work-Life Balance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e2.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eManageable schedules, mental health prioritization.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9. Ethical Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e2.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eConfidentiality, compassionate care.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10. Systemic Improvements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e2.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eFair pay, policy changes, employment opportunities.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e11. Nothing\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e1.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eNothing will encourage me\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e12. Faith-based\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e1.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eAllah\u0026rsquo;s blessing\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e13. \u0026nbsp;Job Security\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e1.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003eEmployment after graduation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 246px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOthers (Unique/Diverse)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e3.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 259px;\"\u003e\n \u003cp\u003e\u0026quot;The dressing,\u0026quot; \u0026quot;Comparisons to seniors\u0026quot;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSource:\u003c/em\u003e\u003c/strong\u003e Field Data (2025)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7\u003c/strong\u003e summarizes the factors motivating nursing and midwifery students to remain in the healthcare profession. The most frequently reported motivation was a passion for patient care (26.4%), with participants describing fulfillment from \u0026ldquo;saving lives,\u0026rdquo; \u0026ldquo;love for humanity,\u0026rdquo; and \u0026ldquo;joy in recovery.\u0026rdquo; This underscores the intrinsic value students attach to caregiving and the emotional satisfaction derived from patient outcomes.\u003c/p\u003e\n\u003cp\u003eFinancial support followed as the second most cited motivator (19.9%), including desires for tuition assistance, fair remuneration, and fee reduction. These findings reflect the economic challenges faced by students and highlight the importance of financial incentives in sustaining workforce commitment.\u003c/p\u003e\n\u003cp\u003eProfessional growth (15.0%) was another key factor, with students emphasizing career advancement, specialization, and skill development as essential for long-term engagement. A supportive work environment (12.1%) and recognition and respect (10.1%) were also frequently mentioned, demonstrating the role of mentorship, teamwork, and social appreciation in promoting job satisfaction and retention.\u003c/p\u003e\n\u003cp\u003eAdditional motivators included family and social encouragement (8.1%), academic success (4.9%), and work\u0026ndash;life balance (2.6%). A few respondents mentioned ethical practice (2.3%), systemic improvements (2.0%), and faith-based motivation (1.3%), while a small number (1.6%) reported that \u0026ldquo;nothing\u0026rdquo; would encourage them to remain in the profession.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative Findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe qualitative phase explored the lived experiences, motivations, and challenges shaping the career aspirations of nursing and midwifery students at Kpembe Nursing and Midwifery Training College. Thematic analysis yielded five major themes and corresponding sub-themes, illustrating how personal, institutional, and sociocultural factors intersect to influence students\u0026rsquo; professional journeys. (See Figure 2)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 1: Initial Motivations and Career Choice Drivers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudents\u0026rsquo; motivations for pursuing nursing and midwifery were deeply rooted in personal encounters, empathy, and early professional exposure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePersonal and Family Health Experiences: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Many participants described how personal or family health experiences inspired their career choice. Witnessing illness, childbirth, or inadequate healthcare within their communities awakened a desire to help. One student shared,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Honestly, I chose nursing after my grandmother got very sick. I saw how the nurses cared for her, and it really touched me. I wanted to be that person for someone else.\u0026rdquo;\u003c/em\u003e (P1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAnother reflected,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;When I was in SHS, my elder sister gave birth at home because the midwife wasn\u0026rsquo;t available. I felt helpless. That day, I promised myself I would become a midwife so I can help other women.\u0026rdquo;\u003c/em\u003e (P2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAltruistic Values and Compassionate Calling: \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Intrinsic compassion and the drive to serve humanity were dominant motivators. Students repeatedly emphasized \u0026ldquo;saving lives\u0026rdquo; and \u0026ldquo;helping others\u0026rdquo; as central to their professional identity. One respondent stated,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I believe every woman deserves a safe birth. That\u0026rsquo;s something I truly value\u0026hellip; \u0026hellip;saving lives, especially of mothers and babies.\u0026rdquo;\u003c/em\u003e (P2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEarly Clinical Exposure Impact: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Experiential learning during internships strengthened students\u0026rsquo; career commitment. For some, these encounters were transformative:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;During our clinical at the district hospital, I helped an elderly woman with her wound dressing. She was scared, but I reassured her. Later she thanked me and said I reminded her of her daughter. That moment stayed with me.\u0026rdquo;\u003c/em\u003e (P1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOthers noted that such interactions confirmed their calling and fostered a sense of belonging in the profession.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 2: Evolving Professional Identity and Aspirations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs students progressed, their career goals evolved toward specialization and community impact.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eShift Toward Specialization: \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Several respondents expressed aspirations beyond general practice. Some desired to specialize in pediatrics, trauma, or public health nursing.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cem\u003e\u0026ldquo;I came in wanting to be a general nurse, but now I am fascinated by mental health nursing and want to pursue that.\u0026rdquo;\u003c/em\u003e (P11).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;My goal is to specialize in oncology nursing. I feel a strong pull to support patients and families through that journey.\u0026rdquo;\u003c/em\u003e (P13)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePreference for Clinical Practice: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;A strong preference for hands-on clinical work emerged, with students viewing direct patient care as the most rewarding aspect of their training.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;I love working directly with people. Research or academic teaching feels less immediate.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(P9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCommunity Service Orientation: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;A commitment to serving underserved populations was a recurring theme. Participants emphasized a desire to work in rural areas, reflecting both moral obligation and awareness of community needs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;My long-term goal is to return to my village and be the nurse I wished we had when my cousin was sick.\u0026quot;\u003c/em\u003e (P14).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 3: Structural Challenges and Barriers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDespite high motivation, students faced several systemic and personal challenges.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial Constraints: \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Economic hardship was the most pervasive barrier. Participants described difficulty affording study materials, transportation, and accommodation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;It has been tough. Sometimes I worry about paying school fees or buying supplies. It makes focusing on studies difficult.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(P9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcademic and Clinical Workload: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Students found the demands of training physically and emotionally taxing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;I didn\u0026apos;t expect it to be so demanding. The long hours, the emotional stress, it\u0026apos;s not easy.\u0026quot;\u003c/em\u003e (P1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAnother added,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;The combination of academic pressure and clinical responsibilities is overwhelming at times.\u0026quot;\u003c/em\u003e (P10).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocietal Stigma and Gender Stereotypes: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Cultural perceptions of nursing and midwifery as low-status or female-oriented careers were also noted. A male student remarked,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;\u003c/em\u003e\u003cem\u003eYes, especially as a male nursing student. Some people think nursing is just for women. I just try to educate them...\u003c/em\u003e\u003cem\u003e\u0026rdquo;\u003c/em\u003e (P1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOthers faced community pressure to abandon their studies for marriage or different professions.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 4: Support Systems and Coping Mechanisms\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSupport networks, both social and institutional, played a critical role in sustaining students\u0026rsquo; motivation and resilience.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFamily and Peer Support Networks: \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Emotional encouragement and occasional financial assistance from family members were frequently cited.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;We form study groups, and that\u0026apos;s my support system. We cry together and we push each other.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(P10).\u003c/p\u003e\n\u003cp\u003e\u0026quot;My uncle supports(me sometimes... I also talk to my classmates; we encourage each other.\u0026quot; (p1)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSpiritual Resilience and Personal Faith: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Religious faith and prayer provided psychological comfort. Participant acknowledged praying as offering a lot of help.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Praying helps me a lot,\u0026rdquo;\u003c/em\u003e (P2),\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ewhile another said,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eI believe God called me to do this work. On hard days, I hold onto that.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(P11).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Support Systems:\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Tutors and mentors provided moral guidance, even in informal capacities. One participant noted\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;The encouragement from one particular tutor has been invaluable. She believes in me more than I believe in myself sometimes.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(P12).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOthers acknowledged external assistance, such as church support or scholarships, that alleviated some burdens.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 5: Educational and Institutional Support Needs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudents provided thoughtful recommendations to enhance their academic and professional experiences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEnhanced Mentorship and Career Guidance: \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Participants emphasized the need for structured mentorship and exposure to diverse nursing career paths.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;Especially mentorship. It\u0026apos;s hard to know where you\u0026apos;re heading without guidance.\u0026quot;\u003c/em\u003e said one student (P1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial Aid and Resource Access: \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Requests for expanded financial support and improved access to learning resources were consistent.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;More financial aid would help. Also... better accommodation, we live far from campus.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e(P2).\u003c/p\u003e\n\u003cp\u003e\u0026quot;Access to a reliable internet connection for research would make a huge difference in our learning.\u0026quot; (P10).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCurriculum and Practical Training Enhancement: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Students advocated for a more practice-oriented curriculum and mental health support. As one participant noted:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;I think more practical exposure... would help. Also, the curriculum could focus more on specializations...\u0026quot;\u003c/em\u003e one stated (P1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAnother emphasized,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;More mental health support is needed. Many students are stressed but don\u0026apos;t talk about it.\u0026quot;\u003c/em\u003e (P4).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe qualitative findings reveal a complex but hopeful narrative. Students\u0026rsquo; career motivations are primarily altruistic, strengthened by real-life experiences and faith. However, their progress is challenged by financial and institutional barriers. The presence of strong social and spiritual support systems fosters resilience, yet students call for improved mentorship, curriculum relevance, and financial assistance. Collectively, these insights underscore the importance of holistic educational reform and sustained institutional investment to nurture a motivated, skilled, and resilient nursing and midwifery workforce in Ghana\u0026rsquo;s Savannah Region.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study provides novel evidence on the motivations, barriers, and aspirations of nursing and midwifery students in the Savannah Region of Ghana by employing an explanatory sequential mixed-methods design. While previous research has often examined student career motivations in urban settings, this study delves into the realities of a rural, low-resource context, using qualitative insights to explain the quantitative trends. The integrated findings reveal a narrative of strong intrinsic motivation that is both challenged by systemic barriers and sustained by remarkable resilience, with significant implications for health workforce planning in sub-Saharan Africa.\u003c/p\u003e\u003cdiv id=\"Sec40\" class=\"Section2\"\u003e\u003ch2\u003eExplaining the Drivers of Career Choice and Satisfaction\u003c/h2\u003e\u003cp\u003eThe quantitative data established an overwhelmingly high level of career satisfaction (91.2%) and a strong desire to choose the same career again (82.7%). The qualitative findings provide the crucial explanation for this commitment, revealing that it is deeply rooted in formative, personal experiences rather than abstract ideals. The survey identified 'passion for patient care' as the dominant motivator (46.0%), and the interviews gave life to this statistic. Participants described pivotal moments, such as witnessing a grandmother's care (\"I wanted to be that person for someone else\" - P1) or a sister's traumatic birth (\"I felt helpless... I promised myself I would become a midwife\" - P2). This suggests that the high quantitative satisfaction scores are underpinned by a powerful, empathetic calling forged in personal and family health experiences, which also explains the strong influence of having family members in healthcare (60.6%).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eResolving the Paradox of Barriers and Sustained Commitment\u003c/h3\u003e\n\u003cp\u003eA central quantitative finding was the paradoxical coexistence of high satisfaction with significant reported barriers, most notably financial constraints (41.5%). The qualitative data are essential to resolve this paradox, as they uncover the active resilience strategies students employ, which the survey alone could not capture. While participants confirmed the pervasive financial strain, stating, \u003cem\u003e\"It has been tough. Sometimes I worry about paying school fees...\" (P9)\u003c/em\u003e, they simultaneously described robust coping mechanisms. These included relying on peer support networks (\"We form study groups... We cry together and we push each other\" - P10) and spiritual faith (\"Praying helps me a lot\" - P2; \"I believe God called me to do this work\" - P11). This integration demonstrates that the quantitative measure of high satisfaction is maintained not in the absence of barriers, but through the presence of dynamic, protective support systems that buffer against adversity, aligning with resilience theory (Garcia-Dia et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Thomas \u0026amp; Revell, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eContextualizing Career Aspirations and Institutional Gaps\u003c/h3\u003e\n\u003cp\u003eThe survey clearly mapped students' future trajectories, showing strong aspirations for hospital practice (39.7%) and specialization (36.6%), with minimal interest in research (7.7%) or teaching (6.5%). The qualitative findings powerfully corroborated and explained this clinical preference. Participants expressed a direct desire for hands-on work, with one noting, \u003cem\u003e\"I love working directly with people. Research or academic teaching feels less immediate\" (P9)\u003c/em\u003e. Furthermore, the qualitative data illuminated the real-world consequences of the quantitative finding that 22.5% lacked career guidance. Students explicitly called for \u003cem\u003e\"structured mentorship\" (P1)\u003c/em\u003e and lamented that \u003cem\u003e\"it's hard to know where you're heading without guidance,\"\u003c/em\u003e directly explaining how the lack of guidance quantified in the survey manifests as uncertainty and a constrained view of potential career paths.\u003c/p\u003e\n\u003ch3\u003eImplications for Policy and Practice\u003c/h3\u003e\n\u003cp\u003eTaken together, these integrated findings underscore the need for support strategies that are as multifaceted as the students' experiences. While expanding financial aid is critical to address the primary barrier of affordability, this must be paired with interventions that bolster the identified resilience factors. Formalizing peer support networks and integrating resilience-building into the curriculum can sustain motivation. Furthermore, establishing structured mentorship programs is essential to address the identified gap in career guidance, helping students navigate their clear aspirations for specialization and clinical practice.\u003c/p\u003e\n\u003ch3\u003eStrengths and Limitations\u003c/h3\u003e\n\u003cp\u003eThe primary strength of this study is its explanatory sequential mixed-methods design, which used qualitative data to explain quantitative trends, providing a nuanced understanding of student experiences. However, the cross-sectional design precludes causal inference, and the single-site focus may limit generalizability, though it offers valuable insights for similar rural contexts. A potential limitation of the sequential design is that the quantitative survey was fixed prior to the qualitative inquiry, though this was mitigated by designing the qualitative phase explicitly to explain the initial results. Future longitudinal studies are recommended to track the evolution of motivations and their impact on career retention.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study reveals that nursing and midwifery students in the Savannah Region are a resilient cohort. Their journey is not defined by an absence of challenges, but by a powerful sense of purpose that is activated and sustained through personal support systems and spiritual faith. By using qualitative evidence to explain quantitative trends, this study moves beyond simply identifying barriers and satisfaction to explaining \u003cem\u003ehow\u003c/em\u003e they coexist. The findings provide a robust evidence base for developing holistic educational and policy interventions aimed at sustaining this resilience and building a motivated, future-ready health workforce for Ghana and similar contexts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the ethical principles outlined in the \u003cstrong\u003eDeclaration of Helsinki (2013 revision)\u003c/strong\u003e. Ethical approval was sought from the Ghana Health Service Ethics Review Committee (GHS-ERC); the application is currently under review (Protocol ID: Pending). Administrative permission was granted by the Kpembe Nursing and Midwifery Training College. All participants provided written and oral informed consent after the study\u0026apos;s objectives, procedures, benefits, and minimal risks were thoroughly explained. Participation was entirely voluntary, with no impact on academic standing. Participants retained the right to withdraw at any time without penalty. To ensure confidentiality, all electronic data are stored on password-protected devices, and paper records were securely destroyed after data compilation. The researchers affirm that all procedures were conducted with utmost regard for participant welfare and data protection standards while awaiting the final ethical clearance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo datasets were generated or analysed during the current study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, JKA; formal analysis, investigation, and data curation, JKA, YMS and YSA; formal data analysis and results interpretation, SAY and JK; writing and original draft preparation SAY, JKA and YMS; and writing, review, and editing JKA, YMS and YSA. All authors have read and agreed to the published version of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge Mr. Adomako-Asare Gabriel of the Department of Health Information Management, University of cape Coast Ghana. We are appreciating the efforts of all the respondents and also the staff and management of Kpembe Nursing Training College.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAit Ali, D., Ncila, O., Ouhhamou, S., Rizzo, A., Chirico, F., \u0026amp; Khabbache, H. (2024). Motivations Driving Career Choices: Insights From a Study Among Nursing Students. \u003cem\u003eSAGE Open Nursing\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e. https://doi.org/10.1177/23779608241255876\u003c/li\u003e\n\u003cli\u003eAlanazi, S., Wiechula, R., \u0026amp; Foley, D. (2024). Perceptions of followership among nurses: A qualitative study. \u003cem\u003eInternational Journal of Nursing Studies Advances\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(September 2023), 100222. https://doi.org/10.1016/j.ijnsa.2024.100222\u003c/li\u003e\n\u003cli\u003eBraun, V., \u0026amp; Clarke, V. (2006). Using thematic analysis in psychology. \u003cem\u003eQualitative research in psychology\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(2), 77-101.\u003c/li\u003e\n\u003cli\u003eBraun, V., \u0026amp; Clarke, V. (2021). Thematic analysis: A practical guide.\u003c/li\u003e\n\u003cli\u003eCreswell, J. W., \u0026amp; Clark, V. L. P. (2017). \u003cem\u003eDesigning and conducting mixed methods research\u003c/em\u003e. Sage publications.\u003c/li\u003e\n\u003cli\u003eGarcia-Dia, M. J., DiNapoli, J. M., Garcia-Ona, L., Jakubowski, R., \u0026amp; O\u0026apos;Flaherty, D. (2013). Concept analysis: resilience. \u003cem\u003eArchives of psychiatric nursing\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(6), 264-270.\u003c/li\u003e\n\u003cli\u003eGlerean, N., Hupli, M., Talman, K., \u0026amp; Haavisto, E. (2019). Perception of nursing profession \u0026ndash; focus group interview among applicants to nursing education. \u003cem\u003eScandinavian Journal of Caring Sciences\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(2), 390\u0026ndash;399. https://doi.org/10.1111/scs.12635\u003c/li\u003e\n\u003cli\u003eHaaland, G. H., \u0026Oslash;ygarden, O., Storm, M., \u0026amp; Mikkelsen, A. (2023). Understanding registered nurses\u0026rsquo; career choices in home care services: a qualitative study. \u003cem\u003eBMC Health Services Research\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 1\u0026ndash;12. https://doi.org/10.1186/s12913-023-09259-0\u003c/li\u003e\n\u003cli\u003eHassmiller, S. B., \u0026amp; Wakefield, M. K. (2022). The Future of Nursing 2020\u0026ndash;2030: Charting a path to achieve health equity. \u003cem\u003eNursing Outlook\u003c/em\u003e, \u003cem\u003e70\u003c/em\u003e(6), S1\u0026ndash;S9. https://doi.org/10.1016/j.outlook.2022.05.013\u003c/li\u003e\n\u003cli\u003eHu, H., Wang, C., Lan, Y., \u0026amp; Wu, X. (2022). Nurses\u0026rsquo; turnover intention, hope and career identity: the mediating role of job satisfaction. \u003cem\u003eBMC Nursing\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(1), 1\u0026ndash;11. https://doi.org/10.1186/s12912-022-00821-5\u003c/li\u003e\n\u003cli\u003eJones, C. H., \u0026amp; Dolsten, M. (2024). Correction to: Healthcare on the brink: navigating the challenges of an aging society in the United States (npj Aging, (2024), 10, 1, (22), 10.1038/s41514-024-00148-2). \u003cem\u003eNpj Aging\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1), 41514. https://doi.org/10.1038/s41514-024-00153-5\u003c/li\u003e\n\u003cli\u003eKakyo, T. A., Xiao, L. D., \u0026amp; Chamberlain, D. (2024). The role of motivation in the initiation and maintening mentoring relationships among nurses and midwives. \u003cem\u003eInternational Nursing Review\u003c/em\u003e, \u003cem\u003eOctober 2023\u003c/em\u003e. https://doi.org/10.1111/inr.12977\u003c/li\u003e\n\u003cli\u003eL. N., M., J. M, K., M, Y., \u0026amp; B. M, N. (2014). ICT-Integration in Higher Education and Student Behavioral Change: Observations at University of Arusha, Tanzania. \u003cem\u003eAmerican Journal of Educational Research\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(11A), 30\u0026ndash;38. https://doi.org/10.12691/education-2-11A-5\u003c/li\u003e\n\u003cli\u003eLINCOLN, Y., \u0026amp; Guba, E. (1985). Naturalistic Inquiry. [sl] Sage Publications.\u003c/li\u003e\n\u003cli\u003eMaurud, S., B\u0026oslash;r\u0026oslash;sund, E., \u0026amp; Moen, A. (2022). Gender and ethnicity\u0026rsquo;s influence on first-year nursing students\u0026rsquo; educational motivation and career expectations: A cross-sectional study. \u003cem\u003eNursing Open\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(3), 1667\u0026ndash;1678. https://doi.org/10.1002/nop2.1191\u003c/li\u003e\n\u003cli\u003eMbalinda, S. N., Najjuma, J. N., Gonzaga, A. M., Livingstone, K., \u0026amp; Musoke, D. (2024). Understanding and barriers of professional identity formation among current students and recent graduates in nursing and midwifery in low resource settings in two universities: a qualitative study. \u003cem\u003eBMC Nursing\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 1\u0026ndash;10. https://doi.org/10.1186/s12912-024-01795-2\u003c/li\u003e\n\u003cli\u003eMentag, N. M. (2020). \u003cem\u003eNSUWorks The Lived Experiences of Thriving Nursing Students\u003c/em\u003e. \u003cem\u003e85\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003ePrice, S., \u0026amp; Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: Meeting the needs of novice to mid-to late-career nurses throughout their career span. \u003cem\u003eAdministrative Sciences\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(2), 41\u0026ndash;52. https://doi.org/10.3390/admsci7020017\u003c/li\u003e\n\u003cli\u003eProsen, M. (2022). Nursing students\u0026rsquo; perception of gender-defined roles in nursing: a qualitative descriptive study. \u003cem\u003eBMC Nursing\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(1), 1\u0026ndash;11. https://doi.org/10.1186/s12912-022-00876-4\u003c/li\u003e\n\u003cli\u003eStadnicka, S. K., \u0026amp; Zarzycka, D. (2023). Perception of the professional self-image by nurses and midwives. Psychometric adaptation of the Belimage questionnaire. \u003cem\u003eBMC Nursing\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 1\u0026ndash;14. https://doi.org/10.1186/s12912-023-01564-7\u003c/li\u003e\n\u003cli\u003eTaylor, S., Iacobelli, F., Luedke, T., Matthews, P. A., Monge, M., Cooper, J., Moreira, J., Grippo, P., Girotti, J., Molina, Y., Yanez, B., \u0026amp; Simon, M. A. (2019). Improving health care career pipeline programs for underrepresented students: Program design that makes a difference. \u003cem\u003eProgress in Community Health Partnerships: Research, Education, and Action\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(Special Issue), 113\u0026ndash;122. https://doi.org/10.1353/cpr.2019.0044\u003c/li\u003e\n\u003cli\u003eThomas, L. J., \u0026amp; Revell, S. H. (2016). Resilience in nursing students: An integrative review. \u003cem\u003eNurse education today\u003c/em\u003e, \u003cem\u003e36\u003c/em\u003e, 457-462.\u003c/li\u003e\n\u003cli\u003eWHO. (2020). \u003cem\u003eState of the World\u0026rsquo;s Nursing\u003c/em\u003e. Who Publications.\u003c/li\u003e\n\u003cli\u003eYarbrough, S., Martin, P., Alfred, D., \u0026amp; McNeill, C. (2017). Professional values, job satisfaction, career development, and intent to stay. \u003cem\u003eNursing Ethics\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(6), 675\u0026ndash;685. https://doi.org/10.1177/0969733015623098\u003c/li\u003e\n\u003cli\u003eZhang, J., Shields, L., Ma, B., Yin, Y., Wang, J., Zhang, R., \u0026amp; Hui, X. (2022). The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study. \u003cem\u003eBMC Medical Education\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 1\u0026ndash;9. https://doi.org/10.1186/s12909-022-03609-y\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Career, motivation, Aspiration, perceptions, Nursing and Midwifery, Career Choice in Healthcare, Ghana","lastPublishedDoi":"10.21203/rs.3.rs-7425909/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7425909/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eNursing and midwifery are critical to health system performance, particularly in regions with limited resources and persistent workforce shortages. Students\u0026rsquo; motivations, career aspirations, and perceived barriers strongly influence retention and professional satisfaction. In Ghana\u0026rsquo;s Savannah Region, these dynamics are shaped by cultural and socioeconomic constraints. This study explored the factors influencing students\u0026rsquo; career choices at Kpembe Nursing and Midwifery Training College to inform workforce development strategies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eAn explanatory sequential mixed-methods study was conducted. A cross-sectional survey of 307 first-year students established prevalent trends. Subsequent in-depth interviews with 14 purposively selected students explained these trends. Quantitative data were analyzed using descriptive statistics; qualitative data underwent thematic analysis, with integration occurring at the interpretation stage.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eCareer satisfaction was high, with over 91% of students reporting satisfaction and 82.7% indicating they would choose their career again. Passion for patient care (46.0%) was the strongest motivator. Despite reporting substantial barriers, including financial constraints (41.5%) and lack of career guidance (22.5%), students demonstrated high resilience. Qualitative data revealed that this paradox was sustained by strong intrinsic motivation, altruism, and robust peer and spiritual support systems. Career aspirations centered on hospital practice (39.7%) and specialization (36.6%), with 94.5% intending to remain in the profession.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe study reveals a resilient cohort of students whose strong intrinsic motivation and protective support systems buffer against significant systemic barriers. To sustain this resilience and reduce attrition, institutional strategies must move beyond addressing financial hardship alone. Fostering robust mentorship, formalizing peer support, and integrating resilience-building into the curriculum are critical to developing a motivated and future-ready health workforce for the region.\u003c/p\u003e","manuscriptTitle":"Career Aspirations and Motivations: Perceptions of Nursing and Midwifery Students at Kpembe Nursing and Midwifery Training College, Savannah Region","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-31 15:32:27","doi":"10.21203/rs.3.rs-7425909/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-30T13:18:03+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-30T11:03:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"35453372657406359645032869071944682123","date":"2026-01-05T08:18:30+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-11T12:23:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"34497413486639535791279669536566734945","date":"2025-12-02T17:16:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"22388060652842217645461153816780557523","date":"2025-11-13T12:00:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-21T10:59:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-10T21:23:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-10-10T21:20:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"49b5b949-6a85-4229-8f5a-d26de1cfbe42","owner":[],"postedDate":"October 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-15T02:08:11+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-31 15:32:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7425909","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7425909","identity":"rs-7425909","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}