INTRODUCTION:

Education is associated with an individual's well-being and prospects for improved living, and it is essential to the development of human capital. Academic performance serves as a tangible measure of students' proficiency in foundational knowledge, clinical skills, critical thinking abilities, and overall preparedness to deliver safe and effective patient care¹.

In nursing education, academic performance serves as a crucial indicator of a student's competence and preparedness for the demands of the profession. Learning approaches are methods of learning that are used to learn and are useful for learning throughout one's life. They are also seen to be crucial for success and getting good grades. Three different learning styles have been identified by researchers and experts for students to choose from at higher education institutions².These encompass strategic, surface, and deep learning philosophies

Academic excellence plays a pivotal role in individual placement whether within academic institutions or in securing employment opportunities. Consequently, many individuals actively seek strategies to enhance their academic achievement^3-4.

Higher levels of academic self-efficacy, which is a prerequisite for critical thinking, have been linked to better academic performance among nursing students^5-6.

This variation in academic performance is especially true in nursing profession, as in nursing courses students come from different backgrounds in terms of individual, parental, socio economic, environmental, school including medium of instruction etc. Majority of the students are exposed to new environment first time away from the family, school and familiar environment. It creates stress and adjustment problems among students which is further confounded by too many subjects in initial years. It may affect the students’ performance which may indirectly affect one’s achievement as well^1,7.

It is known fact that, the undergraduate nursing education in India has recently undergone tremendous changes in response to the overall development of the country and Nursing profession⁸. Research indicates that it is well known fact that, Nursing is largest health care profession and nurses are the only professionals who cares the patients in the hospital round the clock. At the same time Nursing is also well known for being a challenging job that requires long hours and hard work. But playing a role in saving lives, and caring for the wellbeing of patients and their families, offers an outstanding level of job satisfaction. In every institution success is measured by the academic performance of the students or by how well students meet the standards set out by the local government and the institution itself ⁹.

Therefore, assessing the nursing students in terms of their academic achievement in both theory and practical examination by understanding their learning approaches and academic performance and ultimately nurture competent expert nurses. This will be instrumental and in shaping the future citizens of the country. Hence, this study was undertaken by the researchers to assess the Learning approaches and Academic Performance Among Undergraduate Nursing Students at Selected College.

METHODOLOGY:

Study was conducted after obtaining ethical clearance from IEC of Apollo College of Nursing, Chennai and permission from the concerned authorities of the settings. A descriptive correlational study was conducted among 390 nursing students at selected colleges, 100 members from B.Sc. I year, 100 members from B.Sc. II year, 96 members from B.Sc. III year, 94 members from B.Sc. IV year, who were selected using Consecutive sampling technique. Data was collected using tools such as Proforma to assess the Background variables proforma of nursing students, Academic variables proforma of nursing students, Approaches and Study Skills Inventory for Students (ASSIST) tool through self-administration method. The ASSIST tool was developed by Brown (2015).¹⁰ It has 52 items that are related to three approaches (deep, strategic and surface) to studying and learning. All items were scored using a five-point Likert scale where 5 = Agree, 4 = Agree Somewhat, 3 = Unsure, 2 = Disagree somewhat and 1 = Disagree.

Tools were validated and reliability was established. The modification and suggestions of experts were incorporated in the final preparation of tools. Students were requested to respond and submit their forms through online mode itself. The collected data were tabulated and analyzed using descriptive statistics like frequency distribution, mean, SD and inferential statistics such as One way ANOVA/t test using SPSS 24.

RESULTS AND DISCUSSION:

Table 1: Frequency and Percentage Distribution of Background Variables among B.Sc. Nursing Students. (N=390)

Variables	Overall (N= 390)		2022-2026 I Year (n= 100)		2021-2025 II Year (n= 100)		2020-2024 III Year (n= 96)		2019-2023 Final Year (n=94)
	f	%	f	%	f	%	f	%	f	%
Age in years
18-20	187	47.94	86	86	86	86	15	15.62	0	0
21-22	160	41.03	14	14	13	13	77	80.2	56	59.57
>22 years	43	11.03	0	0	1	1	4	4.18	38	40.43
Mean age	20.67		19.46		19.69		21.33		22.34
Medium of language (School)
English	370	94.87	99	99	96	96	91	94.79	84	89.36
Tamil	18	4.61	1	1	4	4	3	3.13	10	10.64
Others	2	0.52	0	0	0	0	2	2.08	0	0
Type of School studied
Government	118	30.25	34	34	33	33	28	29.17	23	24.47
Private	272	69.74	66	66	67	67	68	70.83	71	75.53
Board of Hr. Sec
CBSE	50	12.83	16	16	10	10	12	12.5	12	12.77
Matric / State	331	84.87	81	81	89	89	80	83.33	81	86.17
Others (Specify)	9	2.3	3	3	1	1	4	4.17	1	1.06
Basic Education (Before joining Nursing)
H.Sc.	386	98.97	100	100	100	100	95	98.96	91	96.81
Graduate	4	1.03	0	0	0	0	1	1.04	3	3.19
Native State
Tamil Nadu	152	38.97	37	37	39	39	36	37.5	40	42.55
Kerala	232	59.48	63	63	59	59	57	59.37	53	56.39
Others	6	1.55	0	0	2	2	3	3.13	1	1.06
Domicile
Rural	142	36.41	45	45	37	37	38	39.58	22	23.4
Semi Urban	116	29.75	17	17	20	20	29	30.21	50	53.2
Urban	132	33.84	38	38	43	43	29	30.21	22	23.4

Tab 1 reveals that, overall majority of them were aged 18-20 years (47.94%). Regarding year wise, first year and second year students were aged 18-20 years (86%), in third year and final year, majority of them were aged 21-22 years (80.2 %,59.57%).

Their overall mean age was 20.67±1.51, (first year 19.46 ± 1.03, second year 19.69±0.88, third year 21.33±0.97 and final year 22.34±0.82). Their medium of instruction in school was English medium (94.87%, 99%, 96% , 94.79% and 89.36 %), studied in private schools (69.74%, 66%, 67%, 70.83% and 75.53%), board of Hr. Sec in Matric/State board (84.87%, 81%, 89%, 83.33% and 86.17 %), joined B. Sc (N) after completing Hr. Secondary (98.97%, 100%, 100%, 98.96% and 96.81%), were from Kerala (59.48%, 63%, 59%, 59.37% and 56.39 %) and from rural background (36.41%, 45%, 37%, 39.58% and 23.4%) in Overall B.Sc. (N) students, first, second, third and final year respectively.

Fig 1 shows the academic year of B.Sc. Nursing students. Out of 390, 100 were in their first year, 100 in their second year, 96 in their third year, and 94 in their final year.

According to Fig 2, students have selected the Nursing course because of employment opportunities (41.53%), which is followed by parents' preference (24.35%), professional growth (14.10%), service-oriented learning (12.82%), and other factors (7.17%) as reasons to pursue a career in nursing among B. Sc. Nursing students.

According to Fig 3 depicts the Percentage distribution of academic performance of students that, majority of the students scored in B. Sc Nursing >75% (88.29 %), followed by 60-75% (64 %) and <60% (3.125 %) among overall, First year, second year, third year and final year respectively.

Fig 2: Percentage Distribution of Motivational Factors to join Nursing among B.Sc. Nursing Students.

Fig 3: Percentage distribution of Academic Performance of Students

Table 2: Descriptive Statistics of learning approaches (Scores) among B.Sc. Nursing Students (Overall). (N= 390)

Learning approaches	Obtainable Score	Obtained score	Mean	Mean %	SD
Deep Learning	16-80	16-80	56.25	70.31	10.52
Surface Learning	16-80	16-80	54.75	68.43	10.37
Strategic Learning	20-100	20-100	70.28	70.28	13.08

Tab 2 depicts that depicts the mean and standard deviation of deep learning approaches was 56.25±10.52, surface learning approaches was 54.75±10.37 and strategic learning approaches was 70.28±13.08 among B. Sc (N) students. Highest mean score was found in deep learning approaches followed by strategic learning approaches.

Table 3: Comparison of learning approaches among students (B.Sc. I, II, III Year and B.Sc. Final Year) (N=390)

Batches	Obtainable Score	Mean	SD	Mean %	F(ANOVA) value	p value
Deep Learning I Year	16-80	55.72	11.082	69.65	1.288	0.278
II Year		57.74	9.692	72.17
III Year		54.92	10.134	68.65
Final Year		56.60	11.109	70.75
Surface learning I Year	16-80	54.11	10.314	67.63	0.906	0.438
II Year		56.08	9.767	70.1
III Year		53.86	10.193	67.32
Final Year		54.92	11.234	68.65
Strategic Learning I Year	20-100	69.31	13.847	69.31	1.008	0.389
II Year		71.92	12.038	71.92
III Year		69.08	12.377	69.08
Final Year		70.78	14.011	70.78

Tab 3 depicts that, there is no significant difference in learning approaches such as deep learning (F=1.288, p>0.05), Surface learning (F=0.906, p>0.05), Strategic Learning (F=1.008, p>0.05) between the years among undergraduate nursing students. (p>0.05).

Table: 4 Comparison of academic performance among students (B.Sc. I, II, III Year and B.Sc. Final Year) (N=390)

Year of Students	Mean %	SD	F value	p value
I Years (n=100)	73.15	5.452	26.127	P< 0.001
II Year (n=100)	73.17	5.911
III Year (n=96)	76.26	7.322
Final Year (n=94)	84.46	4.588
All Students (N= 390)	74.66	6.42	-	-

Tab 4 depicts that there is a significant difference in academic performance among undergraduate nursing students between First year (73.15±5.452), Second year (73.17±5.911), Third year (76.26 ±7.322) and Final year (84.46± 4.588) (p<0.001).

Table: 5 Correlation between learning approaches and academic performance of College Students (N=390)

Approaches	Test values	Deep	Surface	Strategic	Academic Performance
Deep	r value	1
Deep	p value	-
Surface	r value	0.852**	1
Surface	p value	0.000	-
Strategic	r value	0.930**	0.854**	1
Strategic	p value	0.000	0.000	-
Academic Performance	r value	0.058	0.024	0.056	1
Academic Performance	p value	0.252	0.635	0.269	-
**. Correlation is significant at the 0.01 level (2-tailed).

Tab 5 infers that, there was significant correlation between deep, surface and strategic learning approaches where as there is no correlation between academic performance and learning approaches among B. Sc. Nursing Students (p<0.01).

Table 6: Association between learning approaches and Background Variables of Nursing students (N=390)

Variables	Deep Approach			Surface Approach				Strategic Approach
Variables	Up to mean	Above mean	χ2 and P value	Up to mean		Above mean	χ2 and P value	Up to mean	Above mean	χ2 and P value
Medium in School
English	214	156	7.85 and 0.02	209		161	5.331and .070	208	162	7.248 and 0.027
Tamil	5	13		6		12		5	13
Others	2	0		2		0		2	0
Board of Hr. Sec
CBSE	28	22	0.582 and 0.748	31		19	2.651 and .266	30	20	0.922 and 0.631
Matric	189	142		183		148		181	150
Others (Specify)	4	5		3		6		4	5
Domicile
Rural	74	68	7.520 and 0.023	71		71	6.779and .034	71	71	8.465 and 0.015
Semi Urban	78	38		76		40		77	39
Urban	69	63		70		62		67	65
Preference of the study
Individual Study	94	78	5.702 and 0.058	98	74		5.480 and .065	93	79	7.383 and 0.025
Group Study	54	53		50	57			50	57
Mixed (Both)	73	38		69	42			72	39
Perceived Achievement Motivation
High	57	89	29.74 and 0.000	66	80		10.31 and 0.006	56	90	26.649 and 0.000
Moderate	158	76		145	89			153	81
Low	6	4		6	4			6	4
Perceived Self Confidence
High	71	88	18.39 and 0.000	76	83		6.753 and 0.034	68	91	19.517 and 0.000
Moderate	138	79		132	85			135	82
Low	12	2		9	5			12	2
Interested in going for higher studies
Yes	86	77	3.520 and 0.172	80	83		4.971 and 0.083	77	86	8.668 and 0.013
No	59	32		56	35			60	31
Not sure	76	60		81	55			78	58

Tab 6 depicts that, there is a significant association between deep, surface and strategic learning approaches and selected background variables of undergraduate nursing students” was accepted with regard to medium of instruction in school, domicile, preference of the study, perceived achievement motivation and perceived self-confidence with deep learning approaches. Significant association was also found between domicile, perceived achievement motivation and perceived self-confidence with surface learning approaches. Similarly Significant association was found between strategic learning approaches with selected background variables such as medium in school, domicile, preference of the study, perceived achievement motivation, perceived self-confidence, interested in going for higher studies with strategic learning approaches. (p<0.05).

Table: 7 Association between academic performance and Background Variables of Nursing students (N=390)

Variables	Academic Performance
Variables	Up to mean	Above mean	χ2	P value
Medium in School
English	214	156	4.234	.120
Tamil	6	12
Others	1	1
Board of Hr. Sec
CBSE	28	22	.016	.992
Matric	188	143
Others (Specify)	5	4
Domicile
Rural	74	68	14.371	.001
Semi Urban	55	61
Urban	92	40
Monthly Family Income in Rs
Up to 10000	65	34	6.296	.098
10001 to 20000	50	53
20001 to 50000	49	41
Above 50000	57	41
Preference of the study
Individual Study	93	79	4.692	.096
Group Study	70	37
Mixed (Both)	58	53
Perceived Achievement Motivation
High	74	72	5.141	.076
Moderate	143	91
Low	4	6
Perceived Self Confidence
High	85	74	1.302	.521
Moderate	127	90
Low	9	5
Interested in going for higher studies
Yes	97	66	4.892	0.087
No	57	34
Not sure	67	69

Table 7 depicts, that there was no association between academic performance and Background Variables of Nursing students except with regard to domicile (p<0.05)

DISCUSSION:

These findings are encouraging, as majority of the students have studied in English medium, especially in private school and board of higher secondary were matriculation as well as state board. Most of them are from Kerala existing in rural area with the monthly income of 10001 – 20000 which are essential for achievement of goals successfully in one’s life including academic achievement.

Thus, for nursing students, self-awareness is essential, as it helps them manage their feelings better and show empathy while learning the practical skills needed throughout their studies and preparing for future practice^11,12.

Similar findings were also reported in study was conducted by (Ziaei et.al 2021)¹³, to assess the relationship between learning approaches and academic performance of dental students: A cross-sectional study in Kermanshah, Iran. This study was conducted to determine the relationship between learning approaches and academic performance of dental student. In this cross-sectional study, 128 dental students of Kermanshah University of Medical Sciences were recruited by the stratified random sampling method. Results revealed that most common learning approach in most strong (n = 49, 45.4%) and weak (n = 12, 60%) students was the superficial approach. The results of chi-square test did not show a statistically significant difference between strong and weak students in terms of the learning approach. Lack of concentration is one of the biggest enemies of academic performance of the students. Studies also suggest that divergent teaching learning methodologies such as structured teaching interventions in forms of lecture¹⁴, Bibliotherapy (Metha et al, 2016)¹⁵ and OSCE (Vijayalakshmi et al, 2016)¹⁶ can improve the students’ performance.

Similar study was conducted among nursing students to assess the correlation of learning and study strategies with academic achievement. The study aimed to determine the relationship between learning study strategies and academic achievement of nursing students in 2013. Pearson correlation coefficient showed that the three main components of learning strategies and study skills component, respectively skill (P=0.001, r=0.349), self-regulation (P=0.009, r=0.280) and the component of will (P=0.045, r=0.218) with student achievement (mean grade of last term) had a positive and significant relationship. Results revealed that positive and significant correlation between learning and study strategies with academic achievement in nursing students, so, they suggested that students and teachers use these strategies to improve academic achievement and reduce the academic loss of students.¹⁷ Priya et al. (2018) also recommended that students should be motivated to value their lives and take measures to free themselves from addictive behaviours, including mobile and selfie addiction.¹⁸

CONNCLUSION:

Overall study findings revealed that, the relationship between learning approaches and academic performance among undergraduate nursing students is complex and multifaceted. It is encouraging to note that students use deep learning approaches followed by strategic learning approaches. It is always better to use strategic learning approaches predominantly which may facilitate the better performance and coping with the academic needs and requirements. However, it is essential to recognize the students learning approaches its relation to academic performance and strengthen the healthy and positive learning approaches and strategies. Teachers and other stakeholders should cultivate the habit of positive learning approaches and facilitate healthy learning and educational environment to maximize the academic achievement and to become a good citizen of the country.

ACKNOWLEDGMENT:

The author appreciates all those who participated in the study and helped to facilitate the research process.

CONFLICT OF INTERESTS:

The author declared no conflict of interests.

REFERENCES:

1. Chang SY, Lin SH, Lee CH, Chen HC, Chang YC. Using mobile learning to support medical and nursing education: a systematic review. Nurse Educ Today. 2022; 97:104715.

2. Brown A, White L, Davis R. Adapting nursing education to meet the demands of contemporary healthcare: a systematic review. J Nurs Educ. 2022; 45(3): 210–25.

3. Nuzhat A, Salem RO, Quadri MSA, Al-Hamdan N, Ashour N. Role of academic self-efficacy in education and its relation to academic burnout and academic success. Int J Med Educ. 2019; 10: 131–6.

4. Fooladi E, Karim MN, Vance S, Walker L, Zanjani ME, Ilic D, Brand G. Factors associated with undergraduate nursing students' academic and clinical performance: a mixed-methods study. Front Med. 2022; 9: 793591.

5. Priya S, Venkatesan L, Mary HR, Vijayalakshmi K. Impact of self-esteem upon academic performance of college students. Int J Adv Res Ideas Innov Technol. 2019; 5(6): 52–5.

6. Darbyshire P, Thompson DR, Watson R. Nursing schools: dumbing down or reaching up? J Nurs Manag. 2019; 27(1): 1–3.

7. Hernández-Blanco A, Herrera-Flores B, Tomás D, Navarro-Colorado B. A systematic review of deep learning approaches to educational data mining. Complexity. 2019; 2019:1306039.

8. Vijayalakshmi K, Revathi S, Venkatesan V. Validity of Objective Structured Clinical Examination (OSCE) in psychiatric nursing. J Nurs Trendz. 2016; 7(1).

9. Smith C, et al. Exploring the influence of ethnicity on academic success among undergraduate nursing students: a qualitative study. Nurse Educ Today. 2019; 82: 104–12.

10. Brown S, White S, Wakeling L, Naiker M. Approaches and study skills inventory for students (ASSIST) in an introductory course in chemistry. Journal of University Teaching and Learning Practice. 2015 Sep; 12(3): 1-4.

11. Benjamin LS, Pasay-an E, Vijayalakshmi K, Alqarni AS, Aseeri A, Alsulami A, et al. Emotional intelligence and self-esteem among Saudi Arabian and Indian nursing students: findings from two countries. BMC Nurs. 2024; 23(1): 349.

12. Thomas DS, Natarajan J, Valsaraj BP. Emotional intelligence and its associated factors among nursing students in a Middle Eastern university. Int J Nurs Educ. 2021; 13(1): 61–7.

13. Ziaei N, Shaveisi M, Janatolmakan M, Bahramani RS, Khatony A. Relationship between learning approaches and academic performance of dental students: a cross-sectional study in Kermanshah, Iran. Educ Res Int. 2021; 2021: 1–7.

14. Chandra A, Appavu S. Effectiveness of structured teaching programme on polycystic ovarian syndrome among nursing students. i-Manager’s J Nurs. 2018; 8(2): 28.

15. Metha J, Vijayalakshmi K, Venkatesan L. Effectiveness of bibliotherapy upon coping skills among B.Sc. nursing first year students. TNNMC J Ment Health Nurs. 2016; 4(2): 8–12.

16. Vijayalakshmi K, Revathi S, Venkatesan V. Validity of Objective Structured Clinical Examination (OSCE) in psychiatric nursing. J Nurs Trendz. 2016; 7(1).

17. Mohammadi I, Thaghinejad H, Suhrabi Z, Tavan H. The correlation of learning and study strategies with academic achievement of nursing students. J Basic Res Med Sci. 2017; 4(3): 8–13.

18. Priya V, Vijayalakshmi K. Selfie addiction among college students. Res Rev Int J Multidiscip. 2018; 3(9): 78–81.

Received on 05.08.2025 Revised on 03.11.2025

Accepted on 13.12.2025 Published on 30.04.2026

Available online from May 02, 2026

Int. J. Nursing Education and Research. 2026;14(2):153-158.

DOI: 10.52711/2454-2660.2026.00030

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.