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Stigma Associated With Academic Failure in Nursing Education: A Triangulated Qualitative Study of Nursing Students
Esther Albertinah Mpangane1, Nkhensani Florence Mabunda1, Deliwe Rene Phetlhu1
1Department of Nursing, Faculty of Health Care Science, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Aim:
To integrate the perspectives of repeating nursing students, nurse educators, and non-repeating nursing students to understand how stigma associated with academic failure manifests within nursing education institutions.
Design:
Qualitative triangulation study.
Methods:
Data were collected across four campuses of a South African nursing education institution using individual semi-structured interviews with repeating nursing students (n = 8) and focus group discussions with nurse educators (n = 47; nine groups) and non-repeating nursing students (n = 51; nine groups). Participants were purposively sampled based on their direct experience of the phenomenon. Data were analysed using thematic analysis within each participant group, followed by triangulation to identify convergence, divergence, and complementarity across datasets.
Results:
Stigma associated with academic failure operated across interpersonal, structural, and internalised levels. Five integrated themes were identified: (1) stigmatising behaviours and labelling; (2) institutional policies and administrative practices; (3) peer exclusion and professional conduct; (4) psychological and financial consequences; and (5) coping responses and resilience. Participants described public identification as 'repeaters', inequitable treatment, financial hardship after stipend withdrawal, diminished confidence, anxiety, and social isolation.
Conclusion:
Stigma associated with academic failure is systemically embedded within nursing education and reinforced through educator practices, peer interactions, and institutional systems. Multilevel interventions are required to foster equitable, psychologically safe, and inclusive learning environments.
Impact:
Findings provide evidence to guide educator development, anti-stigma interventions, student support initiatives, and policy reform within nursing education institutions.
Patient/Public Contribution:
No patient or public involvement occurred in the design, conduct, reporting, or dissemination of this study beyond participation of nursing students and nurse educators as research participants.
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