Lived Experiences of Nursing Students and Educators on Self-Management in Teaching and Learning in Ghana: An Interpretive Phenomenological Study

Abstract

Introduction

As students enter nursing education, they shift away from parental control and school support, taking responsibility for themselves and their academic performance. This independence requires self-management abilities. However, few studies have explored the experiences of nursing students and educators on self-management in the teaching and learning.

Objective

The study aimed to understand the lived experiences of self-management in teaching and learning context from the perspectives of nursing students and educators from different nursing colleges in Ghana.

Method

A qualitative interpretive phenomenological approach was used. Individual in-depth interviews were conducted with 17 first- and third-year nursing students and eight nurse educators. Verbatim transcriptions were analyzed using the steps of the interpretive process and the hermeneutic circle, with continual review and analysis between the parts and the whole.

Results

This study explored self-management in the teaching and learning context among nursing students, revealing four major themes: strategizing for progress and success, nurturing health and well-being, developing self-belief, and partnering with others, each with associated subthemes. The findings indicate that self-management elements are deeply interconnected and interdependent. Strategizing for progress and success involves time management, goal setting, self-discipline, and continuous self-evaluation. Nurturing health and well-being is essential for a sound mind and body through self-care. Developing self-belief, including confidence and self-assurance, is key to academic success. Both students and educators emphasized partnering with others, highlighting collaborative learning and support networks as crucial to self-management in nursing education.

Conclusion

These themes provide valuable insights for nursing students, educators, and institutions by shedding light on their experiences with self-management in teaching and learning. By understanding these perspectives, educators and institutions can implement innovative teaching approaches that effectively support students in developing self-management skills.

Keywords

interpretive phenomenology lived experiences nursing education self-management

Introduction/Background

There is a need to prepare competent nurses with a range of skills within higher education all around the globe (Baker et al., 2021). Research has indicated that academic success depends on a combination of individual and social factors and not merely knowledge of content (Nagaoka et al., 2013). Student support helps to address increased attrition rates and low outputs, particularly in nursing and midwifery programs (Mudaly & Mtshali, 2018). The educators’ aim is also to prepare nursing students for practice and issues the students might encounter, thus, equipping them with the skills to manage these challenges independently (Mthiyane & Habedi, 2018). In addition, self-management skills can be learned by the individual, fostering readiness for autonomous practice (Duprez et al., 2017).

Learning self-management skills is important for nursing students (Kadiyono & Hafiar, 2018). These skills and abilities of self-management may transcend the education environment as the students will apply them after nursing education (Kadiyono & Hafiar, 2018; Wiyono & Kholidya, 2018). The concept of self-management thus goes beyond a student merely managing time and workload and conforming with assessment guidelines and deadlines (Olorunfemi-Olabisi & Akomolafe, 2013). It requires improving emotional intelligence and resilience, maintaining motivation, managing stress and self-doubt under challenging conditions, and engaging in ongoing personal and professional development (Dembo & Seli, 2011).

As students enter nursing education, they move away from parental control and the secondary school system and take responsibility for themselves and their academic performance. These students encounter difficulties in adjusting to the combination of academic and personal life issues. The learning environment in nursing education may be emotionally stressful for first-year students (Doe et al., 2018). This in turn affects the academic performance of the students and their well-being.

The majority of training of nurses in Ghana occurs in nursing training colleges (Bell et al., 2013). It is a 3-year diploma program during which students are expected to combine both academic and clinical work to complete their studies. The 3-year diploma program prepares the nursing students to become registered general nurses. The workload increases significantly in the final (third) year of study and includes both theoretical and practical examinations, research and patient care. This heightened demand necessitates the development of self-management skills to ensure the successful completion of the program.

Literature Review

The training of nurses is important as they form a crucial component of the health workforce (International Council of Nurses [ICN], 2021). The aim is to provide students with evidence-based knowledge to address societal requirements therefore nursing education includes theoretical and practical learning that promotes critical thinking and clinical reasoning (Falcó-Pegueroles et al., 2021).

Learning in the higher education setting requires skills such as self-management to ensure academic success. Self-management in teaching and learning provides an internal environment that fosters active engagement in studies. This concept extends beyond health education where individuals are actively involved in their care and empowered to identify challenges and solve problems related to their illness or health goals (Rothenbuhler, 2015). Worldwide, nurses play an important role in supporting patients with self-management (Duprez et al., 2016). They therefore require both the competencies to support patients with self-management and to manage themselves in the academic and clinical practice environments.

When students are not actively encouraged by educators to take responsibility for their learning, it impedes the development of essential self-management skills such as goal-setting and time management (Ghasemi et al., 2020). While teaching approaches such as clinical simulations are becoming popular in nursing education as they typically focus on replicating real-world clinical scenarios, they primarily focus on building technical and critical-thinking skills. However, it has been observed that unless students are encouraged to take a reflective and self-directed approach during debriefing, the development of self-management skills can be limited (Bahri et al., 2016).

Self-management skills contribute to professional development and the ability to adapt to the developing healthcare landscape (Duprez et al., 2017). A study conducted among undergraduate nursing students in five medical schools in China found a significant relationship between attributes of self-management and academic performance (Kong et al., 2021). This suggests that students’ academic performance holds promise when they are actively and sufficiently capable of self-managing their academic lives. The concept of self-management is, therefore, necessary for nurses to engage in continuous professional development throughout their careers and develop their self-management skills as they climb the academic ladder from diploma to master level or beyond. Nursing students are expected to develop self-management capabilities, yet the curricula often lack explicit strategies to support this development (Landeen et al., 2016).

There is a limited exploration of self-management in the teaching and learning context among health professions, specifically in nursing education, hence the need for the study. While there are studies that have explored teaching self-management skills to nursing students for the delivery of patient care (De Lange-Cloete, 2022; Duprez et al., 2016; Rothenbuhler, 2015; Sattoe et al., 2015), no studies have been conducted on the experiences of nursing students and educators of self-management in the teaching and learning context. The concept of self-management is rooted in the Ecological Systems theory (Ryan & Sawin, 2009) and hence the lived realization thereof is influenced by various individual and environmental contextual factors (Grey et al., 2015; Modi et al., 2012; Ryan & Sawin, 2009).

Therefore, this study aimed to understand the lived experiences of self-management in the teaching and learning context from the perspectives of nursing students and educators from different nursing colleges in Ghana.

Method

Design

An interpretive phenomenological approach was used to explore lived experiences and how meaning is attributed to self-management in a unique cultural and historical context (Frechette et al., 2020).

Research Question

How is self-management realized in the teaching and learning context from the perspective of Ghanaian nursing students and nurse educators?

Population and Sample

The Ashanti region in Ghana has a large number of nursing training colleges, namely 13 public nursing training colleges. Four of these colleges were purposively selected: two colleges that had a good throughput (50–100% in the 2020 licensing exams) and two colleges with a poorer throughput (0–49% in the 2020 licensing exams; anecdotal reports, official data unavailable), and also considering geographical variation (thus, urban and district/periurban). Colleges 1 and 4 were in the urban city of Ashanti region and Colleges 2 and 3 were in two different districts of Ashanti. Across the four colleges, first-year student numbers range from 100 to 200, third-year students from 100 to 250, and nurse educators from 15 to 30 per college. Purposive sampling was used which enabled the selection of participants who have an extensive understanding of the phenomenon. Twenty-five participants: 17 nursing students (10 females and seven males in their first year or third year) and eight nurse educators (four females and four males) were selected. All participants signed an informed consent form.

Maximum variability in terms of gender, class level of students, and years of teaching experience was obtained by ensuring that at least one female, one male, one first-year nursing student, one third-year nursing student, and one nurse educator with teaching experience between 1 and 5 years and one nurse educator with teaching experience above 5 years were included. After the 14th interview of student participants, there was a repetition of themes; the point at which no new insights are emerging from the data. By the sixth interview of the educator participants, thematic repetition occurred. Three more student interviews and two more educator interviews were done to confirm data saturation (Burns et al., 2015).

Inclusion Criteria

First-year and third-year students enrolled in the Diploma in Nursing program at a nursing training college in the Ashanti region of Ghana.

Nurse educators who teach at the nursing training colleges and with at least 1 year teaching experience.

Exclusion Criteria

Second-year diploma nursing students were excluded to enable a clearer comparison of self-management development between first- and third-year students. This approach allowed for a better understanding of how these skills emerge and evolve, as second-year students, being in an intermediate stage, may not provide distinct insights into this progression.

Data Collection

In-depth individual interviews were conducted by using interview guides with open-ended and probing subquestions. The interview guides explored the lived experiences of nursing students and educators on self-management in the teaching and learning context. Example questions included: “Please explain, in your own words, what is your understanding of self-management (this term can also mean taking care of or managing yourself and your academic work)? Feel free to use examples.” and “How would you explain self-management in teaching and learning? Feel free to use examples from your experience. For example, how do students cope with their studies, what strategies do they employ to ensure success and achieve well-being?.” Participants were interviewed in English because it is the medium of education at the colleges.

Prior to the study, Author A received training in interviewing skills and attended an online webinar on qualitative research and interview techniques. Being fluent in English, Author A who is a nurse educator conducted individual interviews under the guidance of Author B who assessed interviewing skills and provided feedback. Two pilot interviews were conducted to refine the interview guide questions. The duration of the individual interviews ranged from 30 to 90 min, ensuring sufficient time for an in-depth discussion.

Institutional Review Board

Approval was obtained from the Health Research Ethics Committee, Stellenbosch University with HREC Reference No: S20/08/210 (PhD). Permission was obtained from the principals of the selected nursing training colleges and permission letters were obtained. All participants signed an informed consent form independently after providing clarification when needed. Participants were informed that their information would remain confidential, accessible only to the research team. To ensure anonymity, interviews were transcribed using numerical identifiers instead of names.

Data Analysis and Trustworthiness

Verbatim transcriptions of the audiorecorded interviews were done by a professional transcriber and double-checked to ensure credibility whilst ensuring confidentiality. ATLAS.Ti version 23 software was used to code self-management-related themes and subthemes. Data was analyzed using the steps of the interpretive process (Crist & Tanner, 2003). Descriptive and interpretive analyses were done to place the initial description in connection with a larger theoretical, social, and cultural framework (Larkin et al., 2006). This interpretive process involved five overlapping phases, namely: Early focus and lines of inquiry, Central concerns, exemplars and paradigm cases, Shared meanings, Final interpretations and Dissemination of the interpretation.

Initial transcripts were reviewed with the research team. Using the hermeneutic circle, self-immersion in literature, acknowledgement of biases, and refinement of understanding of self-management were done. Through thematic analysis, we identified key patterns from in-depth interviews, iteratively moving between data segments and the whole. Constant reflection ensured interpretive validity, resulting in a nuanced understanding of self-management in the teaching and learning context. The research team identified key themes, explored links between past experiences and current self-management practices, and refined interpretations through iterative writing and discussions. Summaries of participant concerns were stored in ATLAS.Ti and continuously revised. Exemplars highlighted common self-management themes, while paradigm cases captured unique insights, such as contrasting student behaviors. Coding and thematic analysis were refined through feedback from the research team, ensuring a structured analytical framework. The first and second authors identified shared meanings as key participant concerns emerged. The interpretive summary helped establish links between patterns in self-management experiences. The research team focused on these summaries to develop interpretations. An audit process ensured thorough evaluation and alignment with study objectives. Final interviews refined emerging interpretations, ensuring all key concerns were addressed. Once no new data emerged, themes and interpretations were finalized, with cross-checking by the research team for validity. The interpretive team's feedback improved manuscript clarity through iterative analysis of narratives, field notes, and discussions. An audit trail documented key decisions, while ongoing reflection and peer debriefing ensured depth and rigor. The study integrated lived experiences with conceptual analysis, using a systematic yet flexible approach to enhance nursing research, policy, and practice.

The study ensured trustworthiness through credibility, transferability, dependability and confirmability (Guba, 1981). To enhance the credibility of the study, both the Lincoln and Guba criteria (Polit & Beck, 2017) and the framework proposed by De Witt and Ploeg (2006) were applied. Credibility was achieved through peer scrutiny, field notes, audio recordings, verbatim transcriptions and discussions between the research team. Rapport with participants and member checking further enhanced credibility. Transferability was ensured by providing detailed descriptions of the study setting, methodology and participant diversity, and linking findings with existing literature. Dependability was maintained through clear documentation of the study process, reflective notes, co-coding and audit trails using ATLAS.Ti. Additional rigor was ensured by balancing the researcher's perspective with the participants’ voices, maintaining openness, and making findings relatable and applicable for future reflection (Crist & Tanner, 2003; De Witt & Ploeg, 2006).

Results

Participant's Characteristics

In total, 25 in-depth individual interviews were conducted across the two groups. Ten female and seven male nursing students in their first or third year participated. The predominance of females in the study can be seen to be in line with current student demographic profiles in nursing training colleges. The mean age was 22 (range 19 to 24). Of the eight nurse educators who participated, four were females and four were males, with a mean age of 41 (range 33 to 53). Three of the nurse educators had the rank of deputy chief health tutor, two were principal health tutors and three were senior health tutors. Their average years of working experience as a nurse educator was 8 years (range 3 to 16 years).

Themes and Subthemes for Lived Experiences

Four main themes were formulated to represent the lived experiences of self-management in the teaching and learning context: strategize for progress and success, nurture health and well-being, develop self-belief and partnering with others (Figure 1). These themes and their subthemes are discussed below.

Figure 1.

Identified lived experiences of self-management in the teaching and learning context.

Theme 1: Strategize for Progress and Success

Participants described this as controlling and regulating learning by valuing and managing time, cultivating self-discipline, setting goals for the self, devising enablers, desiring to pursue, persist and conquer, embracing self-empowerment and engaging in self-discovery, and evaluating and monitoring progress. These attributes of self-management are intertwined and interdependent.

(a) Subtheme 1: Value and Manage Time Effectively

All participants emphasized the importance of valuing and managing time effectively through time-consciousness, personal timetables and punctuality. These enabled students to align their efforts, prioritize tasks, and optimize their learning experiences, ultimately influencing their academic achievements.

I plan my time very well and I make my personal timetable. So, um I know from this time to this time maybe from class, I … sleep for 2 h. We close at 4:30, so by 5:30 I will be up. I will take my bath and take my supper, after that then I will come to class and I will study for 2 h, then after that, I will do my group studies. (Participant 7, nursing student, 23 years, female)

So, whatever goes in how and that goes in time management how you are managing your time within that circle, because if you are to go to the class from morning up to evening, how you are going to go through maybe from morning till evening, you have to plan. (Participant 19, nurse educator, 53 years, female)

(b) Subtheme 2: Cultivate Discipline

All the student participants except one and six out of the eight nurse educator participants mentioned cultivation of discipline as an attribute of self-management, identified cultivating discipline as a key aspect of self-management, emphasizing regular learning, hard work, avoiding laziness and procrastination, conscientiousness, responsibility and managing their environment. They viewed learning as a daily routine and saw conscientiousness in work as a sign of discipline. Taking responsibility for one's actions and managing physical and social learning environments were also recognized as essential to maintaining discipline.

…and being disciplined. So, if you’re able to discipline yourself, you can be at any place at any time, or you can be called to be at any place. Self-discipline is like you are trying to be who you are, or you’re trying to manage yourself in such a way that you wouldn’t go contrary to any rule that has been set for you. So that's how I understand self-management in general. (Participant 1, nursing student, 23 years, female)

Okay, there was one student that boy was always serious in class. She [He] always asks questions in class, and when that student is asked a question, the way he will answer the question, so one day I called the student and confronted [him]. He said, oh sister everyday [I] am in the library when you say something and I don’t understand, I go and research I want to the tutor know that I know, so I have to study hard so that when I come and I will ask questions and if the tutor is able to answer I will know that oh no this tutor is on top of her [game]. So that student always had a lot of distinctions after the final examination. She [He]was very good. She [He] was very good. (Participant 19, nurse educator, 53 years, female)

Five nursing students mentioned setting goals for themselves as an attribute of self-management. They discussed that their common goal was to pass their examinations and complete the program successfully. The nurse educator participants elaborated on goals that students set beyond achieving good grades, toward becoming a qualified nurse.

I messed up my academic life when I was in senior high school. So, when I got admission in the nursing college, I told myself that I would work hard and learn to get good grades in all the courses I am being taught. therefore, [I] wrote this goal on a paper and pasted it beside my college bed. (Participant 2, nursing student, 24 years, male)

… if you don’t set a goal for yourself that you are in the school for a purpose: you want to come out as a nurse or a midwife. Once you know that that's your aim: I have to come out as a qualified nurse, then whatever goes into helping me, you will focus your attention on that. (Participant 19, nurse educator, 53 years, female)

(d) Subtheme 4: Devise Enablers to Reach Goals

All educators with ten students mentioned devising enablers to reach goals toward learning as an attribute of self-management. Such enablers to reach goals included planning timetables and learning resources. While the student participants related planning more to the use of timetables, the nurse educator participants were more particular about effectively planning learning resources.

Alright you as a teacher will have to ensure that to manage yourself you have to ensure that you plan, have adequate time to plan and read over the materials that you intend to teach the students and making sure that all your materials are available for you to be able to deliver to the students. (Participant 25, nurse educator, 43 years, female)

And if you are able to plan your timetable very well, it helps you to excel. (Participant 7, nursing student, 23 years, female)

(e) Subtheme 5: Desire to Pursue, Persist, and Conquer

Twenty participants mentioned the desire to pursue, persist and conquer as a key enabler of self-management. This involved recognizing the intrinsic value of academic success, fostering internal motivation and demonstrating determination and perseverance. Participants expressed:

…when you motivate yourself internally, it boosts you to do more. You [will be] getting a good result [that] will make you do more. (Participant 4 nursing student, 22 years, female)

What you determine during the semester, maybe next semester you plan that this and that you will be doing on that semester. (Participant 7, nursing student, 23 years, female)

Before I can get that title, I must make the grade, first class or I must pass. So, if they are motivated inward, you are encouraged to learn and manage your studies. (Participant 4 nurse educator, 41 years, male)

(f) Subtheme 6: Embrace Self-Empowerment and Engage in Self-discovery

Ten participants mentioned embracing self-empowerment and engaging in self-discovery as an attribute of self-management. This involved empowering yourself to develop a strong sense of self-awareness, the willingness to evolve by embracing change and transformation and the ability to take control of one's education and personal growth. Developing a strong sense of self-awareness and the willingness to transform were described as key components of self-empowerment.

But once you have this super ego that drives you to do things, your[set] priority, you will set yourself [up] safely: ‘maybe let me focus on, or let me rush through what the tutor taught’, yeah, I think that is self-empowerment. (Participant 11, nursing student, 19 years, female)

So, in doing all this to help you to become who you are, manage yourself, and you'll be empowered to do more and more. (Participant 1, nursing student, 23 years, female)

(g) Subtheme 7: Evaluate and Monitor Progress

Twenty-two participants identified evaluating and monitoring progress as a crucial attribute of self-management. This involved assessing learning activities, tracking progress and identifying strengths, weaknesses and areas for improvement.

… as a student, you have to check if how you are learning is helping you. You have to keep your exam papers, projects, and assignments. Over time, you can see how your work has improved or identify areas where you need to focus more. (Participant 10, nursing students, 24 years, male)

I try to get past questions so that I will get to know the format[of] how questions are been set, and I will compare it to my studies: if am able to, I will solve it first, if [I] am not able to catch up with the questions, I try to sit by my book and go through [the subject matter] again. (Participant 7, nursing student, 20 years, female)

Theme 2: Nurture Health and Well-Being

Nurturing of own health and wellbeing was identified as a main theme in this study. Participants described nurturing health and wellbeing as employing self-care strategies to ensure that they have sound minds and that their bodies remain healthy.

(a) Subtheme 1: Employing Self-care Strategies

Self-care strategies are crucial for students to maintain their well-being, manage stress, and perform at their best as mentioned by 13 participants.

And whenever you are sick you don’t go to a drug store or over the counter to buy drugs but rather visit a hospital to make sure that you get proper treatment to help promote your health. (Participant 1, nursing student, 23 years, female)

Okay, my health status, I make sure I have enough rest or enough sleep, I eat very well to boost my immune system and me being a nurse or a student nurse, I have been taught many things on how to promote your health, such that you eat very good food, you don’t eat junk food, you eat a nutritious diet to help promote your immune system. (Participant 1, nursing student, 23 years, female)

Theme 3: Develop Self-Belief

The development of belief in one's abilities was identified as a theme. Participants explained that students who have developed positive self-belief are confident and bold to face academic challenges and take initiative in how they live on campus to become good self-managers.

(a) Subtheme 1: Being Confident and Bold

Six of the participants mentioned being confident and bold as one of the subattributes of self-management. Participants explained self-belief as having confidence and being able to take initiative. They saw confidence as a strong sense of self-assuredness and belief in their abilities. According to them, students who take initiative have a keen ability to recognize gaps, see potential improvements and are willing to step forward to address them, whether it is suggesting new study methods, organizing study groups, or proposing innovative solutions.

At the end, students who can manage themselves well are students who have confidence in themselves that they can do it, no matter what. Because, for instance, when I came to first year, I was kind of reserved as I told you, but along the line I developed confidence, I began to build my confidence level, I was seen participating in all activities that boost academic performance. I had the courage to ask questions in class, and that helped me to manage my academic life well. (Participant 2, nursing student, 24 years, male)

Some students manage themselves by taking the initiative to learn ahead of the class. There was a time I met one student going to the ward [clinical site] alone outside the official clinical hours to go and practice. (Participant 19, nurse educator, 53 years, female)

Theme 4: Partnering With Others

Partnering with others is described as the practice of students working together with nurse educators and the management of the educational institution in various ways to achieve common goals, share knowledge, and enhance their learning experiences.

(a) Subtheme 1: Building Relationships With Peers, Educators and the Institution

Fifteen nursing students and six nurse educators mentioned building relationships as a key subattribute of self-management. This includes relationships between educators and students, educators and management, and among students. Positive student-to-student, educator-to-student and educator-to-institution relationships, were recognized as fostering collaboration, open communication, effective teaching practices and mutual support in the learning environment.

If the relation between the tutor and the management of the college is good, the tutors [nurse educators] tend to teach well and also build positive friendships that will also cover the students. This will allow the students to feel free to go to the tutors for help, and the tutors will willingly assist them. (Participant 25, nurse educator, 43 years, female)

If we are able to build a cordial relationship between student and then tutors [nurse educators], students can always feel free to air their challenges to their tutors so that they can be able to help. But in a case where the tutors and then the student relationship is bad, the students wouldn’t be able to go nearer to the tutor to air their grievances or anything. (Participant 9, nursing student, 20 years, male)

So, I think that the student-student interaction in terms of academics has improved my life on campus a lot. And people who are closer to me can say that. (Participant 2, nursing student, 24 years male)

Discussion

The study set out to explore the lived realization of self-management in teaching and learning context among nursing students. Four major themes: strategizing for progress and success, nurturing health and well-being, developing self-belief, and partnering with others, each with associated subthemes revealed as key findings. The findings indicate that self-management elements are deeply interconnected and interdependent. Participants emphasized the critical role of time management through time-consciousness, personal timetables, and punctuality. Strategizing for progress and success involved goal setting, self-discipline, empowerment, and continuous self-evaluation. Nurturing health and well-being were described as essential for maintaining a sound mind and body through self-care strategies. Developing self-belief emerged as a key factor, with participants highlighting confidence and self-assuredness as fundamental to academic success. Both nursing students and educators underscored the significance of partnering with others, emphasizing collaborative learning and support networks as crucial components of self-management in nursing education.

Strategizing for success is a crucial aspect of self-management in nursing education, encompassing time management, self-discipline, goal setting, planning, persistence, self-discovery, and progress monitoring. These attributes align with self-regulation, enabling students to take control of their learning, improve academic performance, and develop lifelong learning skills. Reflective practice and continuous self-monitoring help students adjust their strategies for better outcomes. Nurse educators play a vital role in fostering these skills through guidance and structured support. The study identified key subthemes, including valuing and managing time effectively, cultivating discipline, setting goals for the self, devising enablers to reach goals, the desire to pursue, persist and conquer, embracing self-empowerment and engaging in self-discovery, and evaluating and monitoring progress all of which contribute to effective self-management.

Valuing and managing time effectively is a vital self-management attribute in nursing education, involving planning, allocation, and utilization of time to meet learning goals (Wiyono & Kholidya, 2018). Given the multiple academic demands, effective time management optimizes learning and enhances academic success (Behdarvand et al., 2023). Participants in this study, including nurse educators and students, emphasized time-consciousness, punctuality, and personal timetables as essential strategies. This aligns with research in Belgium, which links time management to improved academic performance and reduced anxiety (Duprez et al., 2017a; Zhang et al., 2021). Studies from Turkey and Iran indicated that while nursing students possess moderate time management skills, further development is necessary for academic and career success (Akyüz et al., 2020; Altiner et al., 2022). Time management is also a key component of self-regulated learning, as measured by the Online Self-Regulated Learning Questionnaire (Broadbent et al., 2022).

Cultivating discipline is a key aspect of self-management in education, enabling students to regulate impulses, remain focused, and work consistently toward academic goals (Olorunfemi-Olabisi & Akomolafe, 2013; Wiyono & Kholidya, 2018). Studies have shown that disciplined nursing students manage their learning effectively, leading to academic success (Romli et al., 2023). Furthermore, discipline encompasses socially acceptable behavior, responsibility, and respect (Manandhar & Shrestha, 2019), aligning with professional standards in nursing education (Nursing and Midwifery Council [NMC], 2018). It reflects core nursing values such as integrity, competence, and professionalism.

Setting goals is another crucial self-management attribute, helping students strategize for academic success by identifying objectives and breaking them into achievable steps (Kadiyono & Hafiar, 2018; Tanimura et al., 2023). Nursing students proficient in goal setting focus on learning outcomes and demonstrate motivation for long-term success (Ghasemi et al., 2020). Studies in multiple countries confirm that nursing students emphasize task orientation and learning goals, which vary by academic year (Lazcano et al., 2022; Manrique-Abril et al., 2020). Goal setting is integral to self-regulated learning, promoting motivation and academic achievement (Broadbent et al., 2022; Zimmerman, 2000).

Devising enablers to reach goals is essential for structuring learning activities, managing time, and optimizing resources (Manrique-Abril et al., 2020). Planning facilitates prioritization and enhances academic performance (Duprez et al., 2016). Studies indicate that nursing students who plan their schedules effectively excel academically (Çingöl & Karakaş, 2023). Zimmerman's (2000) self-regulation model associates strategic planning with goal achievement, reinforcing its importance in nursing education (Tanimura et al., 2023).

The desire to pursue, persist, and conquer motivates nursing students to engage in learning and overcome academic challenges (Tanimura et al., 2023). Internal motivation fosters determination, goal achievement, and self-regulation (Saeedi & Parvizy, 2019; Zimmerman, 2000). Research highlights the positive impact of intrinsic motivation on perseverance and academic resilience (Messineo et al., 2019; Sarikoc & Oksuz, 2017). Perseverance enables students to set ambitious goals, tackle obstacles, and enhance academic self-confidence (Halperin & Regev, 2021; Terry & Peck, 2020).

Embracing self-empowerment and engaging in self-discovery involves proactive personal development beyond formal education (Kadiyono & Hafiar, 2018). Empowered nursing students actively engage in extracurricular activities, fostering growth and academic success (Al-Niarat & Abumoghli, 2019). Studies link empowerment to improved performance in clinical training and higher academic achievement (Ahn & Choi, 2015; Kirk et al., 2016).

Evaluating and monitoring progress is vital for self-management, allowing students to assess performance, identify areas for improvement, and refine learning strategies (Grech, 2021; Jootun & McGarry, 2014). Reflective practices enhance nursing education and professional growth (Nishimoto et al., 2021). Self-monitoring aids in tracking academic progress, reinforcing learning, and preparing for assessments (Bahri et al., 2016; Wilany & Dewi, 2017). Zimmerman's model emphasizes monitoring as a critical phase in self-regulated learning, ensuring sustained progress and goal attainment (Tanimura et al., 2023; Zimmerman, 2000).

The second main theme was nurturing health and ensuring well-being. This involves prioritizing physical health and seeking the proper treatment when needed (Pronk et al., 2021). Nurturing health and well-being were described under the subthemes: employing self-care strategies to maintain wellbeing, managing stress, healthy eating and getting enough rest and sleep. Employing self-care strategies is integral to academic success, as it ensures the well-being of learners, who are central to the teaching and learning process. While not explicitly included in self-regulated learning models (Tanimura et al., 2023; Zimmerman & Schunk, 2011), the concept has historical roots, as highlighted by Juvenal's assertion of a healthy mind in a healthy body (Highet, 1937). Participants equated self-care with self-management, emphasizing that prioritizing well-being enhances academic performance. Nursing students encounter various stressors, including workload and academic pressure, underscoring the need for strategies to maintain nutrition, sleep, and physical activity (Younas, 2017). Studies from the United States suggest that incorporating self-care behaviors into nursing curricula can reduce psychological distress and support student success (Brouwer et al., 2021; Slemon et al., 2021).

Development of self-belief emerged as a significant third theme with participants describing “being confident and bold” as having a strong sense of self-assuredness and belief in one's abilities. Three studies conducted in Indonesia, Ian and China confirm that students’ confidence level has a positive influence on the way they learn and on their academic performance (Bahri et al., 2016; Ko, 2018; Purwandari et al., 2023). Confidence and boldness are essential aspects of self-efficacy, enabling students to believe in their ability to achieve academic goals (Bandura, 1977). Participants highlighted that self-belief enhances confidence in behavior, attitude, and academic interactions, fostering resilience in facing challenges and improving self-management (Gela & Mengistu, 2018; Ryan & Sawin, 2009). Research confirms that self-efficacy significantly influences nursing students’ academic learning process (Purwandari et al., 2023). Taking initiative in learning enhances competence, as students gain experience and skills that boost their confidence (Ghasemi et al., 2020). A review of nursing student engagement strategies in Iran reported that self-efficacy supports goal-setting and proactive learning (Ghasemi et al., 2020). Students with high confidence levels are more likely to embrace challenges, seek learning opportunities, and persist despite setbacks, reinforcing their academic growth and professional readiness (Gulley et al., 2021; Shorey & Lopez, 2021).

The fourth main theme emerged as partnering with others. Participants reported that partnering with others played a crucial role in the academic life of students. This involves building relationships such as educator–student relationships, educators–management relationships, and student–student relationships. Building and nurturing relationships are crucial for effective teaching and holistic student development (Charlton, 2016). Participants emphasized that educator–student relationships extend beyond knowledge transmission, aligning with findings from KwaZulu-Natal, South Africa, where supportive relationships between nurse educators and students enhanced academic performance (Dube & Mlotshwa, 2018). While valuing positive relationships, participants also recognized the need for professional boundaries. Additionally, the relationship between educators and institutional management significantly impacts student outcomes, with collaboration fostering positive learning environments and effective teaching practices (Van de Velde et al., 2019). Nursing students benefit from social presence, as collaborative interactions help them navigate academic challenges (Grech, 2022). Bandura's (1971) Social Learning Theory underscores the role of social interactions in learning, emphasizing observation, modeling, and imitation of behaviors, attitudes, and emotional responses within educational and peer contexts.

Strengths and Limitations

This is the first study to describe the lived realization of self-management from the perspective of nursing students and educators. Although data collection continued until saturation was reached, the inability to sample from all potential colleges in Ghana presents a limitation, affecting the overall transferability of the findings. Another limitation is that the study was focused on selected nursing colleges in Ghana. Hence, the findings may not be transferable to other settings. Further studies should assess the effectiveness of specific interventions, such as time management or self-regulation training, on improving academic performance in nursing education.

Implications for Nursing Education Practice

Nursing educators should integrate self-management skills into teaching by incorporating time management, goal setting, and self-discipline into the curriculum. Promoting student well-being through stress management and self-care initiatives is essential for academic success. Confidence-building strategies, such as mentorship and peer teaching, can foster self-belief. Encouraging collaborative learning and support networks enhances motivation and resilience. Additionally, educator training on mentoring and student-centered approaches can improve guidance and support. These strategies will better equip nursing students for academic success and future professional practice.

Conclusion

The study highlighted the role of self-management in nursing education through the lived experiences of nursing students and their educators. It revealed that nursing students and educators must cultivate skills such as time management, self-discipline, and self-belief while leveraging available supportive systems and resources to enhance self-management. There was an emphasis on the educator–student relationships extending beyond knowledge transmission while recognizing the need for professional boundaries.

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Footnotes

Acknowledgements

The study was part of MK's PhD in nursing science studies at Stellenbosch University, Cape Town, South Africa.

ORCID iDs

Mercy Kokuro

Talitha Crowley

Anita Serdyn van der Merwe

Cornelle Young

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Stellenbosch University postdoctoral research award (Grant No. ConsoliDoc).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Supplemental Material

Supplemental material for this article is available online.

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