Socio-economic and Environmental Factors Influencing Student Nurses’ Preparedness for Nursing Qualifying Exams

The study assessed socio-economic and environmental factors influencing student nurses’ preparedness for the Qualifying Examination for General Nurses (QEFGN) in school of nursing in Agbor, Delta State, Nigeria. A descriptive survey research of 70 third-year student nurses of Basic Nursing program were selected using convenience sampling technique. Data collected using researchers-developed questionnaire were summarized with simple frequencies, percentages, mean and standard deviation. Average mean scores of 4.17 and 1.98 indicated environmental factors influenced student nurses’ preparedness for QEFGN while socio-economic factors did not. There was no significant association between gender and socio-economic cum environmental factors influencing preparedness for QEFGN. While environmental factors influenced preparedness for QEFGN, socio-economic did not. It was recommended that administrators of nursing training institutions should ensure that adequate and lasting lighting is supplied with a solitary environment provided for the students preparing for the exam.


Introduction
Every educational system consists of an examination system through which the qualities and abilities of the students are assessed by giving grades and positions Rasul & Bukhsh, (2011).Some professional bodies demand that their students undertake standardized tests which will serve as an objective assessment of their knowledge and skills prior to registration and licensure.The Nursing and Midwifery Council of Nigeria organizes professional qualifying examinations for various basic and post basic nursing specialties in Nigeria through its examination division.The Professional Qualifying Examination for General Nurses (QEFGN) is unarguably one that is highly every student nurse attending an approved nursing training institution in Nigeria anticipates because passing it is a major criterion which must be met to be registered and licensed to practice as a professional nurse in Nigeria.(Nursing and Midwifery Council of Nigeria, 2016).
Timely and adequate preparedness of student nurses for QEFGN cannot be overemphasized.It is a rule of the thumb that candidates need at least 3-6 months to adequately prepare prior to the exam.In certain cases, candidates need more.Again, more time spent preparing for these exams given all of the unknown's yields better results.Candidates who diligently prepare for QEFGN are often better practitioners (School of PE, 2020).By shifting nursing education to include preparation for standardized exams in policies, students would approach the exam with more confidence (Glasgow et al., 2019).In preparation for the qualifying examination for General Nurses, students are required to attend grueling revision lectures, conduct research, perform assignments, attend clinical postings, engage in self and group study to complete the general nursing curriculum (School of PE, 2020).According to (Asogbon et al., 2016), socio-economic and environmental factors are among the several factors perceived to influence nursing students' preparedness for QEFGN.Gifford (2014) also stated the social factors include religion, urban-rural differences, norms, social class, proximity to problematic environmental sites and cultural and ethnic variations also influences student preparedness for exams.According to Julie (2015) there are many environmental factors that influence learning and student success.Environment has the potential to positively or negatively impact student competence, confidence and comprehension.Socio-economic factors include peer group, family background, religion, home problems, infrastructure for learning, personal or family crisis, financial problem and stress.Environmental factors include learning environment, class size, environmental condition (peace in the locality crisis e.tc) (Asogbon et al., 2016), However, awareness and sound adaptation to these factors will increase chances of excellent performance in the exams.Consequently, failure to understand these factors prevents the design of remediating interventions for students who are at risk of being inadequately prepared for the licensing examination.It is against this background that the researcher assessed the socio-economic and environmental factors influencing student nurses' preparedness for QEFGN in School of Nursing, Agbor, Delta State, Nigeria.

Study Design
This study is a descriptive survey.A descriptive survey research design allows the use of instruments such as questionnaire to collect data from a representative sample on existing specific variables at a given time, without manipulating them, and to generalize the findings in a population (Omar et al., 2015).

Area of the Study
The study was conducted in State School of Nursing, Agbor, Delta State.The school was purposively selected because it is one of the oldest and highly patronized schools of nursing which has produced quite a number of qualified nurses in the State.The school is located in a densely populated urban area of the State within Ika South Local Government Area, in Delta North Senatorial District of Delta State, Nigeria.

Population of the Study
The population of the study consisted of all third-year student nurses of Basic Nursing Program attending State School of Nursing, Agbor, Delta State in the 2020/2021 academic session.Out of the 84 third year student nurses, 70 students were willing to participate in the study.

Instrument
The Questionnaire on Socio-economic and Environmental Factors Influencing Student Nurse' Preparedness for Qualifying Examination for General Nurses (QSEFISNPQEGN) developed by the researchers was used for data collection in this study.QSEFISNPQEGN contains a total of twelve (12).Section A contains four (4) items on personal data, section B contains four (4) items on socio-economic factors influencing student nurses' preparedness for the Profession Qualifying Examination for General Nurses and, Section C contains five (5) items on environmental factors influencing student nurses' preparedness for Qualifying Examination for General Nurses.Section B and C were designed into five-point rating scale namely: Strongly Agree (SA) = 5 points, Agree (A) = 4 points, Uncertain (U) = 3 points, Disagree (D) = 2 points and, Strongly Disagree (SD) = 1 points.Two experts lectures, in Nursing Science from Nnamdi Azikiwe University, and in Measurement and Evaluation Unit from Nnamdi Azikiwe University validated the instrument.
The reliability of the instrument was determined through test-retest method.This was carried out by administering the questionnaire of the sample size which comprised of 70 student nurses to 10% (i.e.10% pre-testing and 10% post-testing) of the total population of fifty-five (55) student nurses who were attending State School of Nursing, Warri, Delta State.Thereafter, data obtained were coded and analyzing using Pearson's Product Moment Correlation which yielded a reliability coefficient of 0.859.This was considered reliable for the actual study.

Ethical Consideration
Permission to conduct the study was obtained from the Principal of the State School of Nursing.Informed consent was obtained from the student nurses who voluntarily participated in the study.The respondents were assured that their anonymity, confidentiality and privacy would be maintained during and after data collection.

Data Collection
Copies of the questionnaire were administered face to face by the researchers in the classroom during lunch break.The completed copies of the questionnaire were retrieved on the spot and there was 100% return rate.The data collection lasted for a period of one day.

Data Analysis
Data collected from QSEFISNPQEGN were summarized using simple frequencies, percentages, mean and standard deviation.The research questions were answered using mean.Mean score of 3 and above indicated an agreement and a mean score below 3 indicated a disagreement.However, the standard deviation was used to determine or establish the extent to which each individual mean response varies or disperses from each other.The hypotheses were tested using t-test statistics at a significance level of 0.05.The data analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0.All results were presented in tables.Table 1 shows that majority 55 (81.7%) of the respondents within the age bracket of 18-25 years.Among the respondents, 58 (84.1%) were females, all practiced Christianity and most 25 (34.1%) were of Ika ethnicity.Table 2 shows the responses of the student nurses in State School of Nursing, Agbor on the socio-economic factors that influenced their preparedness for the PQEFGN.The findings revealed that family background with mean score = 2.00, parent income with mean score = 2.01, religious belief with mean score = 1.48 and cost of exam registration with mean score = 2.41 have no influence on their preparedness for QEFGN.Average mean score was 1.98 indicating that socio-economic factors do not influence student nurses' preparedness for Qualifying Examination for General Nurses.

Results
Table 3 shows the responses of student nurses in State School of Nursing, Agbor on the environmental factors that influenced their preparedness for QEFGN.The findings revealed that peace around the school environment with mean score = 4.50, being visited all the time by friends and relatives with mean score = 3.52, a noisy environment with mean score = 5.18, and absence of light with mean score = 4.29 influenced their preparedness for QEFGN.Average mean score 4.17 indicating that environmental factors influence student nurses' preparedness for Qualifying Examination for General Nurses.Table 4 reveals that the t-value is -.669 while the probability value is .506.The p-value is higher than 0.05.This implies that there is no significant association between the mean rating of male and female student nurses on the socio-economic factors influencing their preparedness for QEFGN.Table 5 reveals that the t-value is -.743 while the probability value is .772.The p-value is higher than 0.05.This implies that there is no significant association between the mean rating of male and female student nurses on the environmental factors influencing their preparedness for QEFGN.

Socio-economic Factors Influencing Student Nurses' Preparedness for Professional Qualifying Examination for General Nurses
The cluster mean score of 1.98 in Table 2 revealed that socio-economic factors did not influence student nurses' preparedness for QEFGN in state school of nursing, Agbor.In their opinion, family background, parent income, religious belief and cost of exam registration did not influence preparedness for Qualifying Examination for General Nurses.This is not in line with study by Asogbon et al. (2016) states that socio-economic factors such as peer group, family background, religion, home problems, financial problem and stress.Another study by Sian & Nguyen (2014) in the second aspect of their study, the qualitative component identified how financial stress affects young people's study and learning outcomes.According to another study by Norazlan et al (2020) indicated that students with financial problems had their academics affected.Javaid et al (2012) in their study suggests that the income and level of education of father and mother impacts academic achievement quality of student nurses.A limitation to this study lack a larger population sample which poses a barrier to generalizing the findings of this study.

Environmental Influencing Student Nurses' Preparedness for Qualifying Professional Examination for General Nurses
The cluster mean score of 4.17 in Table 3 revealed that environmental factors influenced student nurses' preparedness for QEFGN in state school of nursing, Agbor.In their opinion, peace around the school environment, being visited all the time by friends and relatives, a noisy environment, and absence of light influences preparedness for Qualifying Examination for General Nurses.This is in line with study by Asogbon et al. (2016), states that environmental factors such as learning environment, class size, environmental condition (peace in the locality crisis etc.) another study by Kelly Warfield, (2016) also posed that the environment of school and locality, the physical conditions at home such as large family, small family, insufficient ventilation, improper lighting, uncomfortable temperature, noise, constant visits by friends or relatives, etc., influence the preparedness of the student for exams.Dube & Mlotshwa, (2018) in their study also opined that accommodation, learning facilities, residential area student comes room, communication skills.A study by Gilavand and Amir (2016), has also established several factors in the learning environment that significantly affect students' learning outcomes, such as open space and noise in classrooms, inadequate light, unsatisfactory temperature, overcrowded classes, improper classroom layout and misplaced boards.Munawaroh (2017) in his study explained that learning environment which was created during the learning process influenced student's learning achievement.
The researcher therefore suggests that a focused and detailed research should be carried out on the perceived factors influencing student nurses' preparedness for Qualifying Examination for General Nurses in other Schools of Nursing not used in the study.The researcher also suggests that another study should compare findings for Schools of Nursing with findings for departments of nursing Conclusion The purpose of this study was to identify the socioeconomic and environmental factors influencing student nurses' preparedness for professional Qualifying Examination for General Nurses.Based on the analysis conveyed it can be concluded that environmental factors such as peace around the school environment, being visited all the time by friends and relatives, a environment, absence of light influences student nurses' preparedness for the Professional Qualifying Examination for General Nurses while identified socio-economic factors such as family background, parent income, religious belief and cost of exam registration do not.Also, given the sample t-test result there is no significant association between genders and the influence socio-economic and environmental have on student nurses' preparedness for the PQEFGN.It was also recommended that adequately equipped library/e-library and information resources that will encourage the development of selfstudy and reading culture among the student nurses should be provided by the school management.Also, parents and tutors should help students realize roles in their own success in the PQEFGN

Table 2 .
Socio-economic factors influencing student nurses' preparedness for Qualifying Examination for General Nurses in State School ofNursing, Agbor (n= 70)

Table 3 .
Environmental factors influencing student nurses' preparedness for Qualifying Examination for General Nurses in State School ofNursing, Agbor (n= 70)

Table 4 .
The independent sample t-test result for gender of student nurses and socio-economic factors influencing preparedness for Qualifying Examination for General Nurses

Table 5 .
The independent sample t-test result for gender of student nurses and environmental factors influencing preparedness for Qualifying Examination for General Nurses