Introduction:

Nursing education plays a critical role in shaping the future of healthcare by preparing prospective nurses to deliver high-quality patient care. Ensuring that nursing students are satisfied with their academic experiences is essential, as it encompasses various components, including instructional strategies and the learning environment (Flaubert et al., 2021). Student satisfaction, often defined as a short-term attitude based on the evaluation of educational experiences, services, and facilities, serves as an important indicator of educational quality (Weerasinghe et al., 2017).

Student satisfaction is widely recognized as a key factor in determining positive word-of-mouth recommendations, retention rates, and loyalty to educational institutions. Efforts to enhance the quality of services offered directly impact students' satisfaction and their overall loyalty to the institution (Temizer & Turkyilmaz, 2012). Satisfaction in nursing education, specifically, is linked to several crucial factors such as curriculum content, organization, faculty teaching methods, and the quality of learning activities (Mohammed, 2019). These factors are critical in preparing nursing students to meet the demands of their profession.

The satisfaction of nursing students is particularly significant as it directly correlates with their academic and professional success. High satisfaction levels can improve students’ academic performance, enhance engagement, and contribute to positive outcomes in clinical practice. Given the increasing pressure on healthcare professionals and students, addressing dissatisfaction can help prevent burnout and promote well-being, which is vital in both academic and healthcare settings (Wei et al., 2021).

This study aims to assess student satisfaction with the teaching program, learning facilities, and university cafeteria at the College of Nursing, University of Sulaimani (Old Campus). By evaluating these areas, the study seeks to identify strengths and areas for improvement in the nursing program, ultimately contributing to the enhancement of nursing education quality.

Methodology

Study Design

A cross-sectional study was conducted to assess student satisfaction with the teaching program, learning facilities, and university cafeteria at the College of Nursing, University of Sulaimani (Old Campus). The study utilized a convenience purposive sample design to gather data from students across three academic stages.

Study Setting and Duration

The study was carried out at the College of Nursing, University of Sulaimani, located on the old campus. Data collection occurred between December 3, 2022, and January 9, 2023.

Study Population

The target population included second, third, and fourth-year nursing students enrolled at the College of Nursing, University of Sulaimani. A total of 272 students were eligible to participate in the study.

Sampling Method

A convenience sampling technique was employed to select participants. Of the 272 eligible students, 179 students (65.8%) voluntarily participated in the study. The participants represented the second, third, and fourth academic stages of the nursing program.

Inclusion Criteria

• Nursing students from stages 2, 3, and 4.
• Students currently enrolled at the College of Nursing, University of Sulaimani.
• Students willing to participate in the study.

Exclusion Criteria

• First-year students were excluded from the study.
• Students not currently enrolled or not willing to participate.

Data Collection Instrument

Data were collected using a modified standardized questionnaire. The questionnaire consisted of four parts:

1. Socio-Demographic Characteristics: Questions regarding age, gender, stage, residency, marital status, and perceived economic status.
2. Satisfaction with the Teaching Program: A series of questions assessing satisfaction with various aspects of the teaching program, including preparation for professional practice, relevance to nursing practice, communication skills improvement, and problem-solving skills.
3. Satisfaction with Learning Facilities: Questions focused on the adequacy, repair, and up-to-dateness of nursing lab equipment, space in classrooms and labs, and other aspects of the learning environment.
4. Satisfaction with the University Cafeteria: This section assessed student satisfaction with the services provided by the university cafeteria.

Each item in the questionnaire was rated on a 5-point Likert scale ranging from Very Satisfied (5) to Very Dissatisfied (1).

Scoring System

The level of satisfaction was determined using mean scores as follows:

• 1.00 – 2.32 = Low satisfaction
• 2.33 – 3.65 = Moderate satisfaction
• 3.66 – 5.00 = High satisfaction

Data Collection Procedure

The questionnaire was distributed to students during their academic sessions. Students were given clear instructions on how to complete the questionnaire, and informed consent was obtained prior to participation. The researcher was present to provide clarification when needed. To accommodate the practical and theoretical schedules of students, data collection took place over a period of five weeks.

Data Analysis

Data were entered into SPSS software (version 26) for analysis. Descriptive statistics, including frequencies, percentages, and mean scores, were used to summarize the socio-demographic characteristics and satisfaction levels. Chi-square tests were conducted to assess the association between socio-demographic characteristics and satisfaction levels. A P-value < 0.05 was considered statistically significant.

Ethical Considerations

Ethical approval for the study was obtained from the University of Sulaimani’s Ethics Review Committee. Participation in the study was voluntary, and all participants provided informed consent. Anonymity and confidentiality of the participants were maintained throughout the study, and no identifying information was collected.

Limitations of the Study

The study faced several challenges:

• The different schedules of each academic stage, including practical and theoretical sessions, often conflicted with the researcher’s data collection schedule. This created some difficulties in coordinating the data collection process.

• Results

  Socio-Demographic Characteristics of the Study Sample

  The socio-demographic characteristics of the 179 students who participated in the study are summarized in Table 1. The majority of participants (82.1%) were between the ages of 20 and 22 years, with only 14% being under 20 years old and 3.9% above 22 years. Female students comprised the majority of the sample (73.7%), while males represented 26.3%. Most participants were in their fourth academic stage (43%), followed by 31.8% in the third stage and 25.1% in the second stage. In terms of residency, 58.7% of students lived in dormitories, 39.7% lived at home, and 1.7% resided in relatives' homes. The vast majority of students (95%) were single, with only a small percentage married (3.9%) or engaged (1.1%). Regarding economic status, 57% of students perceived their financial situation as sufficient, 38% as barely sufficient, and 5% as insufficient.

  Student Satisfaction with the Teaching Program

  Table 2 presents the distribution of student satisfaction regarding the teaching program. The mean scores for all satisfaction items fell between 2.33 and 3.65, indicating a moderate level of satisfaction across all components of the teaching program. Key findings include:

  • 39.11% of students were neutral regarding how well the program prepared them to become professional nurses, with a mean score of 3.16.
  • 32.96% of students reported feeling confident in their ability to practice clinically, with a mean score of 3.07.
  • The mean score for the college’s ability to explain essential concepts effectively was 3.03, with 26.82% of students dissatisfied.
  • Satisfaction with the progression of the program from simple to complex concepts was moderate, with a mean score of 3.07.

  Overall, the students expressed moderate satisfaction with how the teaching program improved their problem-solving skills (3.05), communication skills (3.27), and nursing process application in clinical practice (3.12). However, the use of technology to enhance learning was rated lower, with a mean score of 2.77, indicating dissatisfaction with this aspect.

  Student Satisfaction with Learning Facilities

  As shown in Table 3, student satisfaction with the learning facilities was generally low, especially in the first four questions. Key findings include:

  • Satisfaction with the availability of sufficient equipment in the nursing lab was rated as low, with a mean score of 2.31. A significant proportion of students (37.43%) were very dissatisfied with this aspect.
  • The condition of the nursing lab equipment was also rated poorly, with 33.52% of students dissatisfied and a mean score of 2.16.
  • Space in the nursing lab was insufficient for effective learning, with 32.96% of students reporting dissatisfaction and a mean score of 2.24.
  • The equipment in the lab was reported as outdated by 39.66% of students, with a mean score of 2.20.

  For other aspects of the learning environment, such as the adequacy of classrooms, ventilation, and lighting, students reported moderate satisfaction (mean scores between 2.33 and 3.65). For example, the mean score for classroom comfort was 2.94, and the adequacy of library resources received a mean score of 2.74.

  Association Between Socio-Demographic Characteristics and Satisfaction with the Teaching Program

  As shown in Table 4, there was no statistically significant association between most socio-demographic characteristics (age, gender, residency, marital status, and economic status) and student satisfaction with the teaching program, with P-values > 0.05. However, a significant association was found between students’ academic stages and their satisfaction with the teaching program (P-value = 0.001). Students in their second and third stages reported higher levels of satisfaction compared to fourth-stage students.

  Association Between Socio-Demographic Characteristics and Satisfaction with Learning Facilities

  Table 5 highlights the association between socio-demographic characteristics and satisfaction with learning facilities. Similar to the teaching program, no significant associations were found between satisfaction with learning facilities and characteristics such as age, gender, residency, and marital status (P-values > 0.05). However, a significant association was observed between students’ academic stages and their satisfaction with learning facilities (P-value = 0.008). Students in their second stage reported higher satisfaction with the facilities compared to those in the third and fourth stages.

  Table 1: Socio-demographic Characteristics

  Characteristics	Frequency	Percentage (%)
  Age < 20	25	14.0
  Age 20 – 22	147	82.1
  Age > 22	7	3.9
  Male	47	26.3
  Female	132	73.7
  Stage 2	45	25.1
  Stage 3	57	31.8
  Stage 4	77	43.0
  Home	71	39.7
  Dormitory	105	58.7
  Kin House	3	1.7
  Single	170	95.0
  Married	7	3.9
  Engaged	2	1.1
  Sufficient	102	57.0
  Barely sufficient	68	38.0
  Insufficient	9	5.0

  Table 2: Satisfaction regarding Teaching Program

  Questions	Very Dissatisfied (%)	Dissatisfied (%)	Neutral (%)	Satisfied (%)	Very Satisfied (%)	Mean Score
  Prepared me to become a professional nurse	12.29	11.73	39.11	21.79	15.08	3.16
  Feel confident about my ability to practice in clinical	9.5	19.55	32.96	30.73	7.26	3.07
  Prepared me to use the nursing process in my clinical practice	7.82	19.55	34.64	28.49	9.5	3.12
  Effectively explained essential concepts	8.94	26.82	26.26	28.49	9.5	3.03
  Program progressed logically from simple to complex concepts	12.85	16.2	35.2	22.35	13.41	3.07
  Effectively used technology to enhance my learning	12.85	31.84	27.93	20.67	6.7	2.77
  Program was relevant to current nursing practice	6.15	23.46	43.58	16.76	10.06	3.01
  Made topics interesting	12.85	22.91	23.46	30.17	10.61	3.03
  Program was knowledgeable	7.26	21.79	28.49	25.14	17.32	3.23
  Helped me improve my communication skills	10.61	16.2	25.14	31.28	16.76	3.27
  Enhanced my problem-solving skills	10.61	21.23	31.28	26.26	10.61	3.05
  Collaboratively worked with each other	14.53	20.11	27.93	26.82	10.61	2.99
  Syllabus clearly described expectations	20.67	13.97	36.31	18.99	10.06	2.84

  Table 3: Satisfaction regarding Learning Facilities

  Questions	Very Dissatisfied (%)	Dissatisfied (%)	Neutral (%)	Satisfied (%)	Very Satisfied (%)	Mean Score
  There is sufficient equipment in the nursing lab	37.43	26.26	16.2	8.38	11.73	2.31
  Equipment in the nursing lab was in good repair	35.2	33.52	15.64	11.17	4.47	2.16
  Nursing lab had ample space	32.96	29.61	20.67	13.97	2.79	2.24
  Equipment in the nursing lab was up to date	39.66	22.35	21.23	11.73	5.03	2.2
  Classrooms had ample space	13.97	21.23	36.87	18.44	9.5	2.88
  Library resources were adequate for my learning needs	17.32	24.58	30.73	21.23	6.15	2.74
  Classroom environment was comfortable	14.53	17.32	37.43	20.67	10.06	2.94
  The classroom has adequate light	8.94	17.32	40.78	22.35	10.61	3.08
  The classroom has good ventilation	9.5	26.82	27.93	23.46	12.29	3.02
  The classroom has a good data show quality	20.11	25.7	27.93	18.44	7.82	2.68
  The whiteboard is appropriate for our study	21.79	25.7	25.7	17.88	8.94	2.66

  Table 4: Association between Sociodemographic Characteristics and Satisfaction with Teaching Program

  Demographic Characteristics	Mean	P-value
  Age < 20	3.1446	0.333
  Age 20 – 22	3.0345	nan
  Age > 22	3.4176	nan
  Male	3.1244	0.514
  Female	3.0437	nan
  Stage 2	3.1197	0.001
  Stage 3	3.3225	nan
  Stage 4	2.8422	nan
  Home	3.0834	0.898
  Dormitory	3.0571	nan
  Kin House	2.8974	nan
  Single	3.0566	0.551
  Married	3.1099	nan
  Engaged	3.6154	nan
  Sufficient	3.04	0.609
  Barley Sufficient	3.0962	nan
  Insufficient	3.1111	nan

  Table 5: Association between Sociodemographic Characteristics and Satisfaction with Learning Facilities

  Demographic Characteristics	Mean	P-value
  Age < 20	2.8727	0.198
  Age 20 – 22	2.5863	nan
  Age > 22	2.6883	nan
  Male	2.6673	0.691
  Female	2.6171	nan
  Stage 2	2.8566	0.008
  Stage 3	2.6986	nan
  Stage 4	2.4475	nan
  Home	2.557	0.548
  Dormitory	2.6814	nan
  Kin House	2.5758	nan
  Single	2.6171	0.475
  Married	2.7922	nan
  Engaged	3.1818	nan
  Sufficient	2.5642	0.139
  Barley Sufficient	2.6738	nan
  Insufficient	3.0505	nan

  Discussion

  The data analysis revealed that the majority of participants reported moderate satisfaction with the nursing teaching program at the College of Nursing, University of Sulaimani. Specifically, 39.11% of students expressed moderate satisfaction with the program’s ability to prepare them for professional nursing practice. Additionally, 32.96% reported increased self-confidence, while 34.64% felt capable of applying the nursing process in clinical settings. However, only 27.93% were satisfied with the program’s use of technology to enhance learning. Furthermore, 43.58% of students found the program relevant to current nursing practice, and 28.49% described the program as knowledgeable. The program’s ability to foster problem-solving skills was rated moderately by 31.28% of students, and similar satisfaction levels were observed in the areas of communication skill development (31.28%) and making learning topics interesting (30.17%).

  A previous study conducted by Mohammed (2019) among nursing students at the same institution found that over half of the participants were only marginally satisfied with the teaching program (51.76%). At that time, the Bologna Process had not yet been implemented, as the college operated on a credit system. Despite the introduction of the Bologna Process, this study found that satisfaction levels regarding the teaching program have remained largely unchanged. This suggests that the transition to the Bologna Process has not had a significant impact on student satisfaction with the nursing program. A continued lack of improvement in satisfaction levels could negatively affect academic performance, as high satisfaction is a key indicator of educational quality and student engagement.

  Wei et al. (2021) highlighted the growing challenges faced by healthcare professionals and students, including burnout, depression, and even suicide. These issues can profoundly affect both health and academic performance, especially in nursing programs. Addressing student burnout early on through tailored strategies can mitigate these negative outcomes and enhance overall satisfaction.

  In a similar study conducted in Basra, Iraq, Ebrahim (2020) found that 64.1% of nursing students were satisfied with their teaching programs. Other studies, such as those conducted by Tomas and Muronga (2022) and Chen and Lo (2015), reported that nursing students in Namibia and the USA, respectively, were also satisfied with their teaching programs. These findings suggest that while moderate satisfaction levels in this study align with global trends, there remains room for improvement in nursing education in Iraq.

  The analysis of student satisfaction with learning facilities indicated widespread dissatisfaction. Specifically, 26.26% of students were dissatisfied with the availability of equipment in the nursing lab, 33.52% expressed dissatisfaction with the condition of lab equipment, and 29.61% felt the lab space was insufficient for learning. Moreover, 22.35% of students reported that the equipment in the lab was outdated. From the researcher’s perspective, engaging learning environments are essential for fostering resilience and effective learning. However, these environments are unlikely to succeed without adequate clinical space and up-to-date equipment.

  Hakim (2014) conducted a study among nursing and midwifery students at Ahvaz Jundishapur University of Medical Sciences, finding that 83.3% of participants were dissatisfied with their educational environment. In contrast, Rodríguez-García et al. (2021) reported high satisfaction among nursing students with their clinical environments. These contrasting findings highlight the importance of addressing deficiencies in physical resources to ensure a conducive learning experience.

  When examining the relationship between socio-demographic characteristics and satisfaction, this study found a significant association between student stages and satisfaction with both the teaching program and learning facilities. Second- and third-stage students reported higher satisfaction levels with the teaching program (mean scores: 2nd stage = 3.1197, 3rd stage = 3.3225) compared to fourth-stage students (mean score = 2.8422), with a significant P-value of 0.001. Similarly, a significant association was observed between student stages and satisfaction with learning facilities (P-value = 0.008), with second-stage students reporting the highest satisfaction (mean score = 2.8566).

  In contrast, a study by Mohammed in 2019 found no significant association between demographic data and student satisfaction in the College of Nursing. These findings indicate that satisfaction may vary depending on the stage of the student’s academic journey, with those in earlier stages experiencing higher satisfaction levels.

  Conclusion

  The study revealed that nursing students at the College of Nursing, University of Sulaimani, reported moderate satisfaction with the teaching program, particularly in areas such as professional preparation, self-confidence, and problem-solving skills. However, satisfaction with the use of technology and the learning facilities was notably lower, with many students expressing dissatisfaction with the outdated and insufficient lab equipment, inadequate lab space, and poor maintenance of learning resources. Despite the implementation of the Bologna Process, satisfaction levels with the teaching program remained similar to those reported in previous years, indicating that the new system has not significantly improved student experiences. Additionally, there was a significant association between the academic stage of students and their satisfaction levels, with earlier-stage students expressing higher satisfaction than those in the later stages.

  Addressing these gaps is critical to improving the overall educational experience, fostering better academic outcomes, and reducing burnout, which remains a significant challenge among healthcare students and professionals.

  Recommendations

  1. Curriculum Review and Involvement: It is recommended that students be actively involved in the revision and evaluation of the nursing curriculum. This will help ensure that the syllabus aligns with student needs and expectations. Each subject’s syllabus should be clearly explained at the beginning of the course to improve transparency.

  2. Upgrading Learning Facilities: The university should prioritize upgrading lab equipment and expanding lab spaces. Up-to-date, well-maintained equipment is essential for hands-on training and developing clinical skills, particularly in a field as practice-oriented as nursing.

  3. Enhanced Use of Technology: There should be an increased focus on integrating modern educational technologies into the teaching process. This will not only improve student engagement but also better prepare students for real-world healthcare environments that rely heavily on technological tools.

  4. Burnout Prevention Programs: Given the increasing rates of burnout among healthcare students, the college should implement strategies to reduce stress and promote mental health. Early intervention programs focused on student well-being could improve both academic performance and overall satisfaction.

  5. Continuous Feedback Mechanisms: The university should establish a structured system for regularly collecting feedback from students regarding their academic experience, learning facilities, and overall satisfaction. This will enable timely identification and resolution of issues that affect student satisfaction.

  6. Focus on Later-Stage Students: Since fourth-stage students reported lower satisfaction levels, specific attention should be given to improving their academic experience by addressing concerns related to clinical practice, lab resources, and workload management.decleration

     Funding

     This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

     Author’s Contributions

     The concept, design, data collection, analysis, and writing of this study were conducted collaboratively. All authors contributed to the final manuscript by reviewing and approving the final edition.

     Disclosure Statement

     The authors report no conflict of interest.

     Acknowledgements

     The authors would like to express their sincere gratitude to the College of Nursing, University of Sulaimani, for providing the opportunity and support to conduct this study. We extend our appreciation to the students who participated in this research, offering their valuable insights and feedback. Special thanks to the faculty members and administrative staff who facilitated the data collection process.