Towards evidence-driven strategic training planning: Academic and institutional predictors of student performance among nursing students in Sampa, Ghana

Background: Academic performance among nursing students is a critical determinant of clinical competence, patient safety, and health-system strengthening. Evidence suggests that academic success is influenced by interactions among student behaviours, psychosocial well-being, institutional teaching quality, and clinical learning conditions. However, few studies in Ghana have examined these multidimensional factors within a coherent theoretical framework. Objective: Guided by Biggs’ Presage–Process–Product (3P) model and Tinto’s integration theory, this study examined institutional, academic, and psychosocial predictors of academic performance—operationalised as semester GPA and course referrals—among registered nursing students at Sampa Nursing Training College, Ghana. Methods: A cross-sectional study was conducted among 229 continuing students using a pre-coded questionnaire deployed through KoboCollect. Composite indices were generated for study habits, learning environment, teaching quality and assessment, clinical support, motivation/self-efficacy, and stress/psychosocial wellbeing. Data were analysed using SPSS (version 27) through descriptive statistics, correlations, group comparisons, and multivariable linear and logistic regression. Results: Of the 229 students, most were female (77.7%), aged 21–24 years (67%), and in Year 2 or 3. The majority lived off-campus (76.9%), relied on family funding (82.1%), used mobile data for internet (93.0%), and reported unreliable electricity (71.6%); only 10.9% had a dedicated study space. Teaching quality and assessment (β = .234, p = .001) and motivation/self-efficacy (β = .247, p = .001) were found to be significant predictors of GPA in a multicollinear linear regression model. On the other hand, study habits were shown to negatively impact GPA (β = –.162, p = .020). It was inferred through logistic regression that teaching quality, when higher, would be partially associated with the occurrence of higher GPAs (OR = 2.47, p = .012) and even lower referral rates (OR = .41, p = .005). High motivation/self-efficacy was another significant factor in the third kick-off stage of referral risk (OR = .37, p = .004). No demographic variables or commute time were observed to have a significant impact on the dependent variable. Conclusion: Educational success is influenced foremost by those factors that can be rectified, such as institutional and psychological ones; notably, the important role of the quality of teaching, the lucidity of the assessment and the motivation/self-beliefs of students was found to outweigh the influence of demographic characteristics. Therefore, the outcomes of the study emphasise that the educational sector should benefit from reforms specifically targeted at the methodology, practice, academic welfare, and health of students. Implications: Making teaching quality more effective, promoting self-regulated learning skills, altering supervision structures to be more progressive, and providing a better learning environment can all have a considerable impact on the academic performance of nursing students.