Instructional support and independent learning: nursing and midwifery students’ perceptions of tutor-provided pamphlets in a training college setting

Background Tutor-prepared pamphlets (compiled lecture handouts) are widely used in nursing and midwifery education, yet debate persists regarding whether they enhance structured learning or inadvertently discourage independent study and broader reading. Empirical evidence from resource-constrained training contexts remains limited. Objective This study examined students’ perceptions of tutor-provided pamphlets, their influence on learning behaviours (use, dependence, and supplementary resource consultation), and the roles of perceived quality, equity, and instructional alignment in shaping policy preferences for continued provision. Methods A cross-sectional survey was conducted among 1,139 students at a nursing and midwifery training college in Ghana. Student t-tests and one-way ANOVA analysed the differences between groups. Pearson correlation, multiple linear regression and binary logistic regression were used to establish the factors that predicted policy preference and support for pamphlet continuation. Results Students reported high perceived benefits (M = 4.02 ± 0.69) and quality (M = 3.94 ± 0.68), while they showed moderate perceived risks (M = 3.00 ± 0.81). The study found that policy selection and quality assessment were linked together with their strongest combination, which produced a correlation coefficient of 0.553 and reached statistical significance at less than 0.001 level. The multiple regression model explained 40.3% of the variance in policy preference (R² = 0.403, p < 0.001) because quality (β = 0.299) and equity (β = 0.211), plus benefits (β = 0.190) emerged as important predictors. The logistic model established that quality (OR = 4.21, 95% CI: 2.82–6.28) and equity (OR = 2.40, 95% CI: 1.69–3.42), together with benefits (OR = 1.93, 95% CI: 1.32–2.83) predicted high levels of support. Conclusion The students who evaluated the tutor-created pamphlets showed strong support for the materials, which they considered to be high-quality resources that met their educational requirements and provided equal access to all users. The research demonstrates that both pedagogical design and constructive alignment serve as essential factors which students use to evaluate their approval of educational programmes. The process of optimising pamphlet structure and its integration methods will maintain their educational advantages while enabling nursing students to learn through self-directed research.