Academic Motivation, Professional Self-Concept, and Self-Esteem in BScN Students and Nursing Interns: A Cross-Sectional Study from Pakistan

Background: Transitioning from nursing education to professional practice is psychologically demanding, often resulting in decreased motivation, self-concept, and self-esteem, which can compromise clinical performance and increase attrition. Despite global awareness of these issues, limited evidence exists from South Asian settings, particularly Pakistan, on how these psychological constructs evolve across academic years. Objective: This study aimed to assess and compare levels of academic motivation, professional self-concept, and self-esteem among Bachelor of Science in Nursing (BScN) students and nursing interns, and to explore interrelationships among these variables. Methods: A descriptive cross-sectional study was conducted at Aga Khan University School of Nursing and Midwifery, Karachi. A total of 300 participants were recruited using non-probability sampling. Data were collected via validated self-report instruments: the Academic Motivation Scale (AMS), the Professional Self-Concept of Nurses Inventory (PSCNI), and the Rosenberg Self-Esteem Scale (RSES). Ethical approval was obtained from the Aga Khan University Ethics Review Committee (Ref No. 5005-SON-ERC-17), in compliance with the Declaration of Helsinki. Statistical analysis was conducted using SPSS v27, employing Kruskal-Wallis tests, Spearman’s correlation, and descriptive statistics. Results: Interns exhibited the lowest scores in self-esteem (Median = 20.06), professional self-concept (Mean = 65.11 ± 15.99), and intrinsic motivation (IMK = 22.16), while Year II students showed the highest PSC (Mean = 78.11 ± 7.12). Significant differences were noted in motivation and PSC across academic years (p < 0.001), and amotivation increased with seniority (Interns: AM = 12.76). PSC positively correlated with multiple motivational subscales (e.g., IMK: r = 0.142, p = 0.014), while RSES showed no significant correlation with motivation. Conclusion: A declining trend in motivation, self-concept, and self-esteem toward the end of nursing training suggests an urgent need for targeted psychological and educational interventions to strengthen students’ professional development and retention. These findings advocate for mentorship and emotional support programs during late academic phases to enhance workforce readiness and patient care outcomes.