Study motivation and academic performance among first-year five-year junior college nursing students: a mixed-methods study

The shortage of nursing professionals in Taiwan has become an urgent public health concern, affecting healthcare quality and workforce sustainability. Graduates of five-year junior college nursing programs represent a major source of entry-level nurses. Understanding the learning motivations and professional perceptions of newly admitted students is therefore essential for strengthening nursing education and supporting early workforce retention. This study aimed to explore first-year students’ learning motivations, perceptions of the nursing profession, and the relationships between motivation and academic performance. This explanatory sequential mixed-methods study employed a cross-sectional quantitative survey followed by qualitative focus group interviews. A total of 93 first-year students (aged 15–16 years; predominantly female) enrolled in a five-year junior college nursing program in southern Taiwan completed the Diverse Motivations for Studying Nursing (DMSN) scale, a 46-item instrument rated on a five-point Likert scale that assesses intrinsic and extrinsic motivations for studying nursing. Academic performance data, including grades in Introduction to Nursing, First Aid, and overall semester grade point average (GPA), were obtained from academic records. Quantitative data were analyzed using independent-sample t-tests and logistic regression. In addition, focus group interviews were conducted with 24 students, and qualitative data were analyzed using clinical qualitative content analysis to further explain quantitative findings. Quantitative analysis showed that extrinsic motivation significantly predicted students’ performance in Introduction to Nursing (OR = 1.073, p = .018), whereas intrinsic motivation was not a significant predictor of academic outcomes. No significant associations were found between motivation and performance in First Aid or overall semester GPA. Qualitative analysis identified five major motivations for studying nursing: choosing courses of interest, the desire to use professional knowledge to help others, job stability, obtaining a nursing license, and viewing nursing as a calling. Students perceived nursing as a demanding profession requiring responsibility, empathy, and strong professional competence. Extrinsic motivation plays a key role in academic performance during the early stage of nursing education. Nursing educators should incorporate motivation-oriented strategies, career-related guidance, and professional identity development into first-year curricula to enhance student engagement and support future workforce retention.