Challenges experienced by nurse educators to minimise the attrition of nursing students: a systematic review

Abstract

Various issues with nursing training in South Africa have led to an increased shortage of newly qualified nurses. Nursing education institutions accredited by the South African Nursing Council can register only a limited number of students. Therefore, it is imperative to keep the attrition of nursing students to a minimum. Despite the assistance of nurse educators to minimise the attrition of nursing students, there are still many who fail to complete their training. A possible cause of this problem might be that nurse educators in South Africa experience challenges in addressing the factors relating to the attrition of nursing students. A mixed-studies systematic literature review using thematic synthesis was conducted in three major stages and eight steps. Evidence was sourced from relevant Health and Medicine databases, including primary studies in any language with an English abstract. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines were followed. Studies focusing on nurse educator challenges and nursing student attrition were critically appraised using the Mixed Methods Appraisal Tool. Thematic content analysis with deductive and inductive reasoning was performed, analysing data only from nurse educators when studies included perspectives from both educators and students. From 1 330 initially identified studies, 37 met the inclusion criteria. Two main themes emerged: (1) Nursing Education Context and (2) Individual and Collective Nurse Educator and Student Dynamics, each with specific sub-themes, categories, and codes. The study highlights the global challenges nurse educators face in ensuring nursing students’ academic success. Key factors influencing nursing education and nurse educator and student dynamics require urgent attention. Persistent challenges in nursing education environments necessitate support from regulatory bodies and educational authorities. Possible solutions include enhancing the nursing profession’s image, revising curricula, and implementing student-focused teaching methods. Support for students during clinical placements and providing conducive learning environments with adequate infrastructure are essential. Fair workload distribution and competitive remuneration are crucial for motivating and retaining nurse educators. Policies need revision to improve continuous professional development and mentorship for new educators. Developing effective clinical and educational learning environments remains a global challenge.

The authors' abstract, as published at the source. BMC Nursing, 2026 · DOI ↗