Voices on academic accreditation: lived experiences of nurse educators, administrators, students, and alumni in nursing education

Abstract

Background

Academic accreditation is a pivotal process in nursing education, ensuring program quality, consistency, and graduate readiness for professional practice. Despite its significance, limited research explores the lived experiences and perspectives of stakeholders, including academic nurse educators, administrators, students, and alumni—engaged in accreditation.

Purpose

This study aimed to explore the lived experiences, perceptions, and insights of nursing education stakeholders regarding the accreditation process, focusing on its impact on educational quality, program reputation, and professional preparation.

Methods

A qualitative phenomenological approach was employed, using purposive sampling to recruit 54 participants from a Saudi nursing college, including academic nurse educators and administrators (n = 24), students (n = 20), and alumni (n = 10). Data were collected through semi-structured interviews.Thematic analysis identified key themes and subthemes associated with participants’ experiences of accreditation.

Findings

Six main themes emerged: (1) knowledge and experience of accreditation; (2) importance and benefits of accreditation; (3) impact of accreditation; (4) preparation for professional practice; (5) challenges of accreditation; and (6) suggestions for improvement. Stakeholders across all groups recognized accreditation as essential for program quality and career readiness. Faculty and alumni emphasized the role of accreditation in enhancing program reputation and credibility, while students highlighted its influence on their learning experiences, though they expressed a desire for more engagement and transparency in the process. Faculty and administrators reported significant challenges, including administrative demands, time management, and resource allocation in maintaining accreditation standards.

Conclusion

This study offers a comprehensive view of accreditation’s multi-dimensional impact from multiple stakeholder perspectives and experiences, reinforcing accreditation’s importance in promoting nursing education quality and alignment with healthcare standards. However, findings suggest a need for institutional support to manage accreditation demands effectively. Future research should investigate accreditation’s long-term impact through longitudinal and multi-site studies to broaden understanding and enhance the generalizability of findings in nursing education contexts worldwide.

Background

Academic accreditation is a cornerstone of any health professions education (HPE) system, including nursing [1]. It plays a critical role in ensuring the quality and consistency of educational programs, fostering a culture of excellence, and thereby upholding professional standards [2]. In the ever-evolving field of nursing education, accreditation processes drive continual evaluation and improvement. Despite its importance, the experiences and perceptions of key stakeholders, including academic nurse educators, students, administrative personnel, and alumni, regarding academic accreditation in nursing education remain relatively underexplored [3,4,5].

This study aims to bridge this gap by exploring the lived experiences, perceived benefits, challenges, and strategies of those directly involved in academic accreditation. Using a phenomenological approach and in-depth interviews, the research captures diverse perspectives and transformative moments within the accreditation process. It highlights the emotional, educational, and professional dimensions that shape these encounters. By providing a comprehensive understanding of participants’ experiences, the study could offer valuable insights and actionable recommendations to enhance the accreditation journey in nursing education.

Literature review

Globally, academic accreditation is a cornerstone and a vital mechanism for ensuring quality assurance in education, particularly in healthcare and nursing education [2]. The International Association of Medical Regulatory Authorities (IAMRA) [6] highlights that accreditation involves an independent evaluation to confirm that educational programs produce competent graduates who meet professional and ethical standards, ensuring they are prepared for clinical and professional demands [6, 7]. It provides a foundation for consistent educational quality across institutions, aligning them with global benchmarks and fostering lifelong learning and further specialization in medical and health programs [5,6,7,8]. Likewise, international accrediting nursing bodies, such as the Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE), establish rigorous standards to ensure that nursing graduates are competent, well-trained professionals equipped to meet the demands of modern healthcare systems [10]. These standards emphasize not only academic excellence but also clinical competence, patient safety, and adherence to ethical practices, aligning with global benchmarks.

While accreditation standards in higher education broadly focus on academic excellence, health sciences—especially nursing—demand additional rigor to address patient safety, clinical competence, and practical application of skills. This distinction underscores the collaborative nature of healthcare accreditation, which necessitates alignment with industry and regulatory standards to prepare graduates for real-world challenges [8]. Specifically, nursing program accreditation incorporates unique and rigorous standards compared to general higher education. While both aim to ensure academic quality, health programs prioritize developing practical skills and ethical adherence, which are essential for safe healthcare delivery. Nursing and related fields demand thorough preparation to equip students for clinical environments, where patient safety and professional standards are critical [2]. Therefore, accrediting health colleges often involves close collaboration with healthcare organizations and regulatory bodies to meet industry standards, ensuring graduates are fully prepared to deliver safe, high-quality patient care—an objective that sets healthcare accreditation apart from other academic disciplines [8].

Building on global accreditation principles, Saudi Arabia has made significant advancements in aligning its academic frameworks with international best practices. A key milestone in this effort is the establishment of the National Commission for Academic Accreditation and Assessment (NCAAA) [9], which reflects the nation’s dedication to fostering educational excellence. As an independent regulatory body, the NCAAA oversees and enhances the quality of both public and private higher education institutions and programs. It has developed systematic guidelines and criteria to ensure institutions uphold rigorous standards through a robust accreditation process. These initiatives align closely with Saudi Arabia’s Vision 2030, which emphasizes human development and economic diversification, particularly in healthcare and education [8, 9].

In Saudi Arabia, nursing program accreditation adheres to the guidelines established by the NCAAA, aligning local programs with globally recognized standards [9]. Through the integration of international accreditation principles, the NCAAA ensures that nursing graduates are well-prepared to deliver safe, high-quality care that meets global expectations. To maintain uniform academic excellence nationwide, the Ministry of Education (MOE) actively promotes adherence to NCAAA standards across all higher education institutions, including nursing colleges [8, 9].

Academic accreditation and the voice of stakeholders

Building on the foundational concepts of accreditation and its importance in advancing educational quality, it becomes essential to explore how this process is perceived and experienced by key stakeholders [5]. Accreditation’s effectiveness depends significantly on the active engagement and insights of individuals directly involved in the educational system. These stakeholders, including academic educators, students, administrators, and alumni, contribute unique perspectives on how accreditation influences educational outcomes, highlighting both its challenges and benefits [10, 11]. Their collective experiences provide a comprehensive understanding of how accreditation shapes the educational environment, ensuring alignment with professional standards and fostering continuous improvement.

Specifically, academic nurse educators are directly involved in crafting and executing curricula, playing pivotal roles in the educational framework. Their insights into accreditation shed light on how criteria impact teaching methodologies, resource allocation, and the overall educational milieu [12]. Students, as the primary beneficiaries of nursing education, possess invaluable insights into the influence of accreditation on learning outcomes, clinical experiences, and career pathways [13]. Their perspectives provide a comprehensive understanding of the efficacy of accredited programs. Administrators overseeing nursing programs possess a comprehensive view of the challenges and benefits linked with compliance. Their viewpoints elucidate institutional responses to accreditation standards, resource management strategies, and efforts to sustain compliance [14]. Additionally, alumni, drawing from their experiences in accredited nursing programs, offer retrospective insights into how their education shaped their professional growth, readiness for practice, and career trajectories [15]. Their feedback contributes to a holistic understanding of the long-term impact of accreditation on nursing education.

Problem statement and study significance

The existing literature consistently underscores accreditation’s significance in driving educational standards, curriculum development, and student preparedness for professional practice [16, 17]. It serves as a benchmark for evaluating key components, such as faculty qualifications, resource adequacy, and student outcomes, contributing to continuous improvement in nursing programs [2, 5, 18,19,20,21,22]. However, challenges such as procedural complexities, resource constraints, and alignment with evolving healthcare demands remain underexplored, especially from the perspectives of those most directly impacted by accreditation [8].

Although prior studies in Saudi Arabia have highlighted the importance of accreditation in medical and health sciences, they primarily focus on institutional contributions, administrative strategies, and procedural outcomes [5, 7, 8, 23]. For instance, Alaskar [5] and Al-Shareef et al. [8] emphasized the need to raise awareness about accreditation processes, promote quality-driven administrative support, and understand faculty and administrators’ roles in ensuring successful implementation. Despite these contributions, a notable gap exists in the qualitative exploration of stakeholder perspectives, particularly in nursing education. Research capturing the lived experiences and perceptions of diverse stakeholders—such as nurse educators, administrators, students, and alumni—remains limited. These perspectives are vital to understanding how accreditation influences teaching methodologies, resource allocation, institutional practices, and long-term professional outcomes.

This study seeks to address these gaps by providing a qualitative exploration of stakeholder experiences, perceived benefits, and challenges associated with accreditation in Saudi nursing education. By capturing the viewpoints of nurse educators, administrators, students, and alumni, the research aims to provide a comprehensive understanding of the impact and challenges of accreditation in nursing programs. Such insights are crucial for refining accreditation processes, enhancing institutional practices, and informing policy decisions that support high-quality nursing education.

Additionally, this research may contribute to the broader discourse on academic accreditation by identifying opportunities for program improvement, aligning accreditation standards with stakeholder needs, and addressing systemic challenges faced by nursing institutions. The findings aim to serve as a valuable resource for future research and policy development and ensure that accreditation processes not only uphold quality standards but also support the professional and educational needs of all stakeholders involved.

Aim of the study

The aim of this study was to explore the lived experiences of stakeholders (nurse educators, students, administrators, and alumni) in the realm of academic accreditation in nursing education.

Methods

Study setting and design

This study utilized a qualitative research design with a phenomenological approach to explore the lived experiences of key stakeholders—academic nurse educators, administrators, students, and alumni—engaged in the academic accreditation process. The aim was to gain an in-depth understanding of their personal experiences and insights related to accreditation [24]. The study was conducted at the College of Nursing-Jeddah (CONJ) [25], affiliated with King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah, Saudi Arabia. Established in 2006, CONJ offers a four-year Bachelor of Science in Nursing (BSN) program and a two-year Master of Science in Nurse-Midwifery (MSNM) program, introduced in 2016. With a faculty of 45 teaching members, CONJ dedicates itself to female students, enrolling approximately 250–300 undergraduates and 4–8 master’s students annually.

Participants

Participants were recruited using purposive sampling, focusing on individuals affiliated with CONJ and actively engaged in the accreditation process (N = 54). The sample included 24 faculty/ nursing educators (six of them are college administrators), 20 current nursing students (comprising all 4 enrolled master’s students and 16 undergraduates), and 10 alumni. This diverse composition provided comprehensive insights into the impact and challenges of accreditation on teaching, learning, and career development.

All stakeholders were actively involved in the accreditation process, contributing through various roles. In addition to faculty and administrators, students participated in feedback sessions, committee memberships, and preparatory activities for accreditation visits. During the accreditation phase, alumni engaged through alumni networks and consultation sessions, offering valuable perspectives on curriculum relevance and professional readiness. The inclusion of all master’s students and 10 alumni allowed for a detailed exploration of the nuanced impacts of accreditation over time, offering rich, textured perspectives, particularly from those who experienced the full cycle of the curriculum.

These contributions were integral to the preparation and implementation phases of accreditation, underscoring the collaborative nature of the process across all stakeholder groups. By ensuring the representation of diverse perspectives, this inclusive approach enriched the understanding of how accreditation influences nursing education outcomes and fostered a collective commitment to maintaining high standards in academic and professional practice.

The sample size was determined based on qualitative research principles, aiming for data saturation where no new information or themes emerged in the data. This approach ensured depth over breadth in understanding the specific and potentially less variable experiences of master’s students and alumni compared to those of undergraduates or academic staff. Data saturation was achieved when no new themes or insights emerged during subsequent interviews, confirming the adequacy of the sample for addressing the study’s objectives [26]. This careful selection allowed us to explore diverse viewpoints and ensured that the study findings are reflective of the broader experiences within these groups.

Data collection instrument

The researchers developed a semi-structured interview guide for this study based on an extensive literature review [4,5,6,7, 10,11,12,13,14] to serve as the study tool for gathering in-depth insights from academic nurse educators, administrators, students, and alumni regarding their experiences with accreditation. See supplementary file 1. The interview guide comprises two main sections: demographic information and interview questions.

-The demographic information section collected essential background details to provide context for participants’ responses. Questions in this section covered age, job title, role in the accreditation process, and years of experience. For students, an additional question focused on academic level, while alumni were asked about their current employment status.

-The interview questions section was organized around key topics to explore each participant’s understanding, experiences, challenges, and recommendations regarding accreditation. Sample questions included:

• Could you share your understanding of the role and importance of accreditation in nursing education? In your view, how do accreditation criteria impact curriculum development and teaching methods?

• What are some challenges you have encountered in aligning your practices with accreditation standards? From your experience, what benefits have you observed as a result of accreditation?

• What areas do you think the nursing program could improve upon in relation to accreditation standards? / What recommendations would you make to enhance the overall accreditation experience?

The developed interview guide underwent a thorough content validity evaluation by five academic experts, who individually assessed its relevance, comprehensiveness, and clarity. No modifications were recommended based on their feedback. Following this, a pilot interview was conducted with two participants—one academic nurse educator and one student—to test the practical application and flow of the guide in real-time settings. During the pilot, we observed the ease with which participants understood the questions, the logical progression of topics, and the time required for the interviews. Feedback from the pilot participants highlighted the guide’s clarity and comprehensiveness, and no further adjustments were deemed necessary. The insights gained from the pilot study reinforced the guide’s effectiveness, ensuring its appropriateness for the main study and confirming its ability to capture rich, relevant data from diverse stakeholders. The pilot study also helped familiarize the researchers with the interview process, ensuring a consistent and smooth approach during the main data collection phase.

Data collection

Upon receiving ethical approval from the CONJ research committee and the KAIMRC Institutional Review Board (IRB: NRJ24/038/9), interviews and focus groups were scheduled based on participants’ availability and preference for in-person or virtual sessions (via Microsoft Teams). Before each session, participants were briefed on the study’s objectives, ethical protocols, and confidentiality measures, and informed consent was obtained. Each interview lasted between 30 and 45 min, continuing until data saturation was achieved. With participants’ consent, all interviews were audio-recorded, and comprehensive notes were taken. Transcriptions were prepared immediately following each session to facilitate data analysis.

Data analysis and trustworthiness

Data analysis was conducted using a thematic analysis approach, following Braun and Clarke’s six-phase framework [27]. This included familiarizing ourselves with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the final report. Coding was performed manually to ensure an in-depth and iterative engagement with the data, allowing researchers to identify recurring patterns and nuanced meanings in participants’ narratives. Transcripts were reviewed line by line, and codes were developed inductively to capture key aspects of the data. Categories were subsequently grouped into broader themes, reflecting the core concepts discussed by participants. To ensure reliability, multiple researchers independently coded portions of the data, and any discrepancies were resolved through discussion and consensus. This rigorous process ensured the robustness and transparency of the thematic analysis.

Data from both semi-structured interviews and focus groups were triangulated to enhance the validity of the findings and to ensure in-depth understanding of the themes that emerged. The analysis was presented in a narrative format supported by direct quotes from participants, and visual aids such as tables and diagrams were utilized to illustrate the relationships between themes and subthemes.

To ensure trustworthiness, the study adhered to Guba and Lincoln’s [28] criteria—credibility, dependability, confirmability, and transferability. Credibility was achieved through peer debriefing, where colleagues reviewed the research process. Dependability was supported by a detailed methodological account for replication purposes. Confirmability involved members checking with participants to validate the findings. Transferability was enhanced through thick descriptions of the setting, participants, and data collection methods, providing a comprehensive view for broader application.

Ethical considerations

Ethics approval

for this study was obtained from the King Abdullah International Medical Research Center (KAIMRC) under IRB Approval Number NRJ24/038/9. The researchers adhered to both institutional and international ethical standards, strictly following the principles outlined in the Declaration of Helsinki. Participant rights and data integrity were upheld at all stages of the study. Participants were fully informed about the study’s purpose and procedures through an introductory session. Emphasis was placed on their voluntary participation, with assurances that they could refuse or withdraw at any time without facing academic or professional consequences. Written informed consent was obtained from all participants prior to their involvement.

To maintain confidentiality and safeguard participant identities, the research team implemented stringent data security measures. All data were anonymized and securely stored on password-protected computers, accessible only to authorized members of the research team. Each participant’s response was assigned a unique code to ensure anonymity. These codes consisted of the letter “P” for participant, followed by a specific number based on the order of interviews. To distinguish participant groups, additional identifiers were used: “Pf” for faculty, “Ps” for students, “Pad” for administrators, and “Pal” for alumni. This systematic coding ensured clarity in reporting findings while preserving individual privacy.

Findings

Participant characteristics

The number of interviewed participants in this study was 54, comprising faculty (n = 24; 44.4%), students (n = 20; 37%), and alumni (n = 10; 18.5%). Among the faculty, 25% (n = 6) served as leaders of accreditation standards, while 75% (n = 18) were members involved in accreditation task force teams. For faculty participants, ages ranged from 30 to over 40, with a mean age of 37.87 ± 7.08 years. The highest percentage of faculty members were assistant professors (n = 15; 62.5%), followed by associate professors (n = 5; 20.8%) and lecturers (n = 4; 16.7%). Faculty experience varied, with a mean of 9.43 ± 7.60 years.

For the students’ group, ages ranged from 19 to 24, with a mean age of 21.3 ± 1.7 years. Students were distributed across academic levels, with 40% (n = 8) in their third year, 40% (n = 8) in their fourth year, and 20% (n = 4) in the MSNM program. Alumni had a mean age of 29.1 ± 3.2 years, and all were employed in hospitals, with a mean experience of 5.6 ± 2.3 years. Half of the alumni (n = 5; 50%) held a bachelor’s degree in nursing, while the remaining half (n = 5; 50%) had completed a master’s degree in midwifery nursing.

Detailed demographic characteristics for each participant group are provided in Supplementary Table 1 for faculty and Supplementary Table 2 for students and alumni.

Thematic analysis framework

The themes and subthemes identified through thematic analysis are illustrated with representative quotations from participants, showcasing their diverse perspectives on the accreditation process according to their codes.

Emerged themes from faculty and administrators’ perspectives

Based on the thematic analysis, five major themes emerged from faculty and administrators’ perspectives regarding their experiences with the accreditation process. Each theme is composed of various subthemes, capturing the nuanced experiences and insights of the participants. These themes include: (1) shared experience; (2) importance and benefits of accreditation; (3) impact of accreditation; (4) challenges; and (5) recommendations for improvement. These five themes, along with their respective subthemes, provide a comprehensive view of faculty and administrators’ experiences with the accreditation process. Their insights highlight both the positive impact of accreditation on program quality and the areas needing improvement, offering valuable guidance for future accreditation endeavors. Table 1 displays the themes and categories that emerged from the qualitative analysis, accompanied by quotations from the perspectives of faculty and administrators. Below is a descriptive summary of each theme:

Theme I. Shared experience

Participants’ responses reflected a shared understanding of their roles within nursing education, highlighting diversity in both their experiences and positions. The range of roles—from faculty members directly involved in teaching to administrators overseeing compliance—illustrates the multifaceted nature of nursing education and accreditation. This diversity fosters a rich set of perspectives, each shaped by individual backgrounds and levels of experience. As one participant noted, “Our team spans roles from faculty members deeply involved in teaching to those managing administrative responsibilities within the college and in the quality unit,” capturing the collaborative yet varied contributions essential to the accreditation process. Another participant reflected, “My experience in this field has shown me how accreditation can impact various aspects, depending on one’s role,” emphasizing how individual roles shape one’s understanding and approach to accreditation.

Theme II. Importance and benefits of accreditation

Participants emphasized the significance of accreditation as a benchmark for quality, program recognition, and compliance evaluation. Many participants saw accreditation as essential for validating the program’s standards and gaining national and potentially international recognition. For instance, one faculty member stated, “An accredited program represents a powerful endorsement, especially as we are the first accredited midwifery program in Saudi Arabia.” This highlights the importance placed on accreditation not only as a measure of quality but also as a tool for enhancing program visibility and attracting resources. Additionally, administrators pointed out that the process serves as a strategy for regular compliance checks and continuous improvement, helping to keep the program aligned with evolving standards.

Theme III. Impact of accreditation

Faculty members perceived the accreditation process to have a substantial impact on both teaching practices and institutional policies, fostering a culture of continuous improvement and strategic planning. They noted that accreditation requirements help maintain consistency in teaching practices, which, in turn, improves student learning outcomes. One participant explained, “Accreditation helps us align our course outcomes with program learning objectives, which I think improves graduates’ employability,” underscoring the value of accreditation in preparing students for the workforce. Administrators also shared that accreditation has driven institutional policies towards a proactive approach to quality enhancement; as one administrator stated, “Accreditation has fostered a mindset of continuous improvement, aligning our departmental goals with these high standards.”

Theme IV. Challenges

Participants highlighted several challenges in the accreditation process, including knowledge and awareness gaps, academic workload, and time management. The documentation requirements and need for standardization in preparing reports added complexity to the process. One faculty member shared, “Balancing my responsibilities as an educator with clinical teaching and quality assurance duties is a significant challenge.” Additionally, administrators pointed out the difficulty of allocating resources effectively and managing technical issues, such as internet connectivity and support for documentation uploads. These challenges underscore the need for better resource management and institutional support to streamline the accreditation process.

Theme V. Recommendations for improvement

To address these challenges, participants offered recommendations, including professional development opportunities, enhanced feedback mechanisms, and improved communication and collaboration. Faculty and administrators advocated for more frequent workshops and orientation sessions, especially for newly hired staff, to familiarize them with quality standards. One administrator mentioned, “Mock visits are helpful in preparing us and ensuring our documentation is in order for the actual accreditation visit.” Another suggestion involved fostering a culture of lifelong learning and quality standardization, with monthly follow-ups to ensure alignment with accreditation requirements.

Table 1 Emerged themes and categories from qualitative content analysis with quotations from faculty and administrators’ perspectives

Emerged themes from students’ perspectives

Table 2 presents the key themes and subthemes derived from a qualitative content analysis of nursing students’ perspectives on accreditation, illustrated with representative quotations. Three major themes emerged from the analysis: (1) knowledge of accreditation; (2) impact of accreditation; and (3) suggestions for improvement. These themes provide insights into students’ understanding, the influence of accreditation on their educational journey, and their recommendations to enhance the accreditation process in nursing education.

Theme I: Knowledge of accreditation

Students exhibited varying levels of familiarity with the concept of accreditation, often recognizing its importance but lacking a comprehensive understanding of its impact until they observed changes in their curriculum. This theme reveals a general awareness that accreditation is a quality assurance mechanism but also highlights a desire among students for greater clarity regarding its purpose and implications for their education. One student reflected, “I’ve heard about accreditation, but I didn’t know all the details until we started seeing changes in our curriculum.” When considering the purpose of accreditation, students understood it as a way to maintain educational standards. As one participant shared, “It seems like accreditation is about making sure our education meets high standards.”

Theme II: Impact of accreditation

Students expressed that accreditation has a significant role in shaping their educational experience, specifically in terms of maintaining high standards and aligning their learning with the practical demands of the nursing field. This theme highlights students’ appreciation for the consistency and relevance that accreditation brings to their curriculum, as well as the confidence it instills in them regarding their readiness for real-world practice. One student noted, “Accreditation keeps our education at a high level, making sure everything we learn is relevant and up to date.” Another commented, “It’s a way of keeping our curriculum current with what’s needed in real-life nursing.”

Students also valued the standardized learning experience that an accredited program provides, seeing it as a reassurance of their preparation for a professional career. “It’s nice to know that the program gives us a consistent learning experience, just like other nursing students,” one participant said. Another added, “Knowing other nursing students are going through a similar program gives me confidence that I’m prepared.” Accreditation’s role in preparing students for clinical practice was also acknowledged, with students feeling that it enhanced their confidence and competence. “Accreditation standards make sure we’re ready for real-life situations, especially in clinical settings,” one student shared. Another expressed, “Knowing our program is accredited makes me feel more confident and prepared to start my nursing career.”

Theme III: Suggestions for improvement

Students provided thoughtful recommendations for enhancing the accreditation process, focusing on the need for greater transparency, increased resources, and opportunities for involvement. This theme reveals students’ desire to be more informed and engaged in the accreditation process, as well as their interest in further practical support to meet accreditation standards effectively. One student remarked, “It would be great if they told us more about what’s going on with accreditation, especially changes that affect us.”

Students also advocated for more practical resources, suggesting that additional hands-on learning experiences would better prepare them for the field. “More resources and awareness would really help us meet accreditation standards and feel ready for the job,” one student suggested. Finally, students expressed a desire for a more active role in the accreditation process, believing that this would increase their sense of investment in their education. “If students were more involved in the accreditation process, we’d feel more connected to the quality of our education,” said one participant. Another added, “I think if we had a say in the accreditation process, it would make us feel like we’re contributing to the program’s success.”

Table 2 Emerged themes and categories from qualitative content analysis for nursing students with representative quotations

Emerged themes from alumni’s perspectives

Table 3 presents the key themes and subthemes derived from a qualitative content analysis of alumni perspectives on accreditation, illustrated with representative quotations. Like students, three major themes emerged from the analysis: (1) knowledge and experience of accreditation; (2) impact of accreditation; and (3) suggestions for improvement. These themes offer insights into alumni’s evolving comprehension of accreditation, its effect on their readiness for professional practice, and their suggestions to further improve the accreditation process in nursing education.

Theme I: Knowledge and experience in accreditation

Alumni shared varied levels of initial familiarity with accreditation, with some acknowledging that they only grasped its importance after entering the healthcare field. For many alumni, accreditation initially seemed like a formal requirement during their studies; however, they came to understand its deeper role in establishing quality standards that shaped their preparedness for clinical challenges. As one alumnus reflected, “I knew accreditation was important, but I didn’t understand how it would impact my education until I started working in healthcare.” Alumni also expressed a sense of value and validation from being invited to participate in accreditation discussions, with one stating, “Being invited to share my views on accreditation made me feel valued”. I felt like my experience as an alumnus was respected and used to improve the program for future students.”

Theme II: Impact of accreditation

Alumni reflected on how accreditation enhanced their readiness for the professional world. They credited accredited training for developing their adaptability in diverse healthcare settings and equipping them to face real-world challenges with confidence. Many emphasized that accreditation ensured a comprehensive education that went beyond theoretical knowledge, focusing on practical skills essential for effective patient care. One alumnus mentioned, “Accreditation gave me the adaptability needed to work in diverse healthcare settings.” Alumni also highlighted that their confidence in clinical skills was largely due to the rigorous standards maintained by their accredited programs.

Theme III: Suggestions for improvement

Alumni offered constructive feedback to further enhance the accreditation experience. They advocated for ongoing professional development opportunities post-graduation to help them stay current with evolving industry standards. One alum suggested, “Post-graduation support would be a huge advantage, especially workshops or seminars to keep us aligned with current industry standards.” Additionally, alumni recommended strengthening alumni networks to facilitate ongoing learning and peer support, emphasizing how such networks could help them stay informed about accreditation-related updates and changes in healthcare practices. As one alumnus remarked, “Building a strong alumni network could help us stay connected and informed about accreditation updates.”

Table 3 Emerged themes and categories from qualitative content analysis for alumni with representative quotations

Comparative, integrated findings, and contrasting perspectives among participants

Table 4; Fig. 1 provide a consolidated view of the themes emerging from the perspectives of faculty, administrators, students, and alumni concerning the accreditation process in nursing education. Addditionally, Fig. 2 visualizes the most frequently mentioned themes and key terms derived from the thematic analysis of stakeholder narratives.

Six core themes surfaced: (1) Knowledge and Experience of Accreditation, (2) Importance and Benefits of Accreditation, (3) Impact of Accreditation, (4) Preparation for Professional Practice, (5) Challenges, and (6) Suggestions for Improvement. While shared themes were evident, contrasting perspectives emerged, highlighting role-specific challenges and priorities.

• Shared Themes: All groups emphasized the importance and benefits of accreditation, its impact on educational standards, and the significance of suggestions for improvement. These shared perspectives highlight the collective understanding of accreditation’s role in enhancing program quality.

• Role-Specific Themes: While faculty and administrators highlighted challenges such as documentation and time management, these were not as strongly emphasized by students and alumni. Similarly, students and alumni focused more on preparation for professional practice and practical readiness.

Shared themes across all stakeholders

All stakeholder groups recognized the importance of accreditation in maintaining educational quality and its broader impact on institutional standards and student preparedness. Faculty emphasized, “An accredited program represents a powerful endorsement, ensuring compliance with quality standards and helping us align with international benchmarks” (Pf). Administrators similarly noted, “Accreditation not only ensures quality but also elevates the program’s reputation nationally and internationally” (Pad). Students viewed accreditation as a tool to keep their education relevant, stating, “Accreditation keeps our education relevant, but it sometimes feels like the process is more for the institution than for us.” (Ps). Alumni provided a retrospective perspective, emphasizing its long-term benefits, with one alumnus noting, “I realized the value of accreditation after entering the workforce—it made me confident about my skills and knowledge”(Pal).

While these shared perspectives highlight a collective acknowledgment of accreditation’s role in enhancing program quality, nuanced differences emerged in how each group perceived its challenges and benefits.

Contrasting perspectives

Challenges

Faculty and administrators highlighted significant challenges in the accreditation process, particularly concerning time management and documentation, which were less evident to students and alumni. One faculty member expressed, “Balancing teaching responsibilities with documentation for accreditation is overwhelming, especially during peak periods” (Pf). Administrators echoed similar sentiments: “Balancing the demand for documentation with administrative duties can be overwhelming” (Pad). Conversely, students and alumni had limited exposure to these operational complexities. A student remarked, “I didn’t notice many challenges as a student, but I think faculty members were under a lot of pressure” (Ps). Another added, “We don’t really see the behind-the-scenes challenges, but we notice changes in our curriculum and exams” (Ps).

Preparation for Professional Practice

Students and alumni focused heavily on how accreditation prepared them for real-world nursing practice. Alumni reflected, “Accreditation gave me the adaptability needed to work in diverse healthcare settings” (Pal), while students commented, “Accreditation standards ensure our readiness for real-life situations, particularly in clinical settings” (Ps). Faculty and administrators, however, focused on institutional goals, with one faculty member stating, “Accreditation ensures our teaching outcomes align with program objectives, ultimately enhancing student employability” (Pf).

Suggestions for improvements

All participant groups provided thoughtful recommendations, but their focus varied. Students emphasized the need for greater involvement, with one stating, “If students were more involved in the process, we’d feel more connected to the outcomes” (Ps). Faculty highlighted the necessity for enhanced training, as one faculty member noted, “We need more training on accreditation standards to handle the complexities of the process better” (Pf). Administrators suggested streamlining communication and ensuring adequate resource allocation to support accreditation efforts.

Integrated view

This integrated analysis underscores both shared themes and contrasting perspectives among stakeholder groups. Faculty and administrators concentrated on operational challenges and institutional strategies, whereas students and alumni emphasized practical benefits and readiness for professional practice. These diverse viewpoints highlight the multifaceted nature of accreditation and its varied impacts, suggesting pathways for improvement through tailored training programs, increased stakeholder engagement, and enhanced communication strategies. By addressing these distinct needs, institutions can foster a more inclusive and effective accreditation process. Overall, this integrated framework paints a comprehensive picture of how different roles perceive accreditation, highlighting shared values and role-specific challenges.

Table 4 Integrated findings and shared themes among participants of academic accreditation

Fig. 1

Integrated findings and shared themes among participants of academic accreditation

Fig. 2

Word Cloud of emergent themes and terms in nursing accreditation across stakeholder perspectives

Discussion

The participants in this study varied in age, experience, and roles, including faculty, administrators, students, and alumni involved in nursing accreditation. This demographic diversity provided a comprehensive view of accreditation, capturing various stages of professional and educational involvement. The range of backgrounds contributed to nuanced perspectives on accreditation, aligning with previous research emphasizing the importance of incorporating multiple stakeholder viewpoints to ensure comprehensive program evaluations that address the needs of all involved [5,12,13]. This holistic approach supports the study’s objective of understanding accreditation from a well-rounded, inclusive standpoint.

Integrative findings of emerged themes

Knowledge and experience of accreditation

Across faculty, students, and alumni, a foundational understanding of accreditation emerged, albeit with differing levels of depth and focus. Faculty members, who are deeply involved in implementing accreditation standards, possess a detailed understanding of its processes and importance for ensuring educational quality. This hands-on involvement enables them to effectively align programs with accreditation requirements, reflecting the findings of Hinchcliff et al. [12], who emphasized faculty engagement as crucial for sustaining program quality. Students, on the other hand, view accreditation primarily as a marker of program credibility that structures their education and aligns it with industry standards. However, their understanding of the intricate accreditation processes remains limited, mirroring findings by Satoh et al. [13] that students value accreditation’s benefits but may not fully grasp its operational demands. Alumni, drawing from their experiences in the workforce, appreciate how accreditation prepared them for clinical challenges, echoing McGarity et al. [17], who found that graduates from accredited programs feel more professionally prepared. This shared understanding among groups underscores a collective commitment to maintaining educational quality, essential for a culture of continuous improvement [3].

The variance in each group’s understanding can be attributed to their unique experiences with accreditation. Faculty members’ depth of knowledge is driven by their role in curriculum development, quality assessment, and direct interaction with accreditation bodies, enabling them to perceive accreditation as a dynamic quality assurance tool. Students benefit from accreditation’s structured educational impact, while their limited procedural awareness suggests a need for greater transparency in accreditation processes. For alumni, accreditation’s value lies in its impact on career readiness, highlighting its role in bridging academic learning with professional application, a finding supported by studies on graduates’ employability and adaptability [17]. Together, these perspectives underscore accreditation’s multifaceted role, not only as a quality benchmark but as a means of fostering confidence, preparedness, and adaptability in healthcare professionals, reinforcing the need for a holistic approach that includes all stakeholders in the accreditation discourse.

Importance and benefits of accreditation

Accreditation is widely recognized by faculty, administrators, students, and alumni as an essential marker of program quality and a mechanism for elevating institutional reputation. Across all groups, participants valued accreditation as a testament to their program’s credibility, which enhances its appeal to prospective students and provides graduates with a competitive edge in the job market. Faculty members, particularly, see accreditation as fundamental to upholding educational standards and ensuring consistency within the program, which aligns with the findings of Al-Shareef et al. [8] who emphasized the role of accreditation in supporting educational quality and institutional recognition. Students and alumni echoed this sentiment, viewing accreditation as an assurance that their education meets rigorous standards, ultimately benefiting their career prospects and professional readiness. This shared appreciation of accreditation highlights its role in affirming the quality and value of nursing education across all stakeholders.

The emphasis on accreditation’s role as a quality benchmark aligns with existing research on its impact in both national and international contexts. For instance, Aljohani [3], highlighted that accreditation significantly boosts program recognition in Saudi Arabia, a key factor for institutions striving for global credibility. Additionally, studies in nursing education, such as Alaskar [5] suggest that accreditation strengthens program identity and fosters essential quality improvements in response to healthcare sector advancements. For specialized fields like midwifery, accreditation offers a structured framework that supports national healthcare goals and enhances program relevance. McGarity et al. [17] observed similar outcomes in the United States, where accreditation has positively impacted career development and skill alignment in specialized healthcare fields. Collectively, these perspectives underscore a global consensus on the value of accreditation in promoting educational excellence, reinforcing program reputation, and ensuring graduates are well-prepared to meet industry standards.

Impact of accreditation

All participant groups—faculty, administrators, students, and alumni—highlight the significant role of accreditation in shaping the educational framework and content of nursing programs. Faculty members reflected that accreditation promotes a standardized, rigorous curriculum that aligns with industry needs, ensuring students gain relevant competencies. Students and alumni echoed this, emphasizing that accreditation creates a structured, high-quality educational environment that prepares them for real-world healthcare challenges. This theme underscores the significance of accreditation in upholding curricular uniformity and conformity to professional standards, a viewpoint that endures in diverse settings and fortifies the basis of clinical practice.

Research supports these findings, illustrating accreditation’s role in strengthening curriculum relevance and student preparedness. Laugaland et al. [29] found that accreditation fosters program consistency, which enhances students’ clinical readiness and improves learning outcomes. Ali and Saad [14] reported that students in accredited programs felt more capable of navigating diverse healthcare settings, attributing their confidence to standardized learning experiences. Likewise, Al-Shareef et al. [8] highlighted how accreditation-driven consistency ensures that learning outcomes align with practical demands, making graduates more adaptable in clinical environments.

Preparation for professional practice

Faculty and alumni alike emphasize that accreditation plays a crucial role in preparing students for their professional careers, equipping them with the skills needed to navigate various healthcare environments. Alumni, in particular, attribute their confidence and adaptability in clinical settings to the high standards upheld by their accredited nursing programs. This perspective underscores the value of accreditation in fostering professional readiness, although students—still completing their education—often lack the direct experience needed to fully appreciate this aspect. This finding suggests a potential benefit in creating clearer connections between accreditation standards and career preparation for students, possibly through targeted discussions or practical examples to build their professional confidence early on.

Research supports these alumni perceptions, showing that accredited programs positively influence graduates’ adaptability and effectiveness in clinical settings. Hinchcliff et al. [12] noted that alumni from accredited nursing programs enter the workforce with greater adaptability and confidence in handling real-world challenges. Alaskar [5], similarly found that graduates of accredited programs report higher career readiness and job satisfaction, particularly in specialized fields. Cheng et al. [19] indicated that employers regard graduates from accredited programs as more competent and adaptable, aligning with institutional aims to produce practice-ready professionals. These studies emphasized that accreditation not only enhances educational quality but also serves as a bridge between academic training and professional practice, proving beneficial across various healthcare systems.

Challenges in accreditation

Faculty members are primarily affected by the operational demands of accreditation, highlighting issues like document preparation, time management, and the difficulty of balancing teaching and administrative duties. These challenges illustrate the significant behind-the-scenes efforts required to uphold accreditation standards, often unrecognized by students and alumni. Faculty insights suggest that enhanced institutional support could help alleviate these burdens, making the accreditation process more sustainable and less disruptive to educational duties.

The challenges voiced by faculty align with findings from recent studies that emphasize the complexities of maintaining accreditation standards. For example, Abou Hashish et al. 2024a, b [30, 31] highlighted the administrative burden associated with documentation and resource alignment, which adds considerable strain to faculty responsibilities. Similar challenges were documented in South Africa by Mtshali et al. [15], who noted that faculty resources are frequently stretched by the need to balance teaching duties with the demands of accreditation compliance. Al-Shareef et al. [8] further observed that accreditation processes can detract from core teaching activities, a concern particularly relevant in healthcare education, where direct student engagement is vital. Supporting this view, Mohamed et al. [16] concluded that while accreditation ensures quality assurance and institutional standards, careful provision and management of resources are essential to avoid compromising teaching quality. They recommended that academic leaders prioritize leadership, administrative support, and resource allocation to enhance satisfaction with the quality of nursing education.

Suggestions for improvement

Participants across all groups provided constructive feedback on ways to improve the accreditation process, emphasizing the need for greater transparency, enhanced practical resources, and the broader involvement of students and alumni in accreditation activities. This collective desire for improvement underscores the value of inclusivity, where all stakeholders feel their voices are acknowledged and their roles are supported throughout the accreditation journey.

Faculty and alumni, in particular, suggested several actionable improvements, including increased professional development opportunities for faculty, strengthened alumni networks, and continuous student engagement in accreditation processes. Faculty advocated for regular workshops and training sessions, a suggestion echoed in Halstead’s research [4], which emphasized the necessity of ongoing training to uphold accreditation standards and drive quality improvement. Likewise, Shellenbarger [32] highlighted that accreditation programs should ensure faculty engage in ongoing professional development to enhance their ability to implement curriculum changes, ultimately preparing graduates to meet the demands of complex healthcare environments.

Alumni also highlighted the benefit of post-graduation opportunities aligned with current healthcare standards, suggesting that these initiatives could better prepare future professionals for evolving industry demands. Strengthening alumni networks was another common recommendation, supported by McGarity et al. [17], who observed that alumni networks promote professional growth and help graduates remain connected to accreditation standards. Additionally, Al-Shareef et al. [8] underscored the importance of alumni involvement, noting that their insights help institutions stay responsive to industry changes, fostering a culture of continuous improvement and quality in education.

Implications of study findings

Implications of accreditation on future nursing practices, policies, and student readiness

The finding underscores the importance of accreditation in producing practice-ready professionals who can adapt to evolving healthcare demands, a sentiment echoed by studies showing that accreditation enhances graduates’ employability and clinical competence [14, 17]. From a policy perspective, the study highlights the need for institutions to develop robust frameworks that integrate accreditation standards into their strategic plans. Faculty members called for clearer policies that reduce administrative burdens while maintaining compliance with accreditation requirements. Additionally, participants advocated for policies that prioritize faculty development, alumni engagement, and student involvement, aligning institutional goals with broader accreditation objectives. Such policies can create a culture of continuous improvement, ensuring that programs remain responsive to changes in healthcare and education [33]. The current workforce demands that nursing graduates possess essential skills and knowledge to excel in complex clinical and professional environments. Nursing education must therefore be structured to ensure graduates are ready and adequately prepared to meet these challenges effectively [34, 35].

Global implications for accreditation process

Although this study is situated in Saudi Arabia, the findings have broader relevance for improving accreditation process globally. Challenges such as documentation requirements, resource allocation, and stakeholder engagement were consistent with international research on accreditation in nursing education [15, 20]. To address these issues globally, institutions can adopt strategies such as standardized accreditation frameworks that allow for benchmarking across different regions. This would enable programs to align with international standards while accommodating local needs. Additionally, fostering international collaborations and knowledge-sharing networks could help institutions learn from best practices in other countries, ultimately enhancing the quality and consistency of nursing education worldwide [36].

Perspectives on the connection of the study findings to vision 2030

Saudi Arabia’s Vision 2030 framework prioritizes human capital development, healthcare advancement, and educational excellence under its themes of a vibrant society, a thriving economy, and an ambitious nation [37]. In summary, and from the authors’ perspectives, the findings of this study directly support these objectives by addressing critical aspects of nursing accreditation. First, the study emphasizes accreditation’s role in aligning nursing programs with global standards, preparing graduates with the skills and knowledge necessary to address modern healthcare challenges. This aligns with Vision 2030’s goal of developing a highly skilled workforce to drive economic diversification and innovation in healthcare. Second, the study identifies challenges such as the need for more professional development, institutional support, and stakeholder engagement. Recommendations to enhance faculty training, foster alumni involvement, and engage students more actively align with Vision 2030’s focus on fostering a culture of continuous learning and excellence in education, strengthening the quality of healthcare professionals [38]. Third, the focus on aligning educational outcomes with industry needs supports Vision 2030’s ambition to position Saudi Arabia as a leader in healthcare education. Ensuring that graduates are employable, adaptable, and confident in their clinical skills contributes to enhancing the quality and reputation of healthcare services in the Kingdom [37]. By addressing these key areas, the study demonstrates how improving nursing accreditation processes supports Vision 2030’s strategic goals of advancing education, healthcare quality, and global recognition.

Strengths and limitations

A notable strength of this study lies in its qualitative approach, which enabled an in-depth exploration of the diverse experiences of key stakeholders—academic nurse educators, administrators, students, and alumni—involved in nursing accreditation. This method provided rich, context-specific insights into the lived experiences and nuanced impacts of accreditation on educational practices, professional readiness, and institutional challenges. By including multiple participant groups representing various stages of the nursing education pathway, the study captured a comprehensive spectrum of perspectives, enhancing the credibility and depth of the findings.

However, certain limitations must be acknowledged. The qualitative design, while rich in detail, inherently limits generalizability, as findings are specific to the study’s context. Conducting the research at a single institution in Saudi Arabia further narrows the applicability of results to other settings, particularly those with differing cultural, institutional, or accreditation frameworks [34, 39]. To address these limitations, future research should adopt multi-site studies encompassing a diverse range of institutions, both within and outside Saudi Arabia. Such studies could examine variations in accreditation practices across different healthcare and educational systems, enhancing the transferability of findings. Additionally, employing mixed-method approaches that integrate qualitative insights with quantitative data could provide a more holistic understanding of accreditation’s impact. Longitudinal research designs could further assess the long-term outcomes of accreditation in terms of institutional performance and graduate preparedness for professional practice.

Conclusion

This study highlights the multifaceted impact of accreditation on nursing education, emphasizing its critical role in enhancing program quality, ensuring consistency, and fostering career readiness among students and alumni. Accreditation not only validates program standards but also strengthens institutional reputation, making nursing programs more appealing to prospective students and valuable in the job market. However, the study also identifies challenges faced by faculty and administrators, including resource allocation, time management, and documentation complexities.

These findings align directly with Saudi Arabia’s Vision 2030, which prioritizes human capital development, healthcare excellence, and educational quality. By addressing challenges and implementing targeted improvements such as professional development, alumni engagement, and enhanced student participation, this study provides actionable pathways for institutions to support Vision 2030’s objectives of building a skilled workforce and elevating the nation’s healthcare and education sectors to global standards. Accreditation processes that foster program consistency and alignment with industry needs further contribute to Vision 2030’s aim of economic diversification and innovation in healthcare.

Looking forward, this study offers valuable insights to inform accreditation policies and practices, ensuring that they serve the dual goals of fostering educational excellence and preparing graduates for a rapidly evolving healthcare environment. By linking findings to actionable recommendations and Vision 2030’s framework, the study positions accreditation as a strategic driver of quality and innovation in Saudi nursing education, with implications for both national progress and global competitiveness.

Recommendations of the study

The present study suggests several actionable recommendations for academic practice, education, and future research. These recommendations aim to enhance accreditation processes, support stakeholder engagement, and align nursing education programs with industry standards and global benchmarks.

Recommendations for academic practice and education

• To improve the effectiveness of accreditation in nursing education, institutions should prioritize professional development by implementing regular training sessions and workshops to enhance faculty understanding of accreditation standards and their application. Specific workshops focusing on quality assurance, curriculum alignment, and compliance documentation can be invaluable in improving teaching quality and program consistency.

• Institutions should also provide structured support for accreditation processes. Establishing dedicated support teams or administrative roles to handle logistical demands, such as managing documentation, organizing accreditation visits, and ensuring resource alignment, would reduce the burden on faculty and administrators, allowing them to focus on educational priorities.

• Enhancing stakeholder engagement is equally vital. Students and alumni should be actively involved in accreditation processes through structured feedback mechanisms and consultation sessions. Alumni networks can provide insights into curriculum relevance and job market alignment, while student involvement can improve curriculum delivery and foster a sense of ownership.

• Another recommendation is to integrate accreditation into nursing curricula. Discussions on accreditation and quality standards should be incorporated into nursing programs to prepare students for professional practice in accredited healthcare environments. This would enhance their understanding of accreditation’s role in maintaining educational and professional quality.

• Leveraging technology in accreditation tasks can also streamline processes. Institutions should utilize digital tools and software to manage data, prepare documents, and facilitate communication among stakeholders, reducing the administrative workload associated with accreditation and improving efficiency.

• Lastly, fostering transparent communication is essential. Regular updates and open communication with stakeholders on accreditation developments can build trust and improve alignment with institutional goals. Transparent reporting of accreditation outcomes can foster a culture of accountability and continuous improvement.

Recommendations for future research

• Future research should explore the long-term effects of accreditation through longitudinal studies to understand its lasting benefits and challenges among faculty, students, and alumni. This approach would provide deeper insights into how accreditation evolves and impacts stakeholders over time.

• Comparative studies across institutions and regions are also recommended. By conducting research across diverse institutions, it would be possible to explore differences in accreditation practices shaped by regional policies, resources, and institutional support. Such studies would enhance the generalizability of findings and reveal best practices for accreditation in different contexts.

• Quantitative assessments of accreditation outcomes should complement qualitative findings by measuring objective outcomes such as student performance, job satisfaction, and career advancement. This data-driven approach would provide robust evidence to support improvements in accreditation processes.

• Finally, research on technology-driven accreditation is essential. Future studies could explore how digital tools and emerging technologies can enhance efficiency, reduce administrative burdens, and improve stakeholder experiences, paving the way for innovative practices in accreditation.

• Through these actionable recommendations and research directions, this study identifies ways to enhance current accreditation practices and contributes to the broader discourse on advancing global standards in nursing education. These efforts will ensure that nursing programs align with both national and international expectations, preparing graduates to meet the evolving demands of the healthcare sector effectively.