An Exploration of Issues Relating to Medical Science Subjects: Nursing Students’ Perception and Experience in Universiti Kebangsaan Malaysia Medical Centre

Second-Year Nursing Students' Retention of Gross Anatomical Knowledge

Human anatomy is a foundational course in nursing education, however, there is growing concern that students do not retain enough anatomical knowledge to successfully apply it in clinical settings. The aim of this study was to determine retention level of anatomy knowledge among second-year nursing students from their first-year anatomy class, and to determine if there is a difference in level of retention based on organ system. For each system, second-year students were asked to answer 9 to 11 multiple-choice questions (MCQs), and the scores from these quizzes were compared to matched test items from their first-year anatomy examinations. There was a significant decrease in the overall mean score from 83.05 ± 8.34 (±SD) in first year to 54.36 ±12.9 in second year (P = 0.0001). Retention levels were system specific. System-specific knowledge retention was highest for the gastrointestinal system (89.7%), respiratory system (88.5%), and genitourinary system (83.6%). This was followed by the integumentary system (80.1%), special senses (79.4%), nervous system (74.9%), and musculoskeletal system (69.3%). Retention was lowest for the lymphatic system (64.3%), cranial nerves (58.8%), vascular system (53.9%), and head and neck (42.6%). The present study shows that nursing students' anatomy knowledge retention was comparatively higher than rates reported by others in medical and allied-health students. The researchers are now investigating knowledge retention in third- and fourth-year nursing students. Further investigation into why retention is higher for specific systems and intervention strategies to improve knowledge acquisition and retention in nursing students is recommended.

The 'bioscience problem' for nursing students: an integrative review of published evaluations of Year 1 bioscience, and proposed directions for curriculum development

BACKGROUND

The difficulties that nursing students have in learning human biosciences have given cause for concern for over 20 years but the problem remains.

OBJECTIVE

To conduct an integrative review of published primary research into the 'bioscience problem', evaluate their outcomes, and provide a contemporary analysis of potential directions for curriculum planners.

REVIEW METHODS

A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar was conducted for empirical research studies, published between 1990 and 2013, designed to either predict performance of students in bioscience assessments in Year 1 of their studies or identify in-course curriculum delivery issues.

RESULTS

The search generated nineteen papers that met inclusion criteria. Twelve papers involved predictive factors for bioscience attainment and seven surveyed student views on curriculum issues. Four others that surveyed reflections of later-year students or qualified nurses on Year 1 outcomes were also retained for additional context. Prediction based on pre-admission academic achievement was not reliable. Student factors including age at entry, self-efficacy in science, and having appropriate study skills in particular appear to be confounding factors. In-course influences such as teaching strategy or lecturer skills are also inconsistent and likely to represent confounders operating at local, institutional level.

CONCLUSIONS

The integrative review approach enabled analysis of incongruencies between studies that have been a barrier to curriculum development. Sound admissions criteria based on pre-university academic performance show promise in resolving the 'bioscience problem' but will likely be contingent on innovative support early in Year 1 for study skills and the fundamentals of human bioscience, plus attention to local quality assurance for curriculum delivery.