Bioscience in the pre-registration curriculum: finding the right teaching strategy

Using structural equation modeling to investigate students' satisfaction with an undergraduate tutorial system

BACKGROUND

The undergraduate tutorial system (UTS) is a crucial measure in China for adhering to the principle of prioritizing foundational education, innovating the undergraduate talent training mode, and building a powerful country of higher education. This study investigated undergraduate students' satisfaction with UTS and the influencing factors, aiming to promote the healthy and sustainable development of UTS and provide practical implications and suggestions for universities.

METHODS

Based on relevant theories, we conducted a survey study and leveraged structural equation modeling to assess students' satisfaction with UTS and explore the influencing factors.

RESULTS

Our Pearson correlation analysis showed that students' satisfaction with mentors was positively correlated with dimensions such as humanistic care (r = 0.844, P < 0.05), mentor assistance (r = 0.906, P < 0.05), and mentor-student communication (r = 0.908, P < 0.05). Path analysis showed that mentor-student communication (β = 0.486, P < 0.01), mentor assistance (β = 0.228, P < 0.05), humanistic care (β = 0.105, P < 0.05) were positive factors affecting students' satisfaction with mentors, while satisfaction with mentors (β = 0.923, P < 0.01) had a positive impact on students' satisfaction with UTS. Students' satisfaction with mentors explained 73.4% of the variation in students' satisfaction with UTS, indicating that satisfaction with mentors was an important intermediary variable of UTS students.

CONCLUSION

The sustainable implementation of UTS requires the effort to improve student satisfaction, and the breakthrough of strengthening the targeted mentorship in "transmitting wisdom, imparting knowledge, and resolving doubts" for students. Efforts should also be devoted to fostering students' comprehensive skills and better serving the cultivation of talents in the new era.

A team approach to delivery of contextually relevant bioscience: encouraging student connections between tacit knowledge and new content acquisition

BACKGROUND

Bioscience is essential knowledge for nursing practice and is an important component of undergraduate nursing education, however students commonly feel anxious about studying the subject. The purpose of this study was to develop appropriately scoped contextually relevant bioscience lesson resources to enhance student engagement and performance and reduce attrition and unit failures over a sustained period.

METHODS

Participants included students enrolled in the core bioscience unit for an undergraduate Bachelor of Nursing degree from a central campus and a widening participation (WP) campus. From 2016 to 2018, unit learning resources were progressively revised to include a structured learning and teaching manual, signposted lectures, and digital resources. Online surveys and formal institutional data collection metrics were used to assess the impact of the changes to unit learning resources.

RESULTS

Student attrition rates and failure rates for the unit were reduced over a two-year period across a diverse student cohort.

CONCLUSIONS

Scaffolded and diverse learning materials support the success of undergraduate bioscience students by improving student engagement and reducing cognitive load.

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 difference between a clinical technician and clinical practitioner is in the scope of practice: the need for a bioscience understanding in paramedicine

"Only teach me what I need to know!" This commonly heard refrain is often spoken by allied health students while studying preclinical sciences (physiology, anatomy, pharmacology). Here we use a clinical scenario undertaken by second-year Bachelor of Paramedic Practice students of acute coronary syndrome to demonstrate the difference in clinical decision making when using a clinical reasoning approach to treatment rather than relying exclusively on a practice guidelines approach. We hope to demonstrate that understanding basic bioscience concepts, such as the Frank-Starling mechanism and the anatomy and physiology of the autonomic nervous system, are key to providing good clinical care in response to ambiguous patient symptoms. Students who understand these concepts underlying their patient care guideline will make better clinical decisions and better provide quality of care than students who follow the guideline exclusively. We aim this as a practical demonstration of the value of detailed understanding of human bioscience in allied health education. As health care providers transition from "technician" to "practitioner," the key distinguishing feature of the role is the ability to practice independently, using "best judgment" rather than clinical guidelines (alone). Evidence suggests that complex case management requires detailed bioscience understanding.

The nursification of a bioscience unit and its impact on student satisfaction and learning in an undergraduate nursing degree

Undergraduate nursing students traditionally find bioscience difficult, which can be compounded by an inability to relate bioscience theory to nursing practice. Subsequently, many registered nurses feel they lack knowledge in this area. Several studies have identified this problem and focused on the importance of linking bioscience theory in undergraduate nursing curricula to clinical practice. The aim of this study was to assess whether nursification (the active association of a subject with nursing theory and practice) of the bioscience content of a first year, first semester unit impacts on the students' learning experience. The study compared two student groups' perceptions of their learning experience; one group enrolled before the bioscience unit was linked to nursing practice (pre-nursification) and the other group enrolled after the content was linked to nursing practice (post-nursification). Retrospective, quantitative analysis of the mean scores of the student feedback surveys found no significant difference between the pre and post-nursification responses with respect to the students' overall satisfaction of the unit or their ability to achieve their learning objectives, however the students in the post-nursification group reported significantly higher mean scores with respect to their motivation and inspiration to learn, and to learn effectively. The findings in this study suggest that integration of nursing practice within a bioscience unit can improve the learning experience of undergraduate nursing students.

The Anatomical Society's core anatomy syllabus for undergraduate nursing

The Anatomical Society has developed a series of learning outcomes in consultation with nursing educators delivering anatomical content to undergraduate (preregistration) nursing students. A Delphi panel methodology was adopted to select experts within the field that would recommend core anatomical content in undergraduate nursing programmes throughout the UK. Using the Anatomical Society's Core Gross Anatomy Syllabus for Medical Students as a foundation, a modified Delphi technique was used to develop discipline-specific outcomes to nursing graduates. The Delphi panel consisted of 48 individuals (n = 48) with a minimum of 3 years' experience teaching anatomy to nursing students, representing a broad spectrum of UK Higher Education Institutions. The output from this study was 64 nursing specific learning outcomes in anatomy that are applicable to all undergraduate (preregistration) programmes in the UK. The new core anatomy syllabus for Undergraduate Nursing offers a basic anatomical framework upon which nurse educators, clinical mentors and nursing students can underpin their clinical practice and knowledge. The learning outcomes presented may be used to develop anatomy teaching within an integrated nursing curriculum.

Introductory anatomy and physiology in an undergraduate nursing curriculum

Using an educational data mining approach, first-year academic achievement of undergraduate nursing students, which included two compulsory courses in introductory human anatomy and physiology, was compared with achievement in a final semester course that transitioned students into the workplace. We hypothesized that students could be grouped according to their first-year academic achievement using a two-step cluster analysis method and that grades achieved in the human anatomy and physiology courses would be strong predictors of overall achievement. One cohort that graduated in 2014 (n = 105) and one that graduated in 2015 (n = 94) were analyzed separately, and for both cohorts, two groups were identified, these being "high achievers" (HIGH) and "low achievers" (LOW). Consistently, the anatomy and physiology courses were the strongest predictors of group assignment, such that a good grade in these was much more likely to put a student into a high-achieving group. Students in the HIGH groups also scored higher in the Transition to Nursing course when compared with students in the LOW groups. The higher predictor importance of the anatomy and physiology courses suggested that if a first-year grade-point average was calculated for students, an increased weighting should be attributed to these courses. Identifying high-achieving students based on first-year academic scores may be a useful method to predict future academic performance.

Can active learning principles be applied to the bioscience assessments of nursing students? A review of the literature

OBJECTIVES

To explore if active learning principles be applied to nursing bioscience assessments and will this influence student perception of confidence in applying theory to practice?

DESIGN AND DATA SOURCES

A review of the literature utilising searches of various databases including CINAHL, PUBMED, Google Scholar and Mosby's Journal Index.

METHODS

The literature search identified research from twenty-six original articles, two electronic books, one published book and one conference proceedings paper.

RESULTS

Bioscience has been identified as an area that nurses struggle to learn in tertiary institutions and then apply to clinical practice. A number of problems have been identified and explored that may contribute to this poor understanding and retention. University academics need to be knowledgeable of innovative teaching and assessing modalities that focus on enhancing student learning and address the integration issues associated with the theory practice gap. Increased bioscience education is associated with improved patient outcomes therefore by addressing this "bioscience problem" and improving the integration of bioscience in clinical practice there will subsequently be an improvement in health care outcomes.

CONCLUSION

From the literature several themes were identified. First there are many problems with teaching nursing students bioscience education. These include class sizes, motivation, concentration, delivery mode, lecturer perspectives, student's previous knowledge, anxiety, and a lack of confidence. Among these influences the type of assessment employed by the educator has not been explored or identified as a contributor to student learning specifically in nursing bioscience instruction. Second that educating could be achieved more effectively if active learning principles were applied and the needs and expectations of the student were met. Lastly, assessment influences student retention and the student experience and as such assessment should be congruent with the subject content, align with the learning objectives and be used as a stimulus tool for learning.

Attitude to the subject of chemistry in undergraduate nursing students at Fiji National University and Federation University, Australia

Attitude to the subject of chemistry was quantified in first-year undergraduate nursing students, at two geographically distinct universities. A purpose-designed diagnostic instrument (ASCI) was given to students at Federation University, Australia (n= 114), and at Fiji National University, Fiji (n=160). Affective and cognitive sub-scales within ASCI showed reasonable internal consistency. Cronbach's alpha for the cognitive sub-scale was 0.786 and 0.630, and 0.787 and 0.788 for affective sub-scale for the Federation University and Fiji National University students, respectively. Mean (SD) score for the cognitive sub-scale was 10.5 (5.6) and 15.2 (4.1) for students at Federation University and Fiji National University, respectively (P<0.001, t-test). Mean (SD) score for the affective sub-scale was 13.1 (5.1) and 20.7 (4.3) for students at Federation University and Fiji National University, respectively (P < 0.001, t-test). An exploratory factor analysis (n=274) confirmed a two-factor solution consistent with affective and cognitive sub-scales, each with good internal consistency. Quantifying attitude to chemistry in undergraduate nursing students using ASCI may have utility in assessing the impact of novel teaching strategies used in the education of nursing students in areas of bioscience and chemistry. However, geographically distinct populations of undergraduate nurses may show very different attitudes to chemistry.

Self-efficacy and relevance of bioscience for nursing, midwifery and healthcare students

AIMS AND OBJECTIVES

To examine nursing, midwifery and allied healthcare students' self-efficacy for science, perceived relevance of bioscience to their studies and expectations for academic success and the changes that occur after completing first-year introductory bioscience subjects.

BACKGROUND

Bioscience is a foundation subject that underpins nursing, midwifery and other allied health courses. Bioscience subjects continue to be source of anxiety for students in those courses. Raising students' self-efficacy and perceptions of the importance and utility of bioscience to practice may be a way of ameliorating students' expectations and confidence in this subject area.

DESIGN

A prospective correlational survey design.

METHODS

Students were surveyed in the first semester of first year and the commencement of the second year. Students were drawn from nursing, midwifery, public health and allied health courses. The surveys contained scales for self-efficacy for science, perceived relevance of bioscience to their course and personal expectations for success in their bioscience subject.

RESULTS

Ninety-seven and 82 students completed survey 1 and 2 respectively. Twenty-six surveys could be matched. Self-efficacy increased from survey 1 to survey 2, but expectations for academic success and task value, a measure for relevance, were lower. This was statistically significant for the matched pair sample. Using a mean split, students with high self-efficacy valued science more and had higher expectations for success in their bioscience courses than those with low self-efficacy.

CONCLUSION

Academic success in bioscience, confidence undertaking science tasks and perceiving bioscience as relevant to their course are interwoven concepts that are important for nursing, midwifery and applied healthcare students and ultimately for their professional practice.

RELEVANCE TO CLINICAL PRACTICE

Literature indicates practitioners may not feel confident in their bioscience knowledge. Assisting undergraduate students to develop confidence in and perceive the relevance of bioscience to their discipline may ultimately impact on clinical practice.

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.

The use of team-based, guided inquiry learning to overcome educational disadvantages in learning human physiology: a structural equation model

The study of human bioscience is viewed as a crucial curriculum in allied health. Nevertheless, bioscience (and particularly physiology) is notoriously difficult for undergraduates, particularly academically disadvantaged students. So endemic are the high failure rates (particularly in nursing) that it has come to be known as "the human bioscience problem." In the present report, we describe the outcomes for individual success in studying first-year human physiology in a subject that emphasises team-based active learning as the major pedagogy for mastering subject learning outcomes. Structural equation modeling was used to develop a model of the impact team learning had on individual performance. Modeling was consistent with the idea that students with similar academic abilities (as determined by tertiary entrance rank) were advantaged (scored higher on individual assessment items) by working in strong teams (teams that scored higher in team-based assessments). Analysis of covariance revealed that students who studied the subject with active learning as the major mode of learning activities outperformed students who studied the subject using the traditional didactic teaching format (lectures and tutorials, P = 0.000). After adjustment for tertiary entrance rank (via analysis of covariance) on two individual tests (the final exam and a late-semester in-class test), individual student grades improved by 8% (95% confidence interval: 6-10%) and 12% (95% confidence interval: 10-14%) when students engaged in team-based active learning. These data quantitatively support the notion that weaker students working in strong teams can overcome their educational disadvantages.

Biosciences within the pre-registration (pre-requisite) curriculum: an integrative literature review of curriculum interventions 1990-2012

BACKGROUND

The learning of biosciences is well-documented to be problematic as students find the subjects amongst the most difficult and anxiety-provoking of their pre-registration programme. Studies suggest that learning consequently is not at the level anticipated by the profession. Curriculum innovations might improve the situation but the effectiveness of applied interventions has not been evaluated.

OBJECTIVE

To undertake an integrative review and narrative synthesis of curriculum interventions and evaluate their effect on the learning of biosciences by pre-registration student nurses. Review methods A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar for empirical research studies was designed to evaluate the introduction of a curriculum intervention related to the biosciences, published in 1990-2012. Studies were evaluated for design, receptivity of the intervention and impact on bioscience learning.

RESULTS

The search generated fourteen papers that met inclusion criteria. Seven studies introduced on-line learning packages, five an active learning format into classroom teaching or practical sessions, and two applied Audience Response Technology as an exercise in self-testing and reflection. Almost all studies reported a high level of student satisfaction, though in some there were access/utilization issues for students using on-line learning. Self-reporting suggested positive experiences, but objective evaluation suggests that impacts on learning were variable and unconvincing even where an effect on course progress was identified. Adjunct on-line programmes also show promise for supporting basic science or language acquisition.

CONCLUSIONS

Published studies of curriculum interventions, including on-line support, have focused too heavily on the perceived benefit to students rather than objective measures of impact on actual learning. Future studies should include rigorous assessment evaluations within their design if interventions are to be adopted to reduce the 'bioscience problem'.

Perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a RN-to-BSN program

BACKGROUND

Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program.

OBJECTIVES

To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics.

DESIGN

A descriptive, cross-sectional study.

SETTINGS

Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited.

METHODS

A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product-moment correlation were used for data analysis.

RESULTS

Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics.

CONCLUSIONS

This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes.

An exploration of student experiences of using biology podcasts in nursing training

BACKGROUND

Students regard biological science as one of the most difficult components of the nursing curriculum. However, a good understanding of this area is essential for effective nursing practice. The aim of this study was to explore nursing students' perceptions of the usefulness of supplementary biology podcasts for their learning.

METHODS

Biological science podcasts (n=9) were made available to first-year nursing students (n=189) as supplementary learning tools. On completion of their first year, students were asked to complete a survey which investigated the frequency of their podcast use, reasons for use and their perception of the usefulness of podcasts as a learning tool. 153 of these students participated in the survey study (80.9%). Two focus groups were conducted with students (n=6) to gain a detailed understanding of student experiences of the usefulness of the podcasts for their learning.

RESULTS

Survey data demonstrated that most students (71%) accessed at least one podcast. The majority of students who reported accessing podcasts agreed that they were useful as learning tools (83%), revision aids (83%) and that they helped promote understanding of course materials (72%). Focus group participants discussed how they found podcasts especially useful in terms of revision. Students valued being able to repeatedly access the lecture materials, and appreciated having access to podcasts from a range of lecturers. Focus group members discussed the benefits of live recordings, in terms of valuing the information gleaned from questions asked during the lecture sessions, although there were concerns about the level of background noise in live recordings. Lack of awareness of the availability of podcasts was an issue raised by participants in both the survey component and the focus groups and this negatively impacted on podcast use.

CONCLUSIONS

Nursing students found the availability of biology podcasts helpful for their learning. Successful implementation of these tools to support learning requires teaching staff to understand and promote the importance of these tools.

Promoting active learning using audience response system in large bioscience classes

This paper considers the challenges of bioscience teaching and learning in pre-registration nurse education. Effective learning requires active student participation which is problematic when teaching large groups of students. New technologies, such as the audience response system (ARS), have been introduced to increase student participation and support them in the understanding of complex bioscience concepts. Within one university department, an evaluation was undertaken to identify the perceptions of pre-registration nurse students on the use of ARS in the teaching and learning of bioscience. Our findings concur with others that ARS increases student participation and aids in identifying misconceptions and in correcting them. Students found ARS very useful and wanted ARS to be used in additional modules too. Although ARS did not seem to motivate students to study adequately before attending the relevant sessions, it increased discussion among students and awareness of their level of knowledge compared to their peers. Further research is required to identify the effectiveness of ARS in the teaching and learning of bioscience and its impact on the performance of the students in their final assessments.

What is provided and what the registered nurse needs--bioscience learning through the pre-registration curriculum

Registered nurses undertaking programmes of study to become non-medical prescribers appear to have limited biological science knowledge. A case study was undertaken to determine whether the nurses entering Prescriber programmes considered studies in bioscience in their pre-registration nursing courses had been sufficient, linked to practice, and had prepared them for their roles as registered nurses. The literature identifies a continuing trend amongst nursing students describing a lack of sufficient bioscience in initial nurse education; there is limited literature on the views of experienced registered nurses. The participants in this study were 42 registered nurses from adult and mental health nursing, community and inpatient services. The results obtained from questionnaires and interviews are described. Questionnaire analysis identified that 57.1% of participants indicated bioscience in their pre-registration nursing programme had been limited and 40.5% stated the bioscience content had not prepared them for their roles on registration. Those reporting extensive coverage of bioscience were all aged over 41 years and had qualified before 1995. Greatest coverage of bioscience in pre-registration programmes was reported in relation to anatomy and physiology, with relatively limited coverage of microbiology, pharmacology or biochemistry. Respondents considered all five topics to be important. Interviews supported the questionnaire findings.

An exploratory study of the application of biosciences in practice, and implications for pre-qualifying education

Reinforcement of learning in practice may help students learn bioscience but is contingent on adequate support from staff nurses. A 'snapshot' of the situation in practice was obtained (2006/7), with context from lecturers. In Stage 1, surgical care nurses were presented with scenarios and interviewed. Responses were located within proficiency standards. Further responses related to application of 'Early Warning System' (EWS) tools on the wards. In Stage 2, a questionnaire was sent to lead bioscience lecturers at English universities. Nurses identified widespread knowledge of clinical observations. Underlying factors were variably articulated, and was not correlated with years in practice or first qualification. Experience was considered most important to learning bioscience but most nurses self-rated their bioscience knowledge as weak. Lecturers anticipated bioscience understanding at registration to be equivalent to around 'A' level standard, yet most thought the actual standard was lower. EWS tools were considered useful by nurses and lecturers, but potentially de-skilling. A dichotomy in expectation and reality of bioscience learning persists. The learning environment in practice is hindered either by practitioners having poor understanding, or low confidence in what they know. Post-qualifying education will help resolve recognised difficulties in student learning of biosciences, though EWS tools may not encourage deeper learning.

Nursing students' perception of a Web-based intervention to support learning

Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point(R) presentations, animations and digitised video clips were introduced in a first year Bachelor of Nursing biological sciences subject at a university in metropolitan Sydney. All students enrolled in this unit were invited to obtain access to the site and the number of hits to the site was recorded using the student tracking facility available on WebCT, an online course delivery tool adopted widely by many educational institutions and used in this study. Eighty-five percent of students enrolled in the subject accessed the learning support site. Students' perception of the value of a learning support site was assessed using a web-based survey. The survey was completed by 123 participants, representing a response rate of 22%. Three themes emerged from the qualitative data concerning nursing students' perception of the web-based activities: 'enhances my learning', 'study at my own pace', and 'about the activities: what I really liked/disliked'. Web-based interventions, supplementing a traditionally presented nursing science course were perceived by students to be beneficial in both learning and language development. Although students value interactive, multimedia learning they were not ready to completely abandon traditional modes of learning including face-to-face lectures. The findings of this study contribute to an understanding of how web-based resources can be best used to support students' learning in bioscience.

Tutorials for large classes of Common Foundation Program biomedical science students: successes and challenges

The aim of this paper is to investigate the problems encountered conducting biomedical science tutorials for nursing students in large classes with a typical student: staff ratio of 45:1. The study is based on level 1 Common Foundation Program students from the School of Nursing and Midwifery, Queen's University Belfast at the conclusion of two phases of biomedical sciences education which include a course of 12 interactive tutorials. Survey and interview methodologies were employed to investigate difficulties encountered by students in these large tutorial classes, to ascertain what characterises a good tutor and to explore student attitudes to interactive learning. The barriers to effective teaching and learning in tutorials are discussed and subsequently, a set of guidelines is proposed to enhance learning in them. These include being aware of the ability of the student group, having a compassionate questioning style, tailoring the teaching environment to fit the aims of the class and experimenting with different tutorial formats.

Teaching mode efficiency and learning preferences of first year nursing students

The student population in universities is very diverse: ranging ages, experiences, culture, level of preparedness and learning styles. This diversity presents academics with increasing challenges to motivate and promote student understanding. The aim of the current study was to develop knowledge of different learning styles among first year health science students and determine the benefits that students obtain from each teaching strategy. A questionnaire was designed for quantitative data collection, consisting of two sections. The first section sought student feedback on their experiences of lectures, tutorials and practical classes; the second section, consists of the 'VARK test', Visual, Aural, Read/write, Kinesthetic sensory modalities determines the different ways of receiving information [Fleming, N.D., 1995. I'm different; not dumb. Modes of presentation (VARK) in the tertiary classroom. In: Zelmer, A. (Ed.), Annual Conference of the Higher Education and Research Development Society of Australasia. J.]. The study identified that the majority of students found the lectures, tutorials and practical sessions to be beneficial to their learning and the combination reiterates and emphasises various life science concepts. The most favoured strategy was practical sessions, while tutorials were seen as least useful. The sensory mode the majority of students preferred to receive information was kinesthetic, the hands on approach to learning. Students are diverse creatures with differing abilities and mode for learning. There is no single right way to present material but by providing several different approaches the differing learning styles of students can be accommodated.

The biological sciences in nursing: a developing country perspective

AIM

This paper reports a study to inform curriculum development by exploring the contribution of bioscience education programmes to nurses' clinical practice, their understanding of the rationale for practice, and their perceptions of their continuing professional development needs.

BACKGROUND

The future of the health services worldwide depends on nurse education programmes equipping practitioners to deliver safe and effective patient care. In the developed world, the structure and indicative content of nursing curricula have been debated extensively. However, despite the rapid expansion in nursing roles brought about by social change, there is little information on the educational needs of nurses in developing countries.

METHODS

This study was undertaken in government teaching hospitals in Cape Town, South Africa in 2003. A purposive sample of 54 nurses from a range of clinical settings completed questionnaires and described critical incidents where bioscience knowledge had directed practice. Questionnaires were analysed descriptively, in the main. Analysis of critical incident reports was based on Akinsanya's bionursing model.

FINDINGS

Most nurses felt that their understanding of the biological, but not the physical sciences, was adequate or better: all felt confident with their knowledge of anatomy, compared with 57.4% (31/54) for microbiology. Respondents attributed the successes and failures of their education programmes to their teachers' delivery of content, ability to relate to practice and management of the process of learning. The biological, but not the physical, sciences were universally (96-100%) regarded as relevant to nursing. However, the critical incidents and nurses' own reports indicated a need for further education in pharmacology (40/54, 74.1%) and microbiology (29/54, 53.7%).

CONCLUSION

To meet the needs of nurses in developing countries, and empower them to meet the increasingly complex demands of their expanding roles, nurse educators need to consider increasing the curriculum content in certain key areas, including pharmacology and microbiology.

Approaches to teaching: current opinions and related research

Three approaches to teaching and learning are introduced. Each approach has its relative merits and disadvantages. Ideally, each approach should not be used in isolation. The use of facilitatory approaches to teaching and learning should be encouraged to assist the development of problem solving, decision making skills and creative and critical thinking in nurses, particularly those studying on competency-based education and training courses and programmes.

Using student nurses as teachers in inquiry-based learning

BACKGROUND

Traditionally, teaching in nurse education colleges and universities in the United Kingdom (UK) has relied substantially on didactic, large group, teacher-led approaches. Emerging literature identifies a shift towards student-centred learning in a variety of formats, such as problem- and enquiry-based learning. These approaches require students to take greater responsibility for both their own learning and that of others. Internationally, and in a number of academic educational disciplines, use of peer-assisted learning, supplemental instruction and peer tutoring as curriculum initiatives has aided improvement in student retention and academic performance. There is, however, a paucity of literature exploring the use of undergraduate student nurses as peer teachers.

AIM

To explore the viability of using student nurses as teachers in an inquiry-based nursing curriculum and to ascertain the value students place on this teaching and learning method.

METHOD

The first phase of the study involved observation of 'parallel resource sessions': teacher-led sessions that addressed a theoretical component of the curriculum. In the second phase, student feedback of these sessions to their peers was observed. This was followed by focus group interviews (with a total of 240 participants), which were analysed using thematic analysis.

FINDINGS

The findings suggest that student nurses were uncomfortable with being used as teachers, often questioned the intrinsic worth of this approach as a developmental tool, and considered the responsibility for teaching the content of parallel resource sessions to lie with nurse educators.

CONCLUSION

Nurse educators must continue to explore innovative approaches to improve both student nurses' experience and their fitness for practice. The strategy of using student nurses as teachers may be appropriate in some circumstances but requires further research, considerable support and continual evaluation.

Supporting biosciences in the nursing curriculum: development and evaluation of an online resource

AIMS

The aim of this project was to develop and evaluate an online resource designed to improve the biosciences knowledge of preregistration nursing students.

BACKGROUND

A number of studies have identified lack of biological subject knowledge and anxiety about studying biosciences as serious problems for nursing students. The availability of a contextualized biological information resource prior to and early in their studies might help to reduce this fear and anxiety.

METHODS

The project used an action research approach, involving an initial analysis of the extent of the problems with biosciences encountered by our nursing students, followed by the development and evaluation of a biology-based open learning resource (entitled Headstart) in collaboration with preregistration nursing students and nurse educators.

FINDINGS

The students in this study expressed a high level of concern about studying biology, and perceived this to be the most difficult aspect of their nursing programme (significantly more difficult than nursing practice). A significant correlation was also found between previous level of biological qualification and confidence in passing module tests. Evaluation of the new online resource illustrated the willingness of nursing students to use such a package, and general approval of its content and mode of delivery, despite a number of problems related to computer access and students' inexperience with information technology.

CONCLUSIONS

This project has provided further evidence of the need for additional resources in biosciences for nursing students. It has also illustrated the way in which a targeted online resource has the potential to provide substantial benefits in terms of supporting the nursing curriculum. Whilst further evaluation is needed, the findings suggest that Headstart has the potential to address a number of issues identified both by this study and by previous research in nurse education.

Pharmacology education: a theoretical framework of applied pharmacology and therapeutics

United Kingdom Government initiatives such as The NHS Plan (DoH 2000) identified the need for nurses to undertake multi-skilled professional roles. In the United Kingdom, the transition to a larger graduate nurse workforce continues, as Universities offer nurse pre-registration courses at diploma and degree levels. Concomitant with the change in educational standard is the need to teach student nurses the theoretical principles of medication management and to develop skills in clinical reasoning skills. Both elements are limited in current educational pre-registration nurse programmes, in order to develop the future, multi-skilled workforce such courses should incorporate the theory and skills of health assessment, physical examination, applied pharmacology and clinical reasoning. This paper aims to examine how knowledge of applied pharmacology and therapeutics can be integrated into an undergraduate pre-registration nursing programme. Discussion focuses on how this generic framework can provide educators with an outline of the theoretical constructs, their application, the teaching strategies involved and instruction on how to prepare nurses to clinically reason with regard to medication management issues. This framework can be adapted to accommodate nurses studying for all parts of the register.

The educational preparation of undergraduate nursing students in pharmacology: a survey of lecturers' perceptions and experiences

BACKGROUND

Nurses have key responsibilities in the administration and management of medication therapy and client education. It is of some concern therefore that the literature indicates that nurses are inadequately prepared in this area.

AIMS

This paper explores the perceptions and expectations of lecturers about teaching and learning pharmacology in preregistration nursing courses.

RESEARCH METHODS

Questionnaires were distributed to lecturers involved in teaching pharmacology to undergraduate nursing students during 2000. The questionnaire was distributed to all university campuses (n = 13) in Victoria, Australia, that are involved in undergraduate nursing education. The questionnaire was an adaptation of the survey instrument used in the Nursing and Medication Education [NAME] project and examined in this questionnaire: the integration of pharmacology teaching into nursing, range and depth of classroom-based pharmacology teaching, approaches to teaching and learning, nursing practice in a clinical context, related importance of patient education and communication skills, and the appropriate professional background of academics teaching pharmacology to preregistration nursing students.

RESULTS

There was great variation between institutions as to the number of hours devoted to pharmacology and when it was offered. A number of respondents indicated that they were dissatisfied with the preparation of graduates and their knowledge base in pharmacology.

LIMITATIONS

The study was limited by a low response rate of 34%.

CONCLUSIONS

A review of nursing curricula is required to improve the knowledge base of nurses in pharmacology and to facilitate their skills in life-long learning.

The teaching of genetics in New Zealand undergraduate nursing programmes

This paper reports the results of a survey to determine how much genetics is taught in the bioscience component of the three-year Bachelor of Nursing degree offered by 16 tertiary education institutes in New Zealand. A questionnaire was mailed to the bioscience lecturers seeking information on the bioscience and genetics content of current programmes. They were also asked to indicate their perception of the impact and relevance of new genetic knowledge on health care and nursing education. Results indicated that on average 250-350 hours are devoted to the teaching of biosciences. Less than 10 hours are devoted to genetics at 66% of institutes, one institute did not teach any aspect of genetics. None of the institutes taught more than 20 hours of genetics in the programme, although 47% of lecturers said they would like to teach more genetics if there were more time available in the curriculum. Lecturers teaching bioscience to Bachelor of Nursing students are aware of the importance of genetics in health care and to nursing in particular, and the majority are of the opinion that more genetics should be included in undergraduate programmes, however 'curriculum crowding' is a problem.

Why is biological science difficult for first-year nursing students?

Many factors contribute to poor performance in examinations in nurse education. Some of these are specific to the biological science subject area. In this study the results of two cohorts of first-year nursing students' biological science examination results were analysed to see if entry criteria and study habits significantly affected examination results. chi(2) contingency tables were used. The following parameters were shown to have a significant effect on biological science examination results: 1. Studied biology previously, chi(2)=48.06, DF=20, n=112 (significant at 0.001); 2. Level of achievement in school biology, chi(2)=11.15, DF=8, n=104 (significant at 0.05); 3. Attendance in class, chi(2)=60.71, DF=36, n=201 (significant at 0.001); 4. Use of recommended readings, chi(2)=34.86, DF=20, n=119 (significant at 0.05). Are nursing students of today giving themselves a decent chance through their study and attendance behaviour in a busy demanding course? Is overloading within the curriculum leading to these behaviours? This study shows that poor previous theoretical biological science significantly influenced biological science examination results. Biological science will continue to prove difficult, particularly for students who have a poor biological background, unless appropriate strategies are put in place both within the course and prior to entry.

Aspects of curriculum policy in preregistration nursing education in the Republic of Ireland: issues and reflections

AIMS

This paper sets out to examine critically aspects of curriculum policy related to preregistration nursing education in the Republic of Ireland.

BACKGROUND

Following a period of industrial unrest concerned with pay, promotional opportunities and conditions of employment amongst nurses and midwives in the Republic of Ireland, a Commission on Nursing was established in March 1997. Along with a series on recommendations pertaining to the role and the professional development of nurses and midwives, the final report of the Commission on Nursing contained recommendations on the educational preparation of nurses. Specifically, the Commission recommended that the future framework for preregistration nursing education in the Republic of Ireland be based on a 4-year degree programme, fully integrated into higher education. As a means of giving effect to this recommendation, the Commission also recommended the establishment of a Nursing Education Forum, whose task it was to develop a strategic framework for the introduction of the proposed preregistration nursing degree programme. The Forum published its final report in October 2000 and this report constituted the most explicit statement of official policy on the nursing curriculum in the Republic of Ireland.

DESIGN

The paper constitutes a critical analysis of selected aspects of the report of the Nursing Education Forum, in the light of scholarly literature on curriculum philosophy and curriculum policy.

SUMMARY OF CONTENT

The paper considers some of the implications for curriculum development and design arising out of the recommendations of the Nursing Education Forum. Among a list of core principles underpinning curriculum regulation and design, the report included the principle of 'eclecticism'. The paper considers this principle with reference to nursing epistemology, pedagogical practice and curriculum policy, and seeks to challenge some of the assumptions underlying this principle.

CONCLUSIONS

The epistemological identity and the structural integrity of primary forms of knowledge in the preregistration curriculum need to be maintained if students are to develop their knowledge and understanding of nursing science.