Theory-practice gap: Nursing students' self-reported depth of understanding of bioscience and its relevance to clinical practice

BACKGROUND

Bioscience subjects are essential as they allow nurses to have a clear understanding of the patient's condition and ultimately allow them to provide appropriate and timeous care. However, these subjects remain a significant problem in the endeavour to produce highly competent nurses.

AIM

The study aimed to investigate the nursing students' self-reported depth of understanding of bioscience and its relevance to clinical practice.

METHODS

A quantitative research approach using a descriptive survey design was employed. The sample (n = 211) included second-, third- and fourth-year undergraduate nursing students. A three-part self-administered questionnaire was adapted and used to collect the data. Data were analysed using IBM Statistical Package for Social Sciences software version 25.0 (IBM SPSS-25). Descriptive statistics and Chi-squared test were performed to describe the relationship among the study variables.

RESULTS

Participants rated their understanding of the application of Human Biology (n = 86, 40.76%) and Pharmacology (n = 88, 41.71%) as good, while Physics (n = 80, 37.91%) and Chemistry (n = 85, 40.28%) were rated as adequate. Most participants rated Human Biology (n = 175, 83.73%) and Pharmacology (n = 181, 86.19%) as essential, while Physics (n = 129, 61.72%) and Chemistry (n = 133, 63.64%) were rated as relevant to clinical practice. Physics (n = 112, 60.54%; n = 95, 50.53%) and Chemistry (n = 126, 68.85%; n = 113 61.41%) were rated as not relevant to monitoring a patient's heart rate and blood pressure. Participants' perception of the relevance of Chemistry in monitoring a patient's blood pressure was statistically significant (χ2 = 6.871 (df 2), p<0.05). Most participants (n = 57, 41.91%) performed at Task specific on Akinsanya's Bionursing model, suggesting an overall understanding of the foundational concepts and principles of bioscience.

CONCLUSION

The findings of the study provided evidence of the students' self-reported depth of understanding and perception of the relevance of bioscience and indicate a need for more emphasis on the importance of bioscience integration in clinical practice.

Integration of anatomy and physiology into nursing practice as perceived by undergraduate students and registered nurses: a scoping review

OBJECTIVE

The current study aimed to determine perceptions of registered and student nurses regarding the integration of anatomy and physiology into nursing practice.

METHODS

This scoping review was conducted following the checklist provided in the Reporting Items for Systematic reviews and Meta-Analysis extension for scoping reviews. Articles published in PubMed, ERIC, and CINAL from January 1, 2002 to September 30, 2022 were included.

RESULTS

A literature review of 20 articles that matched the indicative criteria revealed that both undergraduate student and registered nurses recognized knowledge of anatomy and physiology as important to nursing practice. Student nurses recognized that such knowledge is related to understanding patient pathophysiology, patient observation, treatment selection, and patient safety and forms the basis for nursing practice. Registered nurses who were confident in their knowledge of anatomy and physiology also reported that they were able to explain the rationale for their nursing practice. They also reported that this knowledge is necessary for communication with multiple professions, which promotes patient/family trust in nurses and is the basis for building trusting relationships with patients and their families.

CONCLUSIONS

Although undergraduate student and registered nurses recognized the importance of learning anatomy and physiology, the integration of anatomy and physiology into nursing practice was not the same for all student and registered nurses. This suggests the need to investigate the overall perceptions of nurses regarding the integration of anatomy and physiology into nursing practice and for faculty to discuss how to facilitate critical thinking among students.

Nursing students learning transfer from classroom to clinical practice: An integrative review

AIM

The aim of this integrative review was to examine the theoretical, qualitative, quantitative and mixed-methods literature focused on how nursing students transfer learning from theory courses into clinical practice.

BACKGROUND

As nursing curriculum aligns with the growing body of nursing knowledge, nursing students continue to develop their knowledge base and skill sets to prepare for future nursing practice. The bulk of this preparation involves developing connections between classroom/lab knowledge and further demonstrating those connections in clinical practice. However, the extant state of evidence on undergraduate nursing students' learning transfer has not yet been synthesized.

DESIGN

This integrative review was conducted using the Whittemore and Knafl framework.

REVIEW METHODS

Eight databases were searched in June 2022: MEDLINE, APA PsycInfo, EMBASE, Web of Science, CINAHL, ERIC, Academic Search Complete and Education Research Complete. Literature was included if it focused on undergraduate nursing students who have participated in at least one clinical practicum and reported on learning transfer in clinical settings. Only English-language, peer-reviewed literature was included. Two researchers independently assessed the eligibility of articles at the title-and-abstract level and at the full-text level, followed by an assessment of methodological quality. The Joanna Briggs Institute's critical appraisal checklists were used to assess theoretical papers and literature reviews and the mixed-methods appraisal tool (MMAT) was used to appraise all studies. Reference lists of included articles were searched for additional relevant literature. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.

RESULTS

Twenty-eight articles met our inclusion criteria and were included in this review, including 20 qualitative studies, one quantitative study, three mixed-methods studies, three theoretical articles and one integrative review. The results of this review highlighted that numerous facilitators and barriers influence nursing students' ability to transfer learning within clinical learning environments. Facilitators included having knowledgeable and supportive educators and nursing staff, using strategies to promote connections, fostering reflection and aligning theory and practice. Barriers included unclear connections between course content, incongruencies between classroom and practice, lack of nurse role models, lack of real-world applicability and unsupportive nurse educators.

CONCLUSIONS

The information generated from this integrative review provides evidence about barriers that can be mitigated and facilitators that can be leveraged to facilitate undergraduate nursing students' learning transfer into clinical practice. The findings also highlighted gaps in evidence surrounding the need to understand how nursing students transfer learning from classroom settings to clinical practice settings.

"Connecting the dots" - The transfer of bioscience knowledge by new graduate nurses to the clinical setting: A qualitative study

BACKGROUND

Little is known regarding the transfer of bioscience knowledge gained during undergraduate nursing studies into clinical practice.

OBJECTIVE

To explore the experiences of new registered nurses in applying bioscience concepts in their day-to-day nursing practice.

DESIGN

Descriptive qualitative design.

PARTICIPANTS

Fifteen recently graduated registered nurses (RNs) who were working in acute care settings participated in the study.

METHODS

Semi-structured, face-to-face individual interviews were conducted. Interview data were audio-recorded and thematically analysed.

RESULTS

Four themes were identified from the qualitative interviews. The first and second themes demonstrated nurses' realisation of the relevance of theoretical bioscience knowledge learnt within the classroom to their practice and how this evidence-based knowledge translated into confidence in decisions made. The third and fourth themes revealed the impact bioscience knowledge had on RNs' relationships with patients and family members, which was viewed as providing compassionate care.

CONCLUSIONS

The application of knowledge in biosciences gained during their undergraduate years, provided the basis for RNs to trust in their own clinical judgment and to speak with conviction. 'Connecting the dots' between bioscience knowledge and clinical practice provided the platform for RNs to gain and build trust with their patients. The practical utility of bioscience knowledge in everyday practice allowed RNs to contextualise their nursing care regimen and tailor holistic nursing care delivery to individual patient needs.

"Sage on the stage or guide on the side"-Undergraduate nursing students' experiences and expectations of bioscience tutors in a blended learning curriculum: A qualitative study

AIMS AND OBJECTIVES

This study sought to explore undergraduate nursing students' perceptions of the role and value of their bioscience tutors in a blended learning curriculum.

BACKGROUND

Blended learning approaches typically have reduced face-to-face contact with tutors-particularly in bioscience subjects which nursing students have traditionally found difficult, and the move to more web-based learning resources may compound this difficulty.

DESIGN

Qualitative descriptive study.

METHODS

This qualitative study was conducted with 19 undergraduate nursing students enrolled in bioscience subjects, at a large university in outer metropolitan Sydney, Australia in 2016. Semi-structured interviews were conducted over the telephone or face-to-face. Duration of interviews ranged from 13 to 71 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied.

RESULTS

Two main themes with accompanying sub-themes were identified. The first theme identified the importance of the tutor in bioscience, including their qualities, expertise and contextualisation of learning. The second theme provided insights into students' perceptions of what they considered good and poor approaches to learning.

CONCLUSIONS

This study has clearly shown that while nursing students appreciated the flexibility offered by the online component of a blended learning curriculum, they still wanted an experienced bioscience tutor with clinical experience for their face-to-face classes. While the tutor was seen as crucial to providing clarification and context for content that was often challenging, they also played a key role in engaging and motivating students and creating a learning environment where students felt empowered to ask questions and debate issues with their peers. Given the increased use of online learning, further research could determine if the current study findings are also applicable in nonscience areas of study.

RELEVANCE TO CLINICAL PRACTICE

The importance of students having a sound understanding of the biosciences for safe, effective clinical practice cannot be underestimated.

Nursing students collaborating to develop multiple-choice exam revision questions: A student engagement study

BACKGROUND

Nursing students find bioscience subjects challenging. Bioscience exams pose particular concerns for these students, which may lead to students adopting a surface-approach to learning.

OBJECTIVES

To promote student collective understanding of bioscience, improve their confidence for the final exam, and improve deeper understanding of bioscience.

DESIGN

In order to address exam anxiety, and improve student understanding of content, this student engagement project involved nursing students collaborating in small groups to develop multiple-choice questions and answers, which became available to the entire student cohort.

SETTINGS

This study was conducted at two campuses of an Australian university, within a first year bioscience subject as part of the undergraduate nursing programme.

PARTICIPANTS

All students enrolled in the subject were encouraged to attend face-to-face workshops, and collaborate in revision question writing. Online anonymous questionnaires were used to invite student feedback on this initiative; 79 respondents completed this feedback.

METHODS

Students collaborated in groups to write revision questions as part of in-class activities. These questions were made available on the student online learning site for revision. An online feedback survey was deployed at the conclusion of all workshops for this subject, with questions rated using a Likert scale.

RESULTS

Participants indicated that they enjoyed the opportunity to collaborate in this activity, and almost all of these respondents used these questions in their exam preparation. There was strong agreement that this activity improved their confidence for the final exam. Importantly, almost two-thirds of respondents agreed that writing questions improved their understanding of content, and assisted in their active reflection of content.

CONCLUSIONS

Overall, this initiative revealed various potential benefits for the students, including promoting bioscience understanding and confidence. This may improve their long-term understanding of bioscience for nursing practice, as registered nurses' bioscience knowledge can impact on patient outcomes.