Final year Australian nursing students’ experiences with bioscience: A cross-sectional survey

Qualified nurses' knowledge of the biosciences: Systematic scoping review

AIM

To appraise and synthesise empirical studies on the use of bioscience knowledge in clinical work by qualified nurses. It is assumed that post-registration courses should teach biosciences so that it can be used by qualified nurses in clinical practice. This is about understanding what knowledge is being used to direct patient care, to ensure that the right decisions are being made for the right reasons.

DESIGN

Systematic scoping review of mixed study designs.

DATA SOURCES

Medline, CINAHL, Embase, databases and Google Scholar were searched, 1980 - September 2023, followed by hand searches, reference list check of retrieved papers and personal contacts.

REVIEW METHODS

Potentially eligible papers were scrutinised by 2 reviewers who also completed data extraction, with disagreements resolved through discussion. Quality assessment used CASP checklists appropriate to each study design. Thematic synthesis applied an interpretative approach to extracting data. No meta-analysis was possible.

RESULTS

Fifteen papers were included; eleven with quantitative data and seven with qualitative data. Qualified nurses in general did not feel prepared for their role due to lack of knowledge of the biosciences. There were mixed views on the usefulness of bioscience knowledge for patient care.

CONCLUSIONS

The relationship between bioscience knowledge and clinical practice remains a dichotomy. Whilst there continues to be strong support for applying biosciences to patient care, there is a dearth of convincing evidence to support the usefulness of this knowledge in clinical decision-making.

The impact of integrating bioscience and nursing subjects in a first-year nursing curriculum: A retrospective study

AIM

The aim of this study is to explore the effects of integrating bioscience and nursing units on academic achievement and perception in the first-year nursing curriculum.

BACKGROUND

Nursing students have historically found biosciences difficult and struggle to relate it to nursing practice. In response, nursing and non-nursing academics have employed different teaching modes and integration strategies to enhance learning. Despite these efforts, substantial gaps still persist concerning the integration of biosciences within nursing curriculum and the effect of integration on student academic achievement and student perception.

DESIGN

Retrospective descriptive. The setting was a large University in Victoria Australia with two undergraduate nursing campuses (metropolitan and non-metropolitan).

METHOD

Student academic records and online evaluation surveys that were completed from 2014 to 2019 were examined. Students self-reported their experiences of the unit using a five-point Likert scale and two open-ended questions. Descriptive and inferential statistics were used to analyse the data. Content analysis was used to analyse the two open-response survey items.

RESULTS

First-year student records from 2014 to 2016 (pre-integration) and 2017-2019 (post-integration) were examined. Student mean age was 24.5 years (SD 7.2) and 20.9 years (SD 4.8) pre-integration and post-integration respectively. There was a statistically significant decrease in student attrition from pre-integration (n=536, 29.9%) to post-integration (n=358, 20.2%) (p <0.001), and a significant improvement in students' mean academic scores post-integration in the first semester 61.9 (SD 15.9) and 67.0 (SD 14.9) respectively, confidence interval 3.9-6.2 (p <0.001). Student satisfaction with the units improved post-integration, from 77.8% to 85.8% (χ2 = 10.1076) (p=0.001). However, there was no significant difference in students' perception of feeling overwhelmed, and their self-reported ability to link theory to practice.

CONCLUSION

Integrating bioscience and clinical nursing practice units in the first-year curriculum can help decrease student attrition rates, improve student academic results and increase student satisfaction which may lead to an overall improvement in student learning experiences.

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.

Horizontal integration of bioscience and nursing in first-year nursing curricula: A systematic review

OBJECTIVES

To systematically identify, appraise and summarise available evidence related to the horizontal integration of bioscience and nursing in first-year nursing curricula; to examine students', nurses' and academics' perceptions of the integration and provide recommendations for future curriculum development, practice and research priorities.

DESIGN

A systematic review.

DATA SOURCES

An online search of Ovid Medline, Ovid Emcare, CINAHL, Embase Classic + and Embase, ERIC, A+Education, Scopus (Elsevier) and Google Scholar was conducted between July and September 2021. A manual search of the reference list of included articles was also undertaken.

REVIEW METHODS

This systematic review followed The PRISMA Statement. The study selection process was managed using the Covidence software platform and quality was assessed using JBI Critical appraisal tools and Mixed Methods Appraisal tools. A narrative synthesis of included studies was undertaken.

RESULTS

Six articles were identified which met the inclusion criteria. The study population included students, academics and registered nurses. Four studies used clinical scenarios as a method of horizontally integrating bioscience and nursing content. The integration outcomes were measured by student understanding and learning, satisfaction and motivation. Students', nurses' and academics' perceptions of integration challenges were: i) depth of bioscience content; ii) structure of bioscience content; and iii) knowledge and experience.

CONCLUSIONS

This systematic review did not identify a wide range of methods to integrate bioscience in first year nursing curricula. The use of clinical scenarios increased student understanding and learning. However, teaching academics needed to be cognizant of both nursing and bioscience to achieve the required depth of bioscience content and demonstrate integration of bioscience in nursing practice. There is a need for further investigations of methods of horizontal integration of bioscience and nursing in the first-year nursing curricula.

Nursing students' perceptions of clinical relevance and engagement with bioscience education: A cross-sectional study of undergraduate and postgraduate nursing students

BACKGROUND

Bioscience in nursing education covers a broad range of disciplinary areas (anatomy, physiology, pathophysiology and pharmacology) and underpins clinical assessment and critical thinking in nursing practice. This is imperative for patient safety and favourable patient outcomes. In nursing programs for registration, most bioscience content is taught during the early phases of the program and little incorporated into postgraduate nursing programs.

OBJECTIVES

The aim of this study was to explore student's perceived relationship between clinical relevance and engagement (attention and time) with bioscience content, by surveying undergraduates and postgraduate nursing students.

DESIGN

This sequential mixed methods study included two phases.

METHODS

The first phase comprised of focus group interviews from one Australian University. Thematic analysis of these data, coupled with existing literature, informed the second study phase; a quantitative questionnaire.

PARTICIPANTS

Focus group interviews included N = 30 students from one tertiary site; 10 from each year level. The questionnaire was administered to nursing students undertaking undergraduate nursing studies (1st, 2nd & 3rd years), and postgraduate nursing studies.

RESULTS

Nursing students (n = 406) across three Australian universities (four programmes) completed the questionnaire. The clinical relevance of bioscience was widely appreciated; 91.6% of undergraduate nursing students and 98.5% of postgraduate nursing students indicated that every nurse must have a good understanding of bioscience. However, there was an inverse relationship between engagement with bioscience and timing in the curriculum, as 50% of undergraduate nursing students indicated that bioscience content took up too much of their time, compared to only 20% of postgraduate nurses (odds ratio 0.27 [0.16-0.46], p < 0.001).

CONCLUSION

Nursing students' perceptions of the clinical relevance of bioscience for their career strongly corresponds with their progression through their studies. Unfortunately, as students progress to the later years of their nursing education, their engagement with formal bioscience education decreases. This poses the question 'Are we delivering bioscience content to nursing students at the appropriate time?'

Teaching bioscience to nursing students-What works?

AIM

To compare the effects of flipped classroom and traditional auditorium lectures, on nursing students' examination results in bioscience.

DESIGN

An educational intervention study.

METHODS

All the first-year students in the bachelor programme (N = 493) were entered into a database and randomly assigned to the intervention or the control group in a course in bioscience. The outcome measures are the proportion of students who passed the examination, and the distribution of grades from A to E. Chi-square tests and Mann-Whitney Wilcoxon test were used. The odds to pass versus fail were modelled using binary logistic regression.

RESULTS

The proportion of students who did not pass the final examination was very similar in the intervention and the control groups, 21.4% and 23.6% (p = .574). Our data did not reveal any statistically significant differences concerning the distribution of grades (p = .691). Students with biology and/or natural science had higher odds for passing.

Designing and developing core physiology learning outcomes for pre-registration nursing education curriculum

Physiology is a key element of "bioscience" education within pre-registration nursing programs, but there is a lack of clarity on what is included. Physiology and bioscience content and delivery are highly varied across both higher education institutions and the related programs in the United Kingdom (UK). Despite evidence highlighting concerns over nurses' lack of bioscience knowledge and unsafe practice, there is no universally agreed on curriculum with detailed outcomes of minimum levels of knowledge to support nurses in practice and patient care. This study aimed to inform the construction of discipline-specific physiology learning outcomes to clarify relevant physiological topics required in pre-registration nursing. Initially, 360 learning outcomes were identified from various sources. Using a modified Delphi approach, an expert panel from the Bioscience in Nurse Education group reviewed and modified the list to 195 proposed outcomes. These were circulated to universities in the UK who teach nursing (n = 65). Outcomes that had 80% consensus were automatically included in the next round, with others recommended with modification (response rate 22%). The panel reviewed the modifications, and 182 outcomes were circulated in the second questionnaire (response rate 23%), and further panel review resulting in 177 outcomes agreed. These learning outcomes do not suggest how they should be delivered, but gives the basic level required for qualification as a nurse commensurate with the Nursing and Midwifery Council new standards for the "future nurse."

Digital explanations and nursing students' perception of learning science

A thorough understanding of human physiology and anatomy are pivotal in the preparation of competent nursing students for clinical practice. However, anatomy and physiology are among the most conceptually perplexing subjects that nursing students will encounter throughout the duration of their course. Research in other science-based contexts has demonstrated a positive relationship between student-generated digital media and learning scientific concepts. Therefore, the aim of this study was to explore nursing students' experience in learning science concepts through a formative assessment task which was based on making a 'digital explanation'. Our work was guided by semiotic theory and the study design was a mixed method study where 428 first-year nursing students across five campuses volunteered to complete self-reported surveys during the first and last week of the academic session. Students who consented for an interview were invited to attend one of five focus groups. More than half of the participating cohort had prior experience with science (66%), but only 24% had previous experience with making digital media. After completion of the assessment task, two-thirds of the students strongly agreed or agreed that they learned more about science and fewer students agreed that searching for scientific knowledge could be boring. The qualitative findings confirmed the presence of learning about science and four themes were identified: 'learning about science', 'linking knowledge to practice', 'using technology', and 'making it real'. A key point was that the students began to see connections between science knowledge and nursing practice. But many students were challenged by the technology and the fact that the task was ungraded. Although the digital explanation was an overall positive experience for the nursing students, there is a need for a flexible and graded assessment task to achieve its potential benefits as a teaching and learning task in nursing. We conclude that additional intervention studies are warranted.

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.