Bioscience Knowledge Research Articles

The requirement for bioscience knowledge in medical education

The recent 100-year anniversary of the Flexner review and the release of the Australian Medical Education Study have stimulated vigorous debate about the role of bioscience knowledge in medical education. Two critical questions define debate in this area: does bioscience learning assist in educating medical students to become competent doctors, and, if so, what are the most effective teaching and learning methods to facilitate this outcome? There is tacit acceptance that specific bioscience knowledge is critical for the development of clinical expertise; however, there are few empirical data to support this notion. Two differing theories have been proposed to describe the role of bioscience learning in the development of clinical reasoning skills - the "two-worlds" model and the "encapsulation" model. A series of studies provides support for the encapsulation model. Some medical programs are now integrating bioscience teaching into the clinical years of the course. Evidence of the effectiveness of this on outcomes, such as improved clinical reasoning, is inconclusive.

Clinical assessment performance of graduate- and undergraduate-entry medical students

Background: Recent evidence suggests that graduate-entry medical students may have a marginal academic performance advantage over undergraduate entrants in a pre-clinical curriculum in both bioscience knowledge and clinical skills assessments. It is unclear whether this advantage is maintained in the clinical phase of medical training.Aim: The study aimed to compare graduate and undergraduate entrants undertaking an identical clinical curriculum on assessments undertaken during clinical training in the medical course.Methods: Clinical assessment results for four cohorts of medical students (n = 713) were compared at the beginning and at the end of clinical training for graduate and undergraduate entrants.Results: Results showed that graduate- and undergraduate-entry medical students performed similarly on clinical assessments. Female students performed consistently better than male students.Conclusion: The findings of this study suggest that any academic performance advantage held by graduate-entry medical students is limited to the early years of the medical course, and is not evident during clinical training in the later years of the course.

Does the Transition to an Active-Learning Environment for the Introductory Course Reduce Students’ Overall Knowledge of the Various Disciplines in Biology?

As biology education is being redesigned toward an interdisciplinary focus and as pedagogical trends move toward active-learning strategies and investigative experiences, a restructuring of the course content for the Introductory Biology course is necessary. The introductory course in biology has typically been a survey of all the biosciences. If the total number of topics covered is reduced, is the students' overall knowledge of biology also reduced? Our introductory course has been substantially modified away from surveying the biological sciences and toward providing a deep understanding of a particular biological topic, as well as focusing on developing students' analytical and communication skills. Because of this shift to a topic-driven approach for the introductory course, we were interested in assessing our graduating students' overall knowledge of the various biological disciplines. Using the Major Field Test - Biology (Educational Testing Service (ETS), Princeton, NJ), we compared the test performance of graduating students who had a traditional lecture-based introductory course to those who had a topic-driven active-learning introductory course. Our results suggest that eliminating the traditional survey of biology and, instead, focusing on quantitative and writing skills at the introductory level do not affect our graduating students' overall breadth of knowledge of the various biosciences.

Medicines discovery in the 21st century: the case for a stakeholder corporation

It is widely accepted that biopharmaceutical companies have, in recent times, failed to deliver large numbers of new medicines to patients and have simultaneously failed to deliver large financial returns to their investors. We argue that addition of different business constructs with wider stakeholder ownership and/or control offers a way to improve returns from the great advances in medical science and drug discovery processes. Governments and other payers for medicines, the academic institutions engaged in bioscience knowledge creation, patient advocacy groups, venture philanthropists and charitable foundations can come together with commercial profit-centred businesses to develop corporate constructs that mutually benefit all of the stakeholders. A rebalancing of the social and financial motives in medicines research can arrest recent productivity decreases of the sector.

Comparing the academic performance of graduate- and undergraduate-entry medical students

This study compared the academic performance of graduate- and undergraduate-entry medical students completing the same pre-clinical curriculum and assessment at a large metropolitan university. Arguments have been made for the relative merits of both graduate- and undergraduate-entry medical programmes. However, data on the academic performance of graduate and undergraduate entrants are relatively scarce. This retrospective study adopted a quasi-experimental design to compare data from assessments of bioscience knowledge and clinical skills undertaken across 2 years for four cohorts of medical students (who commenced their studies between 2002 and 2005). Percentage final results for four bioscience knowledge subjects and four clinical skills assessments (based on objective structured clinical examination [OSCE] results) were compared for 240 graduates and 464 undergraduates using multivariate analysis of variance (manova). Graduate-entry students performed marginally better than undergraduate-entry students on all four bioscience knowledge assessments (partial eta-squared [n(p)(2)], n(p)(2)=0.04) and also on early clinical skills assessments (n(p)(2)=0.06). Graduate-entry students had a marginal academic performance advantage during the early years of this medical course. Most graduate-entry students had a first degree in a science discipline; thus their advantage may be explained by prior bioscience knowledge. Their performance advantage in clinical skills is less easily attributed to prior learning. Instead, this result provides some evidence for a possible advantage related to age. The marginal differences in early academic and clinical performance probably suggest that both graduate and undergraduate entry should exist in parallel to preserve multiple points of entry to the medical profession.

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.

Learning bioscience in nursing education: perceptions of the intended and the prescribed curriculum

AbstractThis study used a curriculum inquiry framework to investigate the perceptions of 184 nursing students and nurse educators in relation to bioscience in the nursing curriculum. These participants’ attitudes to science and bioscience, self‐efficacy in bioscience and perceptions of bioscience were investigated using scales based on previous research. Nursing students were found to have significantly more positive attitudes to bioscience in nursing education than nurse educators, and nurse educators were not found to have significantly better self‐efficacy in bioscience than the students, although this might have been expected. The results of focus group discussions, used to investigate this in more depth, suggested that some nurse educators and clinical preceptors may not have sufficient science background or bioscience knowledge, to help nursing students apply bioscience knowledge to practice. As a result of this, it is suggested that the aims of the intended and prescribed nursing curricula are not being fulfilled in the implemented curriculum. Because of the increasing acuity of illness in hospitals, the fact that nurses are becoming more autonomous in their practice and the increasing expectation that nurses, in some cases, will be able to prescribe as well as administer medications, bioscience knowledge is becoming even more important. The teaching of bioscience and its application to clinical practice needs to improve if nurses are to be credible members of the multi‐disciplinary team.

The biological sciences in nursing: a developing country perspective

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. 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. 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. 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%). 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.

電気泳動法の教育ツールとしての活用 薬学教育現場での応用

For training of graduates in various fields such as clinical bed-side pharmacists, and basic pharmaceutical researchers, the faculties in the pharmaceutical university should give them broad area of knowledge of pharmaceutical sciences, clinical pharmacy and life sciences. Electrophoretic method in pharmaceutical sciences is dealt as tools to understand analytical science, and it is necessary to teach enough principles and the practical skills for electrophoresis. In the point of view, students could attain to more knowledge of biosciences, especially of proteins, from the separation action in electrophoresis.For education of clinical pharmacy, it is useful tool for investigation of laboratory test values, analysis of a patients' ability of drug metabolism, and clinical analysis of patients' physiological conditions. While, analytes by electrophoresis can be visualize by adequate dyeing, and the visualization could produce great educative results.Therefore, application of electrophretic method in the field of life science and education of pharmacists will increase in near future, and is expected to be more important in addition to their role in traditional analytical science.

Brokering knowledge in biosciences with InnoCentive. Interview by Semahat S. Demir.

Brokering knowledge in biosciences with InnoCentive. Interview by Semahat S. Demir.

A preliminary report on the differences in the perceived impacts of undergraduate bioscience knowledge on clinical practice among Korean RNs.

Nursing has evolved as a unique and independent field over the last decades. Unfortunately, many nurses in Korea express concern that they lack appropriate background knowledge in bioscience necessary to practice nursing competently. To determine the reasons of their concerns, we examined the perceptions of RNs regarding bioscience courses in their undergraduate (Baccalaureate and 3 year diploma program) and their perceived relations to the practice of nursing. The structured questionnaires were sent to 3 university-affiliated tertiary hospitals in Seoul, Korea. The responses given by the nurses in the two groups were similar. The nurses in this study reported that the bioscience courses they took as undergraduates had little relation to their professional tasks. This lack of link between bioscientific knowledge and nursing practice may be partly due to the fact that the courses are taught by non-nursing faculties who are not familiar with nursing tices. It also appears that bioscience knowledge deficit was most prominent during nursing assessment regardless of the program they attended or the unit they are currently working. Bioscience courses should be integrated into the nursing curriculum properly and taught by nursing faculty who have a strong background in biological sciences.

Nursing and the Division of Labour in Healthcare

Introduction D, Hughes, D. Allen, L. griffiths and S. Philpin.- PART ONE: INTER-PROFESSIONAL AND INTRA-PROFESSINAL RELATIONSHIPS.- Temporal-spatial Dimensions of teh Hospital Division of Labour D. Allen.- Doctors' and Nurses' perceptions of medical and nursing roles S. Snelgrove and D. Hughes.- From Student to Nurse: the Impact of Project 2000 on Occupational Socialisation in the world S. Philpin.- Nurses and Bioscience Knowledge: How New Expertise Impacts on Old Roles and Relationships S. Jordan.- PART TWO: BARRIERS TO CHANGE.- Inside the Black Box: barriers to Change in the Hospital D. Hughes and D. Allen.- Expanded Nursing Roles and the Hospital Division of Labour D. Allen and D. Hughes.- PART THREE: NEW ROLES, NEW TEAMS.- Nurse practitioners: Shaping the New Role A. Williams and D. Rogers.- Negotiating the Professional Division of Labour in a Community Mental Health Team L. Griffiths.

Understanding medicines: conceptual analysis of nurses’ needs for knowledge and understanding of pharmacology (Part I)

The advent of nurse prescribing in the United Kingdom (UK), albeit from a very limited formulary at first, provides a timely prompt for careful reflection on the extents and depths of understanding of medicines required by nurses for a variety of different purposes. This paper, which is the first of a two-part work, presents a conceptual analysis of what is required for patient care and support, pro re nata (as required) administration of medicines, protocol-directed administration of medicines (dependent prescribing), independent prescribing from the current Nurse Prescribers’ Formulary or independent prescribing from extended formularies or the entire British National Formulary. It includes review, with common examples, of presentational issues distinguishing between approved, generic names of medicines and trade or brand names, and some discussion of combination medicines; and of recent research that has demonstrated that patient care was improved when the bioscience knowledge of nurses increased.

Getting it right? An exploration of issues relating to the biological sciences in nurse education and nursing practice.

Concerns have been expressed that bioscience education is not meeting the needs of nursing students in the UK. This paper explores the situation further by comparing student perceptions with those of experienced practitioners (Part One of the study) and also evaluates the confidence of staff nurses in explaining the rationale for care applied to a common but specific disorder (influenza; Part Two). Questionnaires were used. Responses were elicited from DipHE Nursing (Project 2000) adult/child branch students (n=153) from two universities and from adult/child care staff from their local clinical placements (n=171 in Part One of study; n=266 in Part Two). The questions asked followed two themes: (1) confidence in understanding biological science and (2) issues of teaching and learning. Most questions utilized a rating scale from 1 to 10; this scale provides no central value and a vertical line was drawn to encourage respondents to identify which half of the scale their responses came under (basically, a negative or positive viewpoint). The significance of the data distribution either side of the midline was analysed statistically (simple sign test), as were any differences in distribution between the groups (chi-square test). Median values were also determined. The data do not provide support for views that the biosciences are being significantly diminished by modern curricula, but also show no evidence for a great improvement in the bioscience knowledge base in recent years. What was surprising was the lack of confidence expressed by staff nurses: one illuminating finding was the lack of confidence in articulating their knowledge to patients and, even less so, to other health professionals. The paper reiterates a need for a national teaching and learning strategy for pre- and postregistration education in the biosciences. In particular, a means to raise the level of understanding of staff nurses must be identified urgently so that the mentoring of students in these subjects is improved.

Revealing the contribution of bioscience*-based nursing knowledge to clinically effective patient care

Objectives: To discuss how bioscience-based nursing knowledge contributes to clinically effective patient care and demonstrate the value of evidence derived from qualitative research and clinical expertise with reference to the ‘evidence-based’ hierarchy. We also present a second argument that an ‘evidence-based’ focus on outcomes may not be sufficiently sensitive to reveal and evaluate those aspects of process, including nursing knowledge and expertise, which influence nursing interventions and affect patient outcomes.Design: The paper draws on qualitative data generated in a study examining the influence of nurse’s bioscience knowledge on the achievement of patient outcomes in post-anaesthesia practice.Setting: Two UK regional centres comprising in patient and day care post-anaesthesia practice in a number of surgical specialist areas.Participants: Thirty-two experienced post-anaesthesia nurses.Analysis: Hermeneutic text interpretation. An interpretative method which reflects the convergence of researcher’s and participants’ perspectives in order to understand the meaning of written descriptions of experiences.Findings: Nursing activities comprise a number of segmental outcomes. These segmental outcomes influence overall patient outcomes. Nurses used bioscience based knowledge as one source of best available evidence to influence achievement of intended patient outcomes.Conclusion: In order to demonstrate how nursing knowledge constitutes a valid source of evidence, segmental outcomes of care need to be defined and evaluated. In this way, the fine details of the process are more apparent and questions about the evidence underpinning nursing interventions are easier to answer. Although the setting is a specialist area of practice, the findings have wider applications because segments of care can be considered for any nursing interventions.

The biosciences in the pre-registration nursing curriculum: staff and students' perceptions of difficulties and relevance

This paper considers the problematic position of the biological sciences in pre-registration nurse education — ‘The Bioscience Question’. There is no consensus and little research on the appropriate content and depth of bioscience knowledge required by nurses. Attempts to apportion curriculum time for the biosciences are confounded by the difficulty experienced by nursing students with this area. Within one university department, a survey was undertaken to investigate the perceptions of pre-registration students, and their teachers, of the teaching and learning of biological science, in comparison with other areas of the curriculum. Our findings concur with others that the biosciences are a source of disproportionate difficulty and anxiety to nursing students. Among the students, but not the lecturers, there was some, by no means universal, support for the suggestion that these problems could be reduced by a reallocation of curriculum time in favour of the biosciences. Although it was agreed that bioscience theory should be related more closely to nursing practice, there was no evidence that this lessened the students' difficulties with the subject. In contrast to lecturers, students felt the biosciences to be one of the areas of the pre-registration curriculum most relevant to clinical practice.

Using bioscience knowledge in nursing: actions, interactions and reactions.

This paper draws on empirical data from a study undertaken to explore the outcomes of the applied physiology component of a post-registration diploma in nursing (DN). Most students completing the DN were utilizing their new bioscience knowledge in clinical practice, and reported increased participation in interprofessional discussions and team decisions. Respondents found themselves better able to monitor and evaluate doctors' decisions and this led to friction with some medical colleagues. However, the strongest resistance came from senior nurses, very few of whom had completed advanced nursing courses in bioscience and who were generally unwilling to allow respondents to develop new roles. General managers were also perceived as a major barrier to change. There is little evidence of tangible benefits to the nurses themselves: most saw the DN qualification as a way of protecting their status as professional nurses in the face of managerially driven organizational change, rather than as a route to occupational advancement.

Should nurses be studying bioscience? A discussion paper

The growth of bioscience knowledge over the last two decades has increased the potential benefits of scientifically based patient care by contributing to the theory of clinical care. However, there is little evidence that knowledge, derived from the human biosciences is being fully incorporated into nursing theory and practice. Nursing has developed its own unique professional body of knowledge, heavily influenced by behavioural science. If nursing theory leans towards behavioural science, but practice is devoted to problems of biological disturbance, nursing may be facing a widening theory-practice gap, greater than other professions. The theory-practice gap in nursing may be widened by the exclusion of bioscience from nursing theory. Nurses' relative disinterest in the natural sciences can be attributed both to sociological reasons and to problems stemming from the symbol-object dichotomy that recur in the teaching of natural sciences. Reflection on practice and examination of education method are suggested as strategies for re-introducing bioscience into nursing theory and practice. A challenge facing nurse educators is the integration of biological science into the nurses' conceptual ecologies. For, if nursing fails to make bioscience its own, much of the clinical welfare of patients will become a medical monopoly.