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.