McVicar Andrew, Andrew Sharon, Kemble Ross
School of Nursing and Midwifery, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.
Lord Ashcroft International Business School, Anglia Ruskin University, Chelmsford, Essex, UK.
Nurse Educ Today. 2015 Mar;35(3):500-9. doi: 10.1016/j.nedt.2014.11.003. Epub 2014 Nov 27.
The difficulties that nursing students have in learning human biosciences have given cause for concern for over 20 years but the problem remains.
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.
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.
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.
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.
护理专业学生在学习人体生物科学方面存在的困难已引发20多年的关注，但问题依然存在。
对已发表的关于“生物科学问题”的原始研究进行综合综述，评估其结果，并为课程规划者提供对潜在方向的当代分析。
对电子数据库CINAHL、Medline、英国护理索引和谷歌学术进行系统检索，查找1990年至2013年间发表的实证研究，这些研究旨在预测学生在第一年生物科学评估中的表现或识别课程教学中的问题。
检索产生了19篇符合纳入标准的论文。12篇论文涉及生物科学成绩的预测因素，7篇调查了学生对课程问题的看法。另外4篇调查高年级学生或合格护士对第一年学习成果的反思的论文也被保留以提供更多背景信息。基于入学前学业成绩的预测并不可靠。学生因素，包括入学年龄、科学方面的自我效能感，特别是具备适当的学习技能，似乎是混杂因素。教学策略或讲师技能等课程中的影响也不一致，可能代表在地方机构层面起作用的混杂因素。
综合综述方法有助于分析研究之间的不一致性，而这一直是课程开发的障碍。基于大学前学业表现的合理录取标准有望解决“生物科学问题”，但可能取决于在第一年早期为学习技能和人体生物科学基础提供创新支持，以及关注课程教学的地方质量保证。
