Pathophysiology team teaching: Bioscientist contribution to knowledge integration in a nursing subject.

Aims Bioscience content within undergraduate nursing degrees provides foundational knowledge of pathophysiology, anatomy, physiology, microbiology and pharmacology. However, nursing students often find studying the bioscience components of undergraduate nursing program daunting (Friedel & Treagust 2005, Craft et al. 2013). This is related to factors such as the volume of content, degree of difficulty and insufficient linkage between bioscience concepts and nurses' clinical practice. Students who are unable to conceptualise the relevance of bioscience with nursing subjects and subsequent nursing practice may not appreciate the broader importance of bioscience, and hence may adopt a surface approach to learning (Craft et al. 2013). The aim of this study was to develop a model within Nursing Practice in the Context theory subject, to include a bioscientist lecturing to complement the nursing lecturer, in order to explicitly demonstrate links between physiology, pathophysiology and nursing practice. Background A deep understanding of bioscience and the ability to draw on this information in the context of nursing clinical practice is integral to achieving high standards of patient care. For example, registered nurses with appropriate bioscience knowledge can contribute to diagnosis and hence influence patient outcomes (Prowse & Health 2005). Nurses' foundational knowledge, including bioscience understanding, is critical to their role as a 'knowledge broker' by being an advocate for patient safety (Logan & Angel 2011). Hence, the importance of bioscience is apparent within the workplace. In addition, during undergraduate studies, the importance of bioscience is appreciated by some students, who agree that bioscience forms the foundation of nursing and hence we believe that a good level of bioscience knowledge is required for nursing clinical practice (Friedel & Treagust 2005, Craft et al. 2013). Although bioscience has been shown to be integral to effective nursing practice, bioscience content requires con-textualisation. To demonstrate the relevance of bioscience to nursing students, nursing academics have been included within a bioscience unit, whereby the nursing academic within a bioscience laboratory session on the pulmonary system would discuss the clinical aspects of lung volume testing and what inaccuracies may arise if the patient is not relaxed (Larcombe & Dick 2003). On the other hand, almost half of nursing educators agreed that their science background was insufficient to their understanding of bioscience relevant to nursing (Friedel & Treagust 2005). This lack of confidence in nursing educators bioscience knowledge may limit their ability to teach bioscience effectively to nursing students. In our project, we approached the contextualisation of bioscience by developing a model that incorporated a bioscientist into a nursing subject, to show the relevance of bioscience for patient care. As far as we are aware, our project reports for the first time on a bioscientist teaching into a clinical nursing unit to strengthen the pathophysiology content, which may improve the integration of these subject topics. Methods The model developed in this project was a unique, two-part lecture structure: (1) the bioscientist teaching the physiology and pathophysiology in the first component of the lecture, followed by (2) the nurse academic focussing on the context of nursing practice, which included the referring to pathophysiology taught by the bioscientist. The bioscience-clini-cal nursing team teaching approach was conducted during the 2nd year of the Bachelor of Nursing course, after all bioscience subjects had been completed (prior content taught by bioscientists included anatomy, physiology and pathophysiology). A 15-item quantitative questionnaire was developed, with responses scored on a Likert scale (1=strongly disagree; 5=strongly agree). Questionnaire items related to patient care, pathophysiology-nursing links, and the relevance of the bioscientist contribution. Questionnaires were paper based and distributed to all students who attended a lecture towards the end of the semester (lecture attendance not compulsory). Time during the lecture was provided for completion and return; students were advised that participation was optional and anonymous. Convenience sampling was used; of the 88 students enrolled, a total of 43 students returned completed surveys. Means and frequency distributions of survey items were calculated, and internal consistency was determined using Cronbach's alpha test (value 0-7). Results The most important findings from this study are that more than 90% of respondents agreed that having a bioscientist who focused on nursing student needs helped to increase knowledge of patient conditions, and bioscientist teaching was beneficial to relate physiology and pathophysiology to nursing care (Table 1). This demonstrated that the teaching approach used was successful, emphasising the relevance of physiology and pathophysiology to patient conditions and outcomes. Similarly, most respondents saw the relevance of pathophysiology to clinical nursing practice, and were confident in their ability to apply pathophysiology to nursing practice. The majority of respondents also valued having a bioscientist teach with the nursing lecturer in this unit. Conclusions The results of our study show overwhelming support for this model, including a bioscientist who is focussed on the needs of nursing students, complementing the nursing lecturer, in a nursing practice subject. Students indicated that they could contextualise bioscience concepts with clinical nursing practice, and importantly, made links with patient care. First-year students have been shown to be confident that when they reach the workplace, they will recognise the relevance of bioscience to nursing (Craft et al. 2013), and our study of second-year students indicated that our teaching approach was effective in enhancing these connections. Registered nurses who draw on bioscience knowledge have been shown to improve patient care (Prowse & Health 2005, Logan & Angel 2011), and strategies to link bioscience content with clinical nursing practice that are integral for effective nurses. Relevance to clinical practice Our data strongly supported our model of physiology and pathophysiology teaching team delivered by a bioscientist and nursing academic, was successful in providing students with the ability to conceptualise pathophysiology for patients and clinical practice. Improved understanding of the knowledge and application of pathophysiology will better inform clinical decisions, and ultimately improve quality of patient care. [ABSTRACT FROM AUTHOR]