Aim: To appropriately scaffold an introductory bioscience unit for nursing students from diverse backgrounds.
Design: Team teaching approach focused on contextual requirements of students. The unit content was repackaged progressively over a two-year period to incorporate specific signposting and scaffolding to reduce cognitive load (Figure 1).
Setting: Tertiary education institution in Australia. The teaching team comprised a staff group with clinical nursing experience, clinical exercise physiology experience, graduate qualifications specialising in advanced anatomy and physiology, and at least three years of undergraduate teaching in anatomy, physiology, nursing and microbiology units.
Participants: Participants included students enrolled in the core bioscience unit for the undergraduate Bachelor of Nursing degree from the central campus and the Widening Participation (WP) campus. As part of the WP brief, improved access to the course was facilitated by increasing the overall position (OP) cut-off by 5-OP points representing a considerably lower entry threshold for WP campus students.
Redevelopment of unit learning and teaching materials:
Learning and teaching manual
In 2016, a learning and teaching manual was compiled, and interacting organ systems packaged together to reinforce global functions for students. For example, the Master control module coupled the nervous and endocrine systems as the soft and hardwired regulators of all cellular functions. Laboratory activities, questions and assessment were all included in the learning and teaching manual to ensure it was used as an evolving resource for students. Each module was signposted to include: Fundamental anatomy and physiology; Getting to know you; and Clinical connections sections. Fundamental anatomy and physiology covered essential anatomical structures and related those to the functions performed by cells, tissues, organs and organ systems as related to maintaining homeostasis. The Getting to know you section was aimed at highlighting tacit knowledge for students in the context of their lived experience, for example relating public speaking to the fight or flight response. The Clinical connections section was included to explicitly link the anatomy and physiology theory to the clinical practice of collecting observations and data from patients as part of a clinical assessment for diagnosis or monitoring of a health condition.
Lecture signposting
In 2017, the lecture structure was standardised and signposts included to guide students through each organ system. Lectures aimed to exploit student tacit knowledge through asking ‘How do you know you’re ok?’ and getting students to think about the head to toe assessment they perform unconsciously on everyone they interact with each day, and to focus familiar observations within the context of a specific organ system. For example, they could identify altered cardiovascular function if a person appeared flushed or pale. This provided a confident starting point for students, affirming that they were not learning about something completely new, rather, putting what they already knew into the context of the profession they were training for. The Clinical case study, Clinical assessment and When things go wrong sections highlighted the importance of regulating homeostasis and again provided tangible examples of knowledge already held by students such as dehydration due to exercise, and blood tests to measure deviations from a normal range. These sections often provided the ‘ah-ha’ moments for students where connections were made between the structure and function relationships underpinning the clinical measurement. Presentation of familiar examples reduced the cognitive loading experienced by students as each new topic was introduced.
Creation of digital resources
Additionally, in 2017, digital resources were planned through consultation between the teaching team, and storyboarding and scripting was undertaken during the planning phase to identify the appropriate scope for each presentation. Following the success of the initial videos generated by the teaching team, professional filming and editing services were sought.
The digital resources were designed to provide short foundation video tutorials describing the location of critical anatomical structures for major organ groups including the heart, the brain, the kidney and the eye with a corresponding instructional video demonstration of animal tissue dissection for these same organs. Three-dimensional (3D) interactive technology (Anatomage) was used to describe the anatomy and physiology of pulmonary ventilation and digestion. Video role plays were also developed to guide students through the stages of common tasks including electrocardiography, spirometry and simple exercises for supporting activities of daily living.
Student feedback: Student feedback was collected using institution implemented indicators of student satisfaction in the form of a centrally administered automated evaluation strategy comprising two formative (once early in semester and once at the end of the teaching period) survey each comprising three Likert scale questions and one extended comment. Student satisfaction scores <3.4 were considered as under-performing, were categorised as average for values ranging from 3.5- 4.3 and were categorised as over-performing if >4.1. A Googleform requesting specific feedback for the newly developed unit learning materials was also available to students via a web link. All student feedback was voluntary and anonymous.