More than Just a Lack of Knowledge: A Discussion of the Potential Hidden-Impact of Poor Pre-enrolment Science Background on Nursing Student Success in Bioscience Subjects

Abstract

As medical knowledge and technology becomes more complex, twenty-first century nurses are required to possess an advanced understanding of many bioscience concepts. It is now recognised that without this advanced knowledge, nurses will not be sufficiently prepared to deal with the intellectual and technological demands of today, let alone the future. While the importance of bioscience education to nursing practice has been long recognised, nursing students, as a group, have a well documented struggle with science subjects. This struggle has been largely attributed to the lower university entrance scores required for nursing courses and a lack of previous science study. However, as in any complex system, a multitude of factors are likely to be responsible for the difficulty faced by many nursing students in their science studies. In this paper, we argue that a lack of engagement with science early in a student's life can significantly influence student's feelings towards science subjects, the achievement goals that they set themselves, and their interest in learning science. Given the wealth of evidence that high-school students are avoiding science-based subjects, low levels of engagement with science and high-levels of anxiety towards science-based subjects are issues increasingly faced by tertiary science educators. As such, understanding the science background of students, and improving their attitudes and feelings towards science, is a critical first step in helping nursing students learn the science required for their future practice.

Full text

International Journal of Innovation in Science and Mathematics Education, 21(2), 26-36, 2013
26
More than Just a Lack of Knowledge: A
Discussion of the Potential Hidden-Impact
of Poor Pre-enrolment Science Background
on Nursing Student Success in Bioscience
Subjects
James W. Cranea,b and Jenny L. Coxc
Corresponding author: James Crane (jcrane@csu.edu.au)
aSchool of Biomedical Science and Centre for Research into Complex Systems, Charles Sturt University,
Bathurst NSW 2795, Australia
bThe University of Queensland, The Queensland Brain Institute, St Lucia, Brisbane QLD 4072, Australia
cFaculty of Science, Charles Sturt University, Bathurst NSW 2795, Australia
Keywords: science, anxiety, nursing
International Journal of Innovation in Science and Mathematics Education, 21(2), 26-36, 2013
Abstract
As medical knowledge and technology becomes more complex, twenty-first century nurses are required to
possess an advanced understanding of many bioscience concepts. It is now recognised that without this
advanced knowledge, nurses will not be sufficiently prepared to deal with the intellectual and technological
demands of today, let alone the future. While the importance of bioscience education to nursing practice has
been long recognised, nursing students, as a group, have a well documented struggle with science subjects. This
struggle has been largely attributed to the lower university entrance scores required for nursing courses and a
lack of previous science study. However, as in any complex system, a multitude of factors are likely to be
responsible for the difficulty faced by many nursing students in their science studies. In this paper, we argue
that a lack of engagement with science early in a student’s life can significantly influence student’s feelings
towards science subjects, the achievement goals that they set themselves, and their interest in learning science.
Given the wealth of evidence that high-school students are avoiding science-based subjects, low levels of
engagement with science and high-levels of anxiety towards science-based subjects are issues increasingly faced
by tertiary science educators. As such, understanding the science background of students, and improving their
attitudes and feelings towards science, is a critical first step in helping nursing students learn the science
required for their future practice.
‘To practice safely and effectively, today’s new nurses must understand a range of nursing
knowledge and science, from normal and pathological physiology to genomics,
pharmacology, biochemical implications of laboratory medicine for the patient’s therapies,
the physics of gas exchange in the lungs, cell-level transport of oxygen for the acutely ill
patient, as well as the human experience of illness and normal growth and development – and
much more.’ (Benner, Sutphen, Leonard, & Day, 2010, p1)
In 1910, the Flexner report, On Medical Education in the United States and Canada 1910,
began a transformation that saw scientific knowledge and investigation take a central position
in medical education (Duffy, 2011). Building medical education upon a foundation of
science produced more knowledgeable practitioners, drove innovation and discoveries in
health care, and led to an unprecedented improvement in human health that helped produce a

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27
doubling of life-expectancy during the 20th Century (Frenk et al., 2010). A century later, the
2010 Carnegie Foundation report, Educating Nurses: A Call for Radical Transformation,
reaffirmed the importance of science in medical education, and more specifically in the
education of nurses (Benner et al., 2010). While nursing educators have been debating the
value of science in the nursing curriculum (Jordan, 1994; Trnobranski, 1993; Wynne, Brand,
& Smith, 1997), advances in medical knowledge and technology have continued unabated.
As a result, today’s nurses need a “sophisticated understanding” of a range of scientific
concepts from anatomy and physiology through to chemistry, physics and genomics to make
informed decisions about patient care (Benner et al., 2010). Recently, questions have been
raised as to whether we are preparing nursing graduates for the demands of the present, let
alone the future (Benner et al., 2010; Frenk et al., 2010). There are also fears that, as nursing-
education struggles to keep pace with research- and technology-driven advances, a “practice-
education gap” is developing (Benner et al., 2010). Perhaps now more than ever, highly
educated nurses, with a comprehensive understanding of science, are required. However, it is
well recognised that nursing students, as a group, struggle with science-based subjects. How
then can tertiary institutions produce the nursing graduates needed? Clearly, improvements
and innovations in the design and delivery of science-based subjects are part of the solution.
However, as with any complex system, a host of other factors influence student learning and
performance. The aim of this paper is to discuss some of the factors that could influence
nursing student’s success in bioscience subject that appear to have been largely overlooked.
We argue that a significant factor impacting on student success is a lack of prior engagement
with, and interest in, science. This lack of engagement/interest may lead to the development
of science anxiety, reduced self-efficacy and performance-avoidance achievement goals, all
of which will negatively influence student learning and performance in science subjects. By
examining some of the potential hidden-impacts of low pre-enrolment science background
we hope to help educators design courses and subjects that will stimulate interest in science
and produce scientifically-literate nursing graduates.
Nursing students and science
The importance of understanding science, and in particular bioscience, to nursing practice is
recognised by both nursing students and practicing nurses. In surveying nurses who had
completed a post-registration course that included bioscience, Jordan and Reid (1997) found
the majority believed that knowledge of applied physiology was strongly related to proper
patient care. In all, 95% of nurses reported that their practice improved as a result of the
course (Jordan & Reid, 1997). Similarly, in a survey of pre-registration nurses and practicing
nurses in the UK, 92% of respondents indicated that biological science knowledge was
important to nursing practice (Clancy, McVicar, & Bird, 2000), and in one New Zealand
tertiary institution, 97% of nursing educators and students agreed that bioscience knowledge
was essential for effective nursing practice (Friedel & Treagust, 2005). In Sweden, the
majority of nurses one year after graduation believed their scientific training was necessary
for the delivery high quality health-care and gave them the skills to perform critical analysis
and evaluate information (Andersson & Edberg, 2010). Consistent with this view, Logan and
Angel (2011) reported that 88% of registered nurses in an Australian study viewed nursing as
an applied science (Logan & Angel, 2011). Further, Davis (2010) found the majority of
registered nurses believed bioscience to be relevant to practice. Anatomy and physiology
were seen as most relevant (76% and 79% of responders, respectively), but microbiology,
pharmacology, and biochemistry were also seen as relevant (66%, 64%, and 62% of
responders, respectively) (Davis, 2010). However, an earlier study by Caon and Treagust
(1993) suggests that student’s opinion of the relevance of science to practice varies according

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to their performance in science subjects. Seventy percent of students that performed well in
their science subjects believed these subjects were relevant to nursing practice, and 73%
believed they would help them become better nurses. In contrast, only 57% of students that
performed poorly in their science subjects thought these subjects were relevant to nursing
practice, and 50% disagreed with the view that these subjects would make them better nurses
(Caon & Treagust, 1993). A similar relationship between student’s performance and attitudes
may account for the findings of Birk et al. (2011). In their study, 29% of students felt that
their first bioscience subject was the most valuable to their nursing practice, but by the end of
their second session only 16% believed the second bioscience subject to be the most valuable
(Birks, Cant, Al-motlaq, & Jones, 2011). One explanation for this shift could be that
student’s attitudes changed as a function of the grade they received in their first bioscience
subject. However, these results indicate that student’s attitudes about the value of science are
fluid and that when students find science difficult they view it as less valuable to nursing
practice.
The fluid nature of nursing student’s attitudes towards science is an important consideration
given the body of evidence indicating that many students find science subjects difficult. In a
study by Caon and Treagust (1993), 90% of low performing students (and 72% of average
performing students) believed the science content was too difficult considering their science
background. Surprisingly, this view was also shared by 42% of the high performing students
(Caon & Treagust, 1993). Further, a survey of nursing students in the UK found the majority
viewed bioscience subjects as more difficult than almost all other subjects in their nursing
course (Jordan, Davies, & Green, 1999). Nursing students also report spending more time on
bioscience subjects than other subjects (Davies, Murphy, & Jordan, 2000; Friedel & Treagust,
2005), that science subjects were a source of anxiety and stress (Andrew et al., 2008; Friedel
& Treagust, 2005; Gresty & Cotton, 2003; Nicoll & Butler, 1996), and that their science
background was not sufficient to cope with the science subjects (Caon & Treagust, 1993;
Friedel & Treagust, 2005; Gresty & Cotton, 2003). These results are consistent with reports
that difficulty with science subjects can cause students to withdraw from nursing courses
(Andrew et al., 2008; White, Williams, & Green, 1999).
The reasons why nursing students struggle to cope with university-level science subjects are,
undoubtedly, numerous. However, some factors have been suggested to predict success in
nursing courses and science subjects. Houltram (1996) found that older nursing students
were more likely to perform better in their course (Houltram, 1996), and similarly, McCarey
et al. (2007) found that older students tended to do better on certain assessment items during
their course than younger (< 26 years of age) students. These results possibly reflect a
greater motivation and confidence of older students (McCarey, Barr, & Rattray, 2007).
Interestingly, both studies found only a weak correlation between entry qualification and
academic performance. Consistent with this finding, Ofori (2000) reported that previous
biology study did not influence nursing student’s success in bioscience subjects (Ofori,
2000). However, in contrast to these reports, a number of studies have found a link between
entry qualifications and academic performance in nursing courses. Wong and Wong (1999)
reported that high school science grades were a significant predictor of overall performance
in a nursing course (Wong & Wong, 1999), and studies by van Rooyen et al. (2006) and
Newton et al. (2007) found entry qualification to be a good predictor of performance in
bioscience and the nursing course overall (Newton, Smith, Moore, & Magnan, 2007; van
Rooyen, Dixon, Dixon, & Wells, 2006). More recently, Whyte et al. (2011) analysed
student’s results at a regional Australian university and found that entry score was the best
predictor of nursing student’s success. In addition, previous biology study was found to be a

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good predictor of performance in bioscience subjects (Whyte, Madigan, & Drinkwater,
2011). However, it is not surprising that students with a history of academic achievement
continue to perform well at university. So, the question remains: how can we help students
without a strong academic background develop an understanding of science?
The science background problem
Clearly, some prior knowledge of chemistry, physics and biology is beneficial to students
taking first year bioscience subjects. However, this raises a problem, and one that is largely
out of the hands of tertiary science educators: most students are not doing science at
secondary school. In 2008, Ainley et al. analysed Australian student participation in science,
maths and technology subjects in their final year of secondary school (Year 12) from 1976 to
2007. The results demonstrate a steady decline in the percentage of students enrolled in
biology, chemistry, and physics subjects over this period. From 1976 to 1991, the percentage
of students enrolled in biology-based subjects fell from 55% to 36%, and by 2007 enrolments
had fallen to 25%. Enrolments in chemistry and physics were even lower, with only 18% of
students enrolled in chemistry and less than 15% enrolled in physics in 2007 (Ainley, Kos, &
Nicholas, 2008). These results are consistent with the reported science background of
nursing students. For example, Whyte et al. (2011) reported that less than 50% of nursing
students had studied biology in high school (Whyte et al., 2011), and nursing students report
feeling that their science background was not sufficient to cope with the science subjects
(Caon & Treagust, 1993; Friedel & Treagust, 2005; Gresty & Cotton, 2003). It is important
to note that falling participation rates in science, technology, engineering and maths (STEM)
subjects is being seen worldwide. The OECDs ‘Programme for International Student
Assessment’ (PISA) report of 2006, Science competencies for tomorrow’s world, highlighted
a number of issues of concern, including an overall decrease in the percentage of students
taking science subjects in the final years of secondary school; that female students were less
likely to enrol in science subjects; and that science teachers lacked training and confidence in
teaching science (OECD, 2007). The OECD study also found that the majority of students
leave high-school with only a basic level of science and mathematics literacy (OECD, 2007).
A focus of the 2006 PISA study was to determine student’s (aged 15 years) attitudes and
interest in science (OECD, 2007). The results revealed that the majority (89%) of Australian
students felt science is valuable to society, but only 55% believed that science was very
relevant to them. While 62% of these students indicated they were interested in learning
human biology, interest in learning chemistry and physics was lower (48% and 44%,
respectively). However, only 36% of students were interested in the way that scientists
design experiments, and only 29% were interested in what was required for scientific
explanations. Further, very few students reported engaging with science content outside of
school. Of the students surveyed, 16% regularly watched science programs on TV; 10%
regularly read science magazines or science articles in newspapers; 11% regularly visited
web sites dealing with science topics; and 5% regularly borrowed books about science.
When asked about the relevance of science to their future study and careers, just over half
(55%) of the students felt science would be important for their future studies, but only 39%
said they would like to have a career that involved science and only 34% said they would like
to study science after secondary school (OECD, 2007). While we have focused here on the
views expressed by Australian students, it should be noted that similar views were expressed
by students in many of the fifty participating OECD countries (OECD, 2007).

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The results of the Ainley et al. (2008) and the 2006 PISA reports reveal much about the
science background of the students entering undergraduate nursing courses in Australia
(Ainley et al., 2008; OECD, 2007). It is highly likely that: 1) a high proportion of students
will not have studied any science subjects in the last years of high school; 2) many students
will not feel confident in their abilities to do science; 3) many students will not have enjoyed
learning about science in the past and feel that science is not relevant to them; 4) most
students will not be interested in how scientific knowledge develops and evolves; 5) the vast
majority of students will not be in the habit of accessing resources about science, regardless
of how this information is delivered; and 6) many students are not interested in learning
science at university and do not want a career that involves science. In short, a substantial
number of students are not confident in their abilities to do science, do not have the desired
content knowledge, and will not be interested in developing and expanding their
understanding of science.
The potential hidden-impacts of poor pre-enrolment science background
The attitudes that students take into their nursing course will influence the relationship and
approach that they take to their undergraduate science subjects. The majority of students will
commence their degrees with little interest in science; lacking confidence in their abilities to
do science; and having made conscious decisions to avoid science-based subjects in the past.
Therefore, it is not surprising that many students feel anxious about the science subjects they
are required to complete and are focused on simply ‘surviving’. Unfortunately, both the
anxiety students feel and the ‘survival’ goal they adopt could have a detrimental effect on
their performance in science subjects.
Anxiety
Over the last 20 years, there has been growing recognition that many students experience
anxiety when exposed to scientists, scientific concepts and tasks (Mallow, 1991). A number
of factors are thought to contribute to the development of this ‘science-anxiety’ including:
previous bad experiences with learning science; negative messages about science during
school years; exposure to school science teachers that are themselves anxious about science
and their science abilities; a lack of science role models; and the prevalence of stereotypes in
popular culture of scientists being male, geeky, and boring. While female students
consistently score higher on science-anxiety surveys, the presence of more general, non-
specific anxiety appears to be the greatest predictor of science anxiety (Mallow, 2006; Udo,
Ramsey, & Mallow, 2001; Udo, Ramsey, & Mallow, 2004). It has been suggested that
students with science-anxiety are more likely to become frustrated with science subjects, and
to develop a lack of confidence in their abilities to learn science and do well in science
subjects. These feelings can culminate in students developing a general dislike for learning
science, a lack of engagement with anything involving science, and in lower grades
(Chiarelott & Czerniak, 1987). However, while the impact of science-anxiety on student
performance is still being determined, the influence of other forms of anxiety (e.g. test
anxiety) on academic performance has been more extensively studied.
Test-anxiety was initially thought to simply affect a student’s performance during
examinations. However, it is now recognised that this anxiety can negatively affect the
acquisition of new knowledge and concepts (i.e. the encoding of information); how a student
studies and prepares for assessment items (i.e. the storage of information); as well as their
recall of information during exams (i.e. the retrieval of information) (Cassady, 2004a).
Naveh-Benjamin et al. (1987) found that a sub-group of students with high test anxiety had

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trouble processing and organising the course material, and this poor organisation was
correlated with lower academic performance. They proposed that reduced exam performance
was not simply a problem of impaired recall of information, but also related to anxiety-
induced impairments in the processing, acquisition and consolidation of new information
(Naveh-Benjamin, Mckeachie, & Lin, 1987). Similarly, students with high test anxiety were
found to have poor study habits and to use less effective study techniques (e.g. repetitive
reading and memorisation). These habits and study techniques are likely to inhibit a
student’s ability to acquire new knowledge and understand new concepts, and thus, impair
their ability to learn and consolidate new information (Cassady, 2004b; McKeachie, 1984).
Students with high test-anxiety are also more likely to credit their poor performance to
internal factors (e.g. low intelligence) or other factors beyond their control (e.g. the difficulty
of the material or the quality of the teaching) (Cassady, 2004b). Consistent with this, anxious
students were also more likely to try to make lecturers feel guilty about the difficulty of the
subject and its assessment items (McKeachie, 1984). Whether science-anxiety similarly
impacts students learning and performance is yet to be determined, but it is safe to assume
that students that are anxious about studying science will experience similar impairments in
their ability to learn, consolidate, and recall new information and concepts.
Interest
The 2006 PISA report reveals that many high-school students have not enjoyed learning
about science in the past and are not interested in learning about science in the future (OECD,
2007). The impact of a lack of interest in science should not be underestimated. Hidi (1990)
has argued that it is interest that determines what we choose to process and the persistence we
display in processing this information (Hidi, 1990). Interest drives people to explore their
environment and learn new things. It drives an individual's intrinsic motivation to learn, and
to expand their knowledge, skills and experiences (Silvia, 2008). Students that are interested
in a subject study more and persist in trying to understand for longer (Silvia, 2008).
However, given that many students lack confidence in their abilities to learn science (Caon &
Treagust, 1993; Friedel & Treagust, 2005; Gresty & Cotton, 2003) it is not surprising that
they lack an interest in science. Indeed, it has been suggested that novelty alone is not
sufficient to generate interest – individuals must also feel capable of understanding the
information. As Sylvia (2008) argues, ‘Finding something understandable is the hinge
between interest and confusion.’ To stimulate student’s interest, teachers need to maximise
the novelty and the comprehensibility of the subject (Silvia, 2008).
Self-efficacy
The fact that many nursing students feel they do not have a sufficient background in science
is also of concern, as it is now accepted that an individual’s views about their ability to
master a skill or learn a concept can affect their attempts to develop this mastery (Bandura,
1977; Pajares, 1996; Walker, 2010). Self-efficacy beliefs are derived from an evaluation of
previous performance in similar tasks, vicarious experience (seeing others perform the task),
verbal persuasion provided by others (e.g. teacher), and the emotional arousal the task
provokes (e.g. anxiety or pleasure) (Bandura, 1977). Further, these beliefs evolve as
individuals engage in tasks, reflect on the outcomes of this engagement, and use this
reflection to construct beliefs about their ability to perform similar tasks in the future
(Pajares, 2002). A person’s self-efficacy beliefs can influence the emotional reactions they
have in response to a given activity and how they perform or meet a challenge (i.e. people
tend to engage in activities that they believe themselves capable of mastering and avoid those
they view as beyond their capabilities) (Bandura, 1977; Pajares, 2002). Individuals that
possess a high self-efficacy are likely to be calmer in the face of challenging tasks and more

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likely to engage in self-directed learning. In contrast, low self-efficacy is associated with an
overestimation of the difficulty of a task; thoughts that can lead to feelings of stress and
anxiety (Pajares, 1996). Consistent with this, science self-efficacy has been reported to
predict up to 24% of academic performance in nursing students (Andrew, 1998).
Achievement goals
How a student feels about their ability to cope with science subjects can also influence the
goals they set themselves for their studies. According to the achievement goal model there
are four distinct achievement goal categories: 1) mastery-approach (focused on obtaining
competence or learning as much as possible); 2) mastery-avoidance (focused on avoiding
incompetence or not learning less than possible); 3) performance-approach (focused on
performing as well, or better, than others); and 4) performance-avoidance (focused on not
performing worse than others (Elliot, Murayama, & Pekrun, 2011; Elliot & Murayama,
2008). The influence of mastery-avoidance and performance-approach goals is still to be
determined. However, it is clear that mastery-approach goals are associated with positive
characteristics and outcomes, and performance-avoidance goals are associated with negative
characteristics and outcomes. Students with mastery-approach goals are more likely to have
positive views of their ability to cope academically (high self-efficacy), to be more persistent
in their attempts to understand, to be willing to engage in difficult activities, more likely to
use deeper-level learning strategies, to be intrinsically motivated, and to enjoy learning.
These students are also more likely to seek and obtain help and have lower levels of test
anxiety (Furner & Gonzalez-DeHass, 2011; Urdan & Schoenfelder, 2006). In contrast,
students with performance-avoidance goals are more likely to have low academic self-
efficacy, to have poor study habits, to engage in surface level processing of information, to
procrastinate, to feel threatened by their studies, to fear failing, and have higher levels of test-
anxiety. Students with performance-avoidance goals are less persistent (especially in the face
of difficulties), lack intrinsic motivation for their studies, are less likely to seek help, and
more likely to engage in self-defeating behaviours (Furner & Gonzalez-DeHass, 2011; Urdan
& Schoenfelder, 2006).
Implications for educators
In this paper, we have argued that a lack of science background means more than simply a
lack of pre-requisite science knowledge. Rather, students that have become disengaged with
science and actively avoided science subjects at secondary school are more likely to
experience anxiety related to their tertiary science subjects, and that this science-anxiety
could influence all aspects of learning (i.e. acquisition, consolidation and recall of new
information). In addition, it can further reduce student’s interest in science, lower their self-
efficacy for science subjects, and lead students to adopt performance-avoidance goals.
Unfortunately, the steady decline in high-school students studying science subjects means
that many students entering tertiary education will possess, or be at risk of developing,
behaviours and attitudes that will significantly impair their performance in science subjects.
Indeed, the literature suggests that many first-year nursing students lack interest in science,
have a low self-efficacy related to science subjects, and may experience significant science-
anxiety. While the achievement goals held by nursing students do not appear to have been
directly investigated, it can be assumed that the combination of science-anxiety, low interest,
and low self-efficacy will lead many nursing students to adopt a performance-avoidance goal
for their science subjects. In our experience, many first year nursing students exhibit
behaviours and attitudes associated with performance-avoidance goals (e.g. poor study habits,
surface level processing of information, high test-anxiety, and fear of failure). From our

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discussions with colleagues, we are confident that many science educators teaching into
nursing courses will also recognise characteristics associated with science-anxiety, low self-
efficacy, and performance-avoidance goals in their students.
It is our contention that the wider issue of lack of interest in science needs to be addressed
head on by nursing courses. This could be achieved by making the first science subject in
nursing (and indeed other allied health) courses focused on introducing (or perhaps re-
introducing) students to science. This ‘Introduction to Science’ subject would focus little on
content knowledge. Instead, it would deal with issues such as the true nature of science, the
benefits of science to society and allied health professions, the relevance of science to their
everyday life, and the value of a scientifically literate population to society. In short, it would
begin a conversation with students that directly addresses the important question of “why are
we learning this?” As Mallow (1986) recommends, this subject would introduce students to
the exploratory nature of science investigation and provide opportunities for students to
follow scientific evidence to logical conclusions. It would introduce students to effective
ways to study science and to develop self-regulation strategies (e.g. personal goal setting).
Group work would predominate – as the best way to learn science is to teach it and students
are often more willing to listen to the questions and answers of other students than that the
lecturer (Mallow, 1986). However, above all, the subject would be a safe place for students
to ask questions, try new things and to fail. Success should be based on satisfactory
completion and engagement with the activities and tasks, not performance measures (e.g.
grades). Such an environment would promote the development of mastery-approach goals
and allow students to explore science again, without the pressure of external expectations. In
this environment, lecturers can then provide the right mix of novelty and challenge that will
drive the development of an interest in science (Silvia, 2008). An introductory science
subject would aim to break down barriers and stereotypes that prevent many students from
engaging with science, reduce student’s science-anxiety, increase their interest in science, and
help students to see the relevance of science.
Of course, in already time-poor nursing courses the introduction of a new subject may not be
immediately feasible. So, what can be done now? Firstly, we should raise awareness
amongst science and clinical lecturers of the potential impact of science-anxiety on student’s
attitudes, achievement goals and performance in science subjects. Lecturers should be
encouraged to talk openly about these issues with students and to share their own experiences
with studying science (i.e. what they found hard and how they overcame it). However, they
should also be warned of the potential impact of reflecting any science-anxiety they may have
back to students. Further, the use of ‘flipped-classroom” models could allow lecturers to use
face-to-face sessions to stimulating student interest and break down walls preventing student
engagement.
Science-anxiety clinics could be created; similar to those established by Mallow at Loyola
University of Chicago. These clinics could be staffed by scientists and counsellors and have
three aims: 1) teach the skills required to study and learn science; 2) determine the causes of
the student’s anxiety and develop strategies for reducing this anxiety; and 3) teaching
students relaxation techniques that can be used to desensitise them to anxiety-provoking
situations (e.g. science exams) (Mallow, 1986, 2006). Helping these students overcome their
science anxiety would be the first step in helping them re-engage with science. However, in
the absence of such clinics, science academics and student support services could, at the very
least, work collaboratively to create support programs that specifically address the academic
and emotional issues students commonly have with science subjects.

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Finally, in an attempt to address low science-interest and high science-anxiety nursing
students, for the last 18 months we have been conducting “Pre-science Workshops”. These
two day workshops are offered on a voluntary basis and are conducted 1-2 weeks before the
commencement of the student’s first science subject. The workshops are run by two science
lecturers, are delivered in a relaxed and informal fashion, and are focused on stimulating
student’s interest in science and reducing their anxiety. While science content is presented, it
is used to stimulate discussions about its relevance to their chosen career and other aspects of
their life. Sessions on how to study science, to evaluate evidence, to tackle exam questions,
and to deal with science-anxiety are conducted. The advantage of these workshops is that
they can tackle issues face-to-face just before the students begin their first science subject.
The initial evaluations of these workshops indicates that students are more interested in
studying science and feel less anxious about their ability to cope with science subjects, both
immediately after the workshop and 5 weeks into their first science subject. Further,
attendees appear to be more likely to pass not just their first science subject but also
subsequent science subjects in their course.
As discussed in this paper, there are a number of factors related to a lack of pre-enrolment
science background (beyond simply a lack of content knowledge) that could influence
nursing student performance in bioscience subjects. While it is widely acknowledged that
nursing students are anxious about science subjects, the root cause of this anxiety and the
impact that it has on student learning and performance in science subjects has received little
attention. This paper aims to raise awareness of the possible links between reduced rates of
science participation in high-schools and the development of science-anxiety. Further, we
have argued that science-anxiety could cause students to develop low self-efficacy for science
subjects and to adopt achievement goals that place them at risk of poor academic
performance. It is hoped that by understanding the science background of nursing students
(and how this may influence student performance) nursing educators will be able to reduce
science-anxiety, engage more effectively with nursing students and stimulate their interest in
science. These interventions may be a key element in the development of scientifically-
literate nursing graduates.
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