Teaching Basic (Biomedical) Sciences in Nursing Degrees: The Role of Registered Nurses

Nursing is a profession in which knowledge, attitude, and skills paly equally important roles. The profession has evolved over the years from simple to evidence-based nursing practice. This could not have been achieved without the evolution that took place in Nursing teaching and learning. A Nursing faculty teaching in an undergraduate or postgraduate Nursing program brings with him/ her a wealth of Nursing experience which he/she kas accumulated over the years as a practicing Registered Nurse (RN). This has been particularly true in core Nursing courses, such as MedicalSurgical Nursing, Critical Care Nursing, Community Nursing, Mental Health Nursing, Forensic Nursing, etc. However, foundation Basic (Biomedical) Science courses/subjects are still being taught by faculty members who do not have Nursing background. One major defect related to this practice is that such faculty members are not teaching these courses/subjects within the “context” of the Nursing practice. Accordingly, the other major defect is the inability of these members to judge on what topics should be included in their courses (what is relevant?), the priority of these topics, and how much is enough.


Introduction
Nursing is a profession in which knowledge, attitude, and skills paly equally important roles. The profession has evolved over the years from simple to evidence-based nursing practice. This could not have been achieved without the evolution that took place in Nursing teaching and learning. A Nursing faculty teaching in an undergraduate or postgraduate Nursing program brings with him/ her a wealth of Nursing experience which he/she kas accumulated over the years as a practicing Registered Nurse (RN). This has been particularly true in core Nursing courses, such as Medical-Surgical Nursing, Critical Care Nursing, Community Nursing, Mental Health Nursing, Forensic Nursing, etc. However, foundation Basic (Biomedical) Science courses/subjects are still being taught by faculty members who do not have Nursing background. One major defect related to this practice is that such faculty members are not teaching these courses/subjects within the "context" of the Nursing practice. Accordingly, the other major defect is the inability of these members to judge on what topics should be included in their courses (what is relevant?), the priority of these topics, and how much is enough.
We propose in this paper that Basic (Biomedical) Science courses/subjects in undergraduate and postgraduate Nursing curricula should be taught by RNs who have postgraduate qualifications (PhD) in the field. Such courses/subjects include Anatomy, Physiology, Embryology, Pathophysiology, Histology, Pharmacology, Biochemistry, Microbiology, Immunology, and Statistics. We base our proposal, and, thus, argument on several andragogy theories which will be described in this paper.
Our lives play out in a cyclical pattern, where learning often leads to new experiences and life experiences that are themselves sources of learning. This relationship between experience and learning is particularly prominent in adulthood when we are engaged in a continual flow of activities in the private, public, and professional spheres of our daily life. At the heart of adult learning is engaging in, reflecting upon, and making meaning of our experiences, whether these experiences are primarily physical, emotional, cognitive, social, or spiritual. In much of our understanding of adult learning including the foundational work in andragogy, self-directed learning, and transformative learning, an adult's life experiences generate learning as well as act as resources for learning.
It was the philosopher and educator John Dewey and his book "Experience and Education", first published in 1938, who has had the most influence on our understanding of the role of experience in learning [1]. Dewey saw learning as a lifelong process involving applying and adapting previous experience to new situations: "What [one] has learned in the way of knowledge and skill in one situation becomes an instrument of understanding and dealing effectively with the situations which follow. The process goes on as long as life and learning continue" [1]. Several writers have mapped out the relationship between life experience and learning. Experiential learning, initiated by Kolb, represents various conceptualizations of the relationship between experience and learning [2][3][4]. The term also refers to the use of certain instructional strategies and programs familiar to adult educators that are designed to make learning as authentic and like real-life as possible. Experiential learning is also used to acknowledge an adult's previous life experiences that can be reflected upon and documented for academic credit [2][3][4]. "Learning," Kolb writes, "is the process whereby knowledge is created through the transformation of experience" [2][3][4]. Experience is at the heart of his understanding of learning. Kolb's learning model consists of four stages that learners go through in this learning process. These include concrete experience, reflective observation, abstract conceptualization, and active experimentation [2][3][4].
Learning is best achieved in a context, which is referred as contextual learning. Book knowledge will only get us so far in a complex world of diverse learners and multiple cultures. This is the reason as to why book knowledge has been modified to include contextual balance with practical examples, applications, and resources as a means of connecting theory and practice for the journey of adult learners and educators. Context refers to the social system that shapes the thought and action of people within a setting such as a classroom, school, organization, community, or nation. Context in adult education has been equated with the history and culture of the learner, the setting where adult education takes place, and learning environments [5][6][7][8][9][10]. The perspective that learning is holistic shifts away from the emphasis on cognitive knowing to acknowledge other ways of knowing such as somatic, spiritual, emotional, moral, experiential, and social learning [11][12][13][14][15][16][17]. Pratt and Associates discuss five perspectives on teaching that reflect different culturally based beliefs about the instructor's role and responsibilities [18,19].
The five perspectives are: 1) transmission, emphasizing effective delivery of content; 2) apprenticeship, involving modeling ways of being and learning through experience; 3) developmental, cultivating ways of thinking about content, discipline, or practice; 4) nurturing, facilitating self-efficacy, encouraging the learner to build confidence; and 5) social reform, seeking a better society.
By the early 1990s, lifelong learning had supplanted the earlier concept of lifelong education. As Hasan explains, "the word 'education' was replaced by 'learning', to signal an emphasis on the learner, the learning processes and outcomes, as opposed to a focus on imparting education" [20]. UNESCO and OECD took the lead in conceptualizing the concept and "coverage was extended to all purposeful learning activity" across the lifespan, and "learning activities in all settings, from formal education to informal and nonformal learning" [21,22]. Indeed, the notion that lifelong learning should not only be lifelong, from cradle to grave, but "' life wide' Learning, Jarvis writes, rarely occurs "in splendid isolation from the world in which the learner lives; it is intimately related to that world and affected by it" [24][25][26]. All learning takes place in a social context. Learning settings are most often divided into formal, nonformal and informal settings [27]. While this is not a perfect typology and there are instances of overlap and intersection, it is a framework that resonates with most adult learners' and adult educators' experiences. Briefly, formal learning settings are those that adults aged twenty-five years and older account for 36% of students enrolled in four-year colleges and universities [28].
In a provocative article on "post-traditional learners" Soares makes the point that "today traditional students represent only about 15 percent of current undergraduates [29]. Informal learning is by far the most prevalent of the three forms of learning in the Coombs typology. Illeris calls it "everyday learning" because it "takes place in all the private and non-organized contexts of everyday life" [30,31]. Because it is so embedded in our lives, to recognize "everyday learning" as learning we do have to stop and think about it as learning. For example, most of us have encountered a health problem that has sent us to the Internet, the library, and health professionals to learn all we can about this problem, its cause, treatment, and perhaps lifestyle changes required to cope with it.
Informal learning often includes several other types of learning. Knowles's andragogy referred to the fact that adults' life experiences not only state who they are as adults, but they also constitute a rich asset for learning [34][35][36][37][38][39]

Discussion and Conclusion
There is a lesson to be learned from problem-based learning (PBL). When PBL was implemented in medical curricula, educators argued that the best PBL facilitator is the one who is an expert (for example cardiologist) in the topic being presented in the PBL case (for example heart murmurs), but who does not dominate the PBL group. Accordingly, having a medical background, being a subject expert, and acting as a facilitator are three major characteristics that make up a good PBL tutor. The moral of the story is that medical students are best taught by medical doctors (MDs), engineers are best taught by engineers, and nurses are best taught by RNs. This is because the instructors are subject experts and deliver the information and skills in the "context of the profession" to which they belong. Basic (Biomedical) Science courses are often taught during the first years of a medical or nursing curriculum.  [46,47]. The theory of situated cognition posits that learning is embedded in the context where it occurs, with the tools of that context, and through social interaction. Cognitive apprenticeships and communities of practice enable this form of experiential learning [48].