The educational preparation of undergraduate nursing students in pharmacology: a survey of lecturers' perceptions and experiences

ISSUES AND INNOVATIONS IN NURSING EDUCATION

The educational preparation of undergraduate nursing students in

pharmacology: a survey of lecturers’ perceptions and experiences

Shane Bullock BSc PhD

Senior Lecturer, School of Arts and Sciences, Australian Catholic University, Fitzroy MDC, Victoria, Australia

and Elizabeth Manias BPharm MPharm MNStud PhD RN FRCNA

Senior Lecturer, School of Postgraduate Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne,

Carlton, Victoria, Australia

Submitted for publication 30 October 2001

Accepted for publication 24 June 2002

Correspondence:

Shane Bullock,

School of Biomedical Science,

James Cook University,

Townsville,

Queensland,

Australia 4811.

E-mail: [email protected]

BULLOCK S & MANIAS E (2002)BULLOCK S. & MANIAS E. (2002) Journal of Advanced Nursing 40(1), 7–16

The educational preparation of undergraduate nursing students in pharmacology:

a survey of lecturers’ perceptions and experiences

Background. Nurses have key responsibilities in the administration and man-

agement of medication therapy and client education. It is of some concern

therefore that the literature indicates that nurses are inadequately prepared in this

area.

Aims. This paper explores the perceptions and expectations of lecturers about

teaching and learning pharmacology in preregistration nursing courses.

Research methods. Questionnaires were distributed to lecturers involved in

teaching pharmacology to undergraduate nursing students during 2000. The

questionnaire was distributed to all university campuses (n ¼ 13) in Victoria,

Australia, that are involved in undergraduate nursing education. The questionnaire

was an adaptation of the survey instrument used in the Nursing and Medication

Education [NAME] project and examined in this questionnaire: the integration of

pharmacology teaching into nursing, range and depth of classroom-based phar-

macology teaching, approaches to teaching and learning, nursing practice in a

clinical context, related importance of patient education and communication skills,

and the appropriate professional background of academics teaching pharmacology

to preregistration nursing students.

Results. There was great variation between institutions as to the number of hours

devoted to pharmacology and when it was offered. A number of respondents

indicated that they were dissatisfied with the preparation of graduates and their

knowledge base in pharmacology.

Limitations. The study was limited by a low response rate of 34%.

Conclusions. A review of nursing curricula is required to improve the know-

ledge base of nurses in pharmacology and to facilitate their skills in life-long

learning.

Keywords: pharmacology knowledge, nursing education, medication knowledge,

teaching strategies, learning, drug administration

� 2002 Blackwell Science Ltd 7

Introduction

Nurses have key roles to play in the administration and

management of medication therapy and client education.

These roles have been clearly described in undergraduate

textbooks such as Fundamentals of Pharmacology (Galbraith

et al. 2001). Indeed, as indicated by Gee et al. (1998), nurses

are ideally placed to promote safe and effective medication

management.

It is of some concern, then, that a number of studies from

Australia (Bullock & Baume 1994, Ives et al. 1996, Manias

& Bush 1999) and elsewhere (Bray & Ghose 1993, While &

Rees 1994, Luker & Wolfson 1999) have revealed that nurses

have an inadequate level of knowledge in this area. In the

light of nurse prescribing rights being recently granted or

extended in the United Kingdom (UK), New Zealand and

Australia there are grounds for concern. Indeed, there is some

apprehension about the capacity to fulfil this new role given

the level of nurses’ pharmacology knowledge (Dixon 1998,

Manias & Bullock 1998, Tattam 1998). In the UK a training

course has been established for nurses seeking prescribing

rights, but its adequacy in meeting the obligations for safe

practice has been questioned (McCartney et al. 1999).

Improvements in pharmacology knowledge are essential

and have been called for internationally by practising nurses

(Ashurst 1993) and academics (White 1994, Manias 1995,

Ives et al. 1996, Manias & Bullock 1998) alike. Such

improvements will no doubt contribute to the quality use of

medicines by the community. Ives et al. (1996) recommended

a comprehensive review of undergraduate curricula and

teaching methods related to pharmacology. Yet, an exam-

ination of the nursing literature reveals very little current

information about these aspects of teaching and learning.

In a recent UK study, Latter et al. (2000b) investigated the

preparation of nurses for their role in medication education.

Their study revealed that there was dissatisfaction amongst

students and staff with the lack of pharmacology within

curricula, and that staff opinion was divided as to who

should teach pharmacology to preregistration students (for

example, nurses, biomedical scientists or pharmacists). It also

identified a lack of curricular opportunities for integration of

knowledge and skills and lack of consistency across the

programmes studied.

The purpose of this paper is to describe the preregistration

pharmacology education of nursing students in one Austra-

lian state, Victoria. In Australia all preregistration nursing

education is undergraduate and takes place within the

tertiary education sector. Graduates emerge with a generalist

Bachelor degree. In order to specialize as a nurse prescriber a

Registered Nurse must undertake postgraduate training.

More specifically, the aims of this paper are to:

• describe the integration of pharmacology teaching into

nursing;

• describe the range and depth of classroom-based pharma-

cology teaching;

• describe the approaches used for teaching and learning;

• explore the role of the clinical context in pharmacology

teaching;

• explore how pharmacology is integrated with patient

education and communication skills.

The study

Methods

For the purposes of this paper pharmacology education is

defined as developing a knowledge base necessary for safe

and effective medication management. Generally, the content

includes theoretical and practical aspects of pharmacody-

namics, pharmacokinetics, actions of common drug families,

drug interactions, adverse effects, drug administration, clin-

ical decision-making and patient education.

Design

This study was conducted as part of a larger project in

Victoria that involved a descriptive analysis of nurses’

preparation in, expectations of, and perceptions about

pharmacology knowledge. The views of lecturers, undergra-

duate nursing students and clinical nurses were sought so as

to shed light on the pharmacology preparation of preregis-

tration students and newly graduated Registered Nurses. The

project did not attempt to analyse the curriculum content of

undergraduate nursing courses comprehensively. This article

focuses on information sought from academic staff only

about the delivery of pharmacology education to undergra-

duate nursing students.

Ethics

Ethics approval was obtained from the ethics committees

of 13 Victorian university campuses involved in the re-

search project. Following this, the academic heads of the

nursing schools of all university campuses conducting un-

dergraduate nursing programmes in the state of Victoria

were contacted. These academic heads were written to,

and asked for, contact details of course coordinators in

nursing. These course coordinators were asked to nomin-

ate suitable staff who could complete a questionnaire ex-

amining various issues about teaching and learning

pharmacology.

S. Bullock and E. Manias

8 � 2002 Blackwell Science Ltd, Journal of Advanced Nursing, 40(1), 7–16

Instrument

The questionnaire was an adaptation of the one recently

administered in the UK in the Nursing and Medication

Education [NAME] project (Latter et al. 2000a), which we

modified for the Australian context. Permission to use the

NAME questionnaire was provided by the authors and the

English National Board for Nursing, Midwifery and Health

Visiting. The questionnaire, which sought information on

the teaching and learning of pharmacology, was divided into

three sections. Section one sought demographic information

from respondents. The format of section two was a com-

bination of closed- and open-ended questions and examined

lecturer experiences on a number of issues. The issues ad-

dressed in section two, which were also adopted from the

Latter et al. (2000a) study, included the following: range

and depth of classroom-based pharmacology teaching, ap-

proaches to teaching and learning, integration of pharma-

cology teaching into nursing, background of academic staff

teaching preregistration nursing students, impact of the

teacher, practice in a clinical context, the importance of

patient education and communication skills, as well as op-

portunities for integration of pharmacology with teaching in

patient education and communication skills. Section three of

the questionnaire comprised a number of Likert scale

questions examining lecturer perceptions of the issues ad-

dressed in section two. The questions in section three were

formatted as statements to which respondents indicated a

degree of agreement or disagreement. They were also pro-

vided with the opportunity to make other comments related

to pharmacology and nursing education in this section. The

questionnaire was pilot tested with a small group of aca-

demic staff (n ¼ 10) who were not involved in the main

study. Their evaluation of the pilot questionnaire indicated

reliability (Cronbach’s a coefficient ¼ 0Æ81) and face validity

of the instrument. The pilot group considered that the

questions were clear, concise and easy to understand, dealt

with issues relevant to nursing education and were docu-

mented in the literature.

Data collection and sample

On the advice of the course coordinators located at the 13

university campuses, 78 questionnaires were mailed to aca-

demic staff in Victoria. Reminder notices were subsequently

posted to these academics. Ten academics contacted one in-

vestigator to indicate that they were not currently involved in

undergraduate nursing courses or that they did not teach in

this area of the curriculum. Twenty-three questionnaires were

returned, giving a response rate of 34%. Twelve of the 13

university campuses that conduct undergraduate nursing

courses participated in the study.

Data analysis

Descriptive statistics, including means, standard error of the

mean, ranges and frequencies, were calculated for items in the

questionnaire. The Statistical Package for Social Sciences

(SPSS for Windows, version 9) was used to analyse the data.

Comments to open-ended questions were subjected to con-

tent analysis in which words, phrases and sentences were

grouped into categories (Berg 2001).

For the tabulated data, the total percentage may not add up

to 100 per cent due to rounding errors or missing values.

Results

Respondent profile

All respondents were employed at lecturer level and all were

Registered Nurses. On average they had been involved in

undergraduate nursing education in the tertiary sector for

8Æ8 years and had been employed at their current institution for

most of that time (7Æ4 years). A profile of respondents’

qualifications and current studies was derived from the data

(see Table 1). More than half held Bachelor’s degrees and a

significant number had postgraduate qualifications. Of those

who were undertaking further study, the majority were

completing a doctorate.

Integration of pharmacology teaching into nursing

In section two of the questionnaire respondents were asked

whether the pharmacology component of the course was

taught as a separate subject. In reply, 39% indicated that this

was the case. Of those who said that it was taught within

another subject, 38% indicated that this was within nursing,

Table 1 Respondent profile (n ¼ 23)

Variables Percentage of respondents

Qualifications*

Registered Nurse 100

Qualified midwife 26

Diploma 9

First degree 57

Graduate diploma 35

Advanced certificate 26

Master’s degree 39

Current studies�

Doctorate 64

Master’s degree 27

Graduate diploma 9

*Some respondents had more than one qualification.�Not all respondents were engaged in further studies.

Issues and innovations in nursing education Preparation of undergraduate nursing students in pharmacology

� 2002 Blackwell Science Ltd, Journal of Advanced Nursing, 40(1), 7–16 9

31% said it was taught within the biosciences and 31%

indicated that it was taught within both nursing and

bioscience subjects.

In section three lecturers were asked whether pharmacol-

ogy should be taught as a separate subject. Respondents to

this question were evenly divided (see Table 2). However,

most agreed that teaching it as a separate subject reduced the

opportunity for integration into nursing subjects.

Range and depth of classroom-based pharmacology

teaching

In section two, the number of teaching hours dedicated

to pharmacology was examined. When the pharmacology

content was integrated into nursing subjects, 39% of

respondents indicated that students received more than

20 hours of pharmacological class contact. In contrast, when

pharmacology was integrated into the bioscience subjects

only 9% received more than 20 hours of class contact. For

those respondents who indicated that pharmacology was

offered as a separate subject at their institution, 75% stated

that this consisted of more than 30 hours of pharmacology

class contact.

When respondents were asked whether the number of

hours dedicated to pharmacology had altered at their current

institution over the period of their employment, the most

frequent responses were that they had not changed (39%) or

had increased (30%). When asked whether they would like to

see a change in the number of pharmacology teaching hours,

more than half indicated that they would like to see an

increase (57%).

Participants were invited to comment further on aspects of

pharmacology teaching (see Table 3). Fifteen respondents

contributed comments. The major categories that emerged

from content analysis were the importance of the teaching

being relevant to and integrated with nursing practice (six

Table 2 Pharmacology in the curriculum

Strongly

agree (%) Agree (%)

Somewhat

agree (%)

Somewhat

disagree (%) Disagree (%)

Strongly

disagree (%)

Pharmacology should be taught as a

separate subject not as part of

a biosciences subject

13 26 13 30 13 4

The teaching of pharmacology as a

separate subject reduces the opportunity

for its integration into nursing subjects

21 21 21 21 9 4

Pharmacology is an important priority area

for the undergraduate nursing curriculum

43 43 – – – 9

A graduate nurse has sufficient knowledge

of pharmacology to enable safe practice

– 13 52 9 21 4

Generally, there is sufficient time in the

nursing curriculum dedicated to pharmacology

4 21 17 21 17 17

Table 3 Respondents’ comments relating to pharmacology and

nursing education

Categories

No. of

responses

Aspects of pharmacology teaching

Relevance to and integration with nursing practice 6

More class time required 5

Curriculum presently undergoing change 2

Concerns over what is taught (science not applied

to practice)

2

Difficulty of integration with nursing practice

Difficulties experienced because:

• experience opportunities widely spaced/does not

match time of teaching

4

• knowledge base of students inadequate 3

• staff in placement too busy 2

• consolidation develops late in course 2

• depends on experience/motivation of supervisor 2

• depends on student motivation/determination 1

No difficulties experienced because:

• student just requires encouragement 1

• this is part of holistic care 1

• this is the principal aim of placement 1

• no further explanation supplied 2

Other comments

Integration of science with nursing important 6

Preparedness/knowledge for practice limited 2

Drug calculation ability poor 2

Concern over science components of nursing course

being reduced

1

Expectations of students too high 1



responses) and that more class time was required in this

discipline (five responses).

A number of other issues relating to lecturer perceptions of

pharmacology in the curriculum were explored in section

three. The Likert Scale responses to these statements are

shown in Table 2. Most respondents agreed that pharmacol-

ogy was an important priority in the curriculum and there

was not enough time dedicated to it. Most felt, however, that

graduate nurses had sufficient pharmacology knowledge for

safe practice.

Approaches to teaching and learning

The timing of pharmacology teaching varied across institu-

tions. Data from section two indicated that it was most

common for pharmacology to be taught during the second

year of the 3-year undergraduate course (49% of respond-

ents), followed by the third year (36%) and then the first year

(16%). Only two respondents (8%) indicated that pharma-

cology was taught in semester one of the first year. In some

institutions, pharmacology was taught across more than one

semester and/or across more than 1 year.

In section two, 61% of respondents reported that their

students were exposed to pharmacology content before the

first clinical placement. Yet, when asked in section three

about students’ first exposure to pharmacology, 82% of

respondents agreed to some extent with the statement that it

was ideal to introduce pharmacology prior to the first student

clinical placement (see Table 4).

All respondents indicated that they used examinations to

assess students’ pharmacology knowledge. Examination for-

mats used included multiple-choice questions, case studies,

short answer questions and drug calculations. In terms of

other assessments, 57% indicated that they set an assignment

in addition to the examination, which took the form of case

studies or class presentations. About one-third of respondents

also used other assessments, including clinical assessments,

drug calculation tests, writing-up care plans, quizzes or

laboratory skill tests. Most felt that current pharmacology

textbooks for nursing students adequately covered the

content required (61%) and were pitched at an appropriate

level (52%).

Practice in a clinical context

Of the respondents, 74% indicated in section two that their

course included clinical practice-based assessments in the

administration of medicines. The formats of these assess-

ments included nursing competency, laboratory skill tests and

drug calculation tests.

When invited to comment on how difficult it was for

nursing students to integrate pharmacology knowledge with

clinical practice, their views were somewhat divergent (see

Table 3). Nineteen respondents proffered comments: 14

Table 4 Practice in a clinical context

Strongly

agree (%) Agree (%)

Somewhat

agree (%)

Somewhat

disagree (%)

Disagree

(%)

Strongly

disagree (%)

Ideally, nursing students should be introduced

to pharmacology prior to their first clinical

placement

26 39 17 4 9 4

It is only on clinical placements that students

can integrate pharmacology theory with

practice issues

4 9 17 21 35 13

The majority of pharmacology teaching

should take place in the hospital setting where

it can be made more relevant to a particular

clinical setting

– 4 30 39 26 –

Clinical practice-based competency assessments

of pharmacology knowledge are less important

than theoretically based assessments

– – 4 48 44 4

It is only on clinical placement that students

acquire knowledge about medications

– 4 13 35 35 13

Generally, there is a lack of integration of

theory and practice in nurse education

13 17 35 13 13 9



respondents claimed that it was difficult, while another five

stated that it was not. Content analysis of the responses

revealed two major categories: that opportunities to integrate

these areas were widely spaced or did not match the time of

teaching (four responses) and concerns were raised about the

knowledge base of students (three responses).

Section three perceptions related to the role of clinical

placements are presented in Table 4. Respondents felt that

there was generally a lack of integration of theory and

practice in nurse education and most regarded clinically

based competency assessments of pharmacology knowledge

as being no less important than theory assessments.

However, most did not support the view that clinical

placements were the only site where students became

knowledgeable about medicines or where theory was

integrated with practice. There was no major support for

pharmacology teaching taking place mostly in the clinical

setting.

Related importance of patient education and

communication skills: opportunities for integration

with pharmacology

In section two, when asked whether there were opportunities

within their courses for students to integrate pharmacology

knowledge with principles of consumer education or princi-

ples of communication skills, 78% of respondents replied

positively to the former question and 65% did so to the latter.

The nature of these opportunities was diverse. Respondents

suggested that consumer education principles were integrated

with pharmacology in lectures and tutorials, in case studies,

during student nurse assessment of patient medication know-

ledge, during education sessions regarding self-administration

of medicines, by using learning tools in clinical placements and

by placing a focus on increasing client control. Opportunities

for students to integrate communication skills with pharma-

cology occurred in communication workshops, laboratory

sessions using role-plays, problem-based scenarios, clinical

placements and in practising health assessments.

In section three the integration of pharmacology know-

ledge with either the principles of communication skills or

patient education was explored (see Table 5). Most re-

spondents disagreed that this was difficult for lecturers to

achieve. When educating patients and their families about

medication, they felt that pharmacology was not more

important than either communication skills or patient

education principles.

Who should teach preregistration nursing students

pharmacology?

In Table 6, the issue of who should teach pharmacology to

nursing students is presented. Most respondents disagreed

with the view that science lecturers were ideally qualified to

teach pharmacology principles to nursing students or that

they pitched their teaching at an appropriate level. They

indicated agreement for the statements that, ideally, the

person teaching pharmacology needed a nursing background

and that science lecturers could not integrate theory and

practice. Interestingly, respondents did not exclude the

involvement of science lecturers as most agreed that teaching

pharmacology should involve lecturers from science and

Table 5 Integration of pharmacology with principles of patient education and communication skills

Strongly

agree (%) Agree (%)

Somewhat

agree (%)

Somewhat


Strongly

disagree (%)

The integration of pharmacology and patient

education skills is difficult for lecturers

to achieve

– 4 30 21 35 4

Pharmacology knowledge is more important

than knowledge about patient education

when it comes to educating patients and their

families about medication

– 4 17 39 35 4

The integration of pharmacology and

communication skills is difficult for lecturers

to achieve

4 13 17 30 26 9

Pharmacology knowledge is more important

than knowledge about communication skills

when it comes to educating patients and their

families about medication

– 9 4 35 39 13



nursing as long as there were opportunities in the curriculum

for someone to relate theory to practice.

Other views

At the end of the questionnaire, in which participants were

given an opportunity to contribute further comments regard-

ing the teaching and learning of pharmacology, 12 respond-

ents commented (see Table 3). Following content analysis,

the major category that emerged was the importance of

integrating the science with the nursing components of the

course (six responses).

Discussion

The findings from our survey show that the organization of

the pharmacology component of preregistration nursing

courses in Victoria varies with respect to the number of

hours devoted to this and timing of when it was offered. It

was common for pharmacology to be programmed in the

second year of the course, but some courses offered it in first

or third year. While it was considered ideal to start teaching

pharmacology prior to the first clinical experience, only 61%

of respondents indicated that this was happening in their

institution. It appeared that students were exposed to more

hours of pharmacology when it was taught as an integrated

subject within nursing subjects compared to when it was

taught in bioscience subjects. Interestingly, if pharmacology

was taught as a separate subject it was allocated a greater

number of hours. The preferred model for this group of

academic staff was to teach pharmacology in an integrated

fashion within nursing or biological science subjects.

Respondents indicated that it should be taught at a time

when it has the most significance for students and in

conjunction with client care. Most indicated that there were

opportunities for pharmacology knowledge to be integrated

with patient education and communication skills.

Inconsistencies in time allocation and approach across

preregistration nursing courses were first raised nearly a

decade ago (Wharrad et al. 1994) and are still apparent today.

This finding was also highlighted in the Latter et al. (2000a)

study. Such diversity occurs because each university is able to

construct its own course according to its own philosophies and

priorities. It is only encumbent upon them to meet certain

requirements for accreditation by the respective Nursing

Boards in each Australian State in order for graduates to be

registered. As a consequence, there is great variability in what

students experience in terms of their preregistration pharma-

cology education. It has been more than 15 years since

preregistration nursing education moved into the tertiary

sector in Victoria and curricula in this area are clearly still not

meeting the needs of students or staff (Ives et al. 1996). There

are no explicit guidelines in Australia as to what level or

amount of pharmacology knowledge is required for practice.

Table 6 Who should teach pharmacology?

Strongly

agree (%) Agree (%)

Somewhat

agree (%)

Somewhat


Strongly

disagree (%)

Ideally, the person who teaches pharmacology

to nursing students needs a background

in nursing

30 39 17 13 – –

Science lecturers pitch their teaching at an

appropriate level for nursing students

13 4 26 17 30 9

Science lecturers are ideally qualified to teach

pharmacology principles to nurses

4 4 35 26 21 9

Science lecturers who do not have a nursing

background cannot integrate pharmacology

theory with practice issues

9 26 35 21 9 –

Pharmacology should be taught by lecturers

from more than one discipline

(i.e. science and nursing)

21 9 52 13 – 4

It does not matter if the lecturer teaching

pharmacology does not have a nursing

background as long as there are opportunities

in the curriculum for someone to relate

pharmacology to nursing practice

4 21 30 21 13 9



Respondents indicated that they regarded pharmacology as

an important part of the preregistration nursing curriculum.

In reporting that pharmacology teaching should primarily

take place in the university setting and that teaching hours

should be increased, nurse lecturers seemed to be aware of

what was needed to improve how this knowledge was

delivered. While most believed that graduates have sufficient

pharmacology for safe practice, it is also clear that they were

dissatisfied with the current preparation of nursing students

and their knowledge base in this area. Graduate nurses have

also expressed this view in previous research. For instance,

Ives et al. (1996) indicated that 35% of graduate nurses

believed that allocating more time to pharmacology in the

classroom setting would have improved their knowledge. In

our study, nurse lecturers raised concerns about the amount

of teaching time, lack of theory-practice integration, and the

professional background of the person teaching pharmacol-

ogy. These concerns contributed to the difficulties they

experienced in implementing an ideal programme in phar-

macology.

With respect to the time devoted to pharmacology, it

was suggested that more time was needed. This view is

consistent with other studies in this area (Jordan et al.

1999, Latter et al. 2000a). However, this concern about

pharmacology teaching time can only be rectified by

increasing the duration of the course or dropping other

material. As the former is unlikely, there would be

significant debate about which aspects of content should

be dropped. This is indeed a contentious issue. In fact,

Trnobranski (1997) found that 11 out of 12 nurse lecturers

surveyed favoured the expansion of their own subject at

the expense of others.

Respondents generally felt that there was a lack of

theoretical–practical knowledge integration in preregistra-

tion nursing education. A number suggested that the

important issue was the variable quality of the clinical

experience and this is consistent with the view of partici-

pants in the Latter et al. (2000a) study. Factors cited in our

study that contribute to the theory–practice gap were a lack

of reinforcement of the theoretical knowledge in clinical

placement, the timing of experience with respect to when

the theory was delivered, the expectations of students by the

clinical teacher, the intermittent nature of clinical experience

and the need for a more continuous exposure, and the hectic

environment of the clinical setting. Generally, respondents

disagreed with the view that most of the learning and

integration of theory and practice occurred on clinical

placement. Furthermore, there was little support for the

view that most pharmacology teaching should take place in

the clinical setting.

There was some agreement that the background of the

teacher was important. Respondents generally supported the

statement that science lecturers may not be ideally qualified

to teach these principles at an appropriate level and that the

person teaching pharmacology should have a nursing back-

ground. This view was consistent with the findings of Latter

et al. (2000a); however, it may be somewhat flawed. Previous

studies have shown that nurse teachers feel that they have

insufficient knowledge of the biological sciences to teach

pharmacology and are unable to link the theory and practice

well (Akinsanya 1987, Courtenay 1991). Latter et al. (2000a)

have indicated a preference for a multidisciplinary teaching

approach in medication education. In our study, most

respondents favoured involvement of both science and

nursing lecturers in teaching pharmacology. Indeed, the poor

integration of theory and practice may have more to do with

a lack of liaison between lecturers of different disciplines. In

the Latter et al. (2000a) study, poor communication was

noted between science lecturers from a school of medicine

and school of nursing at a particular site and a number

indicated little awareness of the wider curriculum beyond the

modules that they taught.

All our respondents indicated that pharmacology know-

ledge was assessed by examination. Interestingly, as Wharrad

et al. (1994) suggested, this was the preferred method of

assessment in the biological sciences. However more than

half of those surveyed indicated that this assessment was

supplemented with additional assessment tasks. They sup-

ported the view that their courses should strike a balance

between theoretical and practical assessment.

Implications for educational practice

There are a number of issues arising out of this study that

need to be addressed. Of particular concern is the dissatis-

faction expressed about the amount of teaching time dedica-

ted to pharmacology, the lack of integration of

pharmacological theory and practical knowledge, and the

nature of student clinical placements. Issues such as these

may well be contributing to the perceived inadequacy of

pharmacology knowledge of Registered Nurses.

In the UK nursing education literature there is a strong

view that the hours devoted to the biological sciences have

been decreased in favour of an enhanced psychosocial

perspective (Wharrad et al. 1994, Trnobranski 1996, Jordan

& Reid 1997, Wynne et al. 1997, Clancy et al. 2000, Davies

et al. 2000). It has been argued that to practise safely,

effectively and autonomously nurses need to understand and

apply the natural sciences that underpin nursing actions

(Eraut et al. 1995, Jordan & Potter 1999). A number of



researchers have been pressing for comprehensive curricu-

lum review in the UK (Wharrad et al. 1994, Trnobranski

1996, Wynne et al. 1997, Clancy et al. 2000, Davies et al.

2000, Latter et al. 2000a), and propose a review of student

selection criteria, teaching strategies and curriculum design.

The review should include the development of guidelines

that enable the identification of appropriate and sufficient

curricular content. Importantly, Clancy et al. (2000) and

Latter et al. (2000a) have pointed out that consideration

also needs to be given to balancing student knowledge

acquisition and subject content with the facilitation of

confidence in their knowledge and skills related to self-

directed and life-long learning. This is particularly important

with respect to developing a pharmacology knowledge base,

given the breadth and depth of understanding required and

need for regular updating as novel medications appear on

the market.

Limitations of the study

The study was limited by the response rate of 34%. There

is evidence that a number of academics who received the

questionnaire were not directly involved in preregistration

pharmacology education, as 10 lecturers contacted one

investigator to query their suitability. It may be that some

additional academics contacted were not currently involved

in undergraduate pharmacology teaching and therefore did

not respond. The low response rate might have been

avoided by providing a better briefing to the course

coordinators of each university as to which staff would

be appropriate targets for this study. Indeed the respond-

ents may represent academics that are most concerned

about teaching and learning issues in pharmacology.

Nevertheless, 23 academics responded to the questionnaire

who were involved in the teaching and learning of nursing

students at the preregistration level in 12 out of 13

universities in Victoria, Australia. It would be valuable to

replicate this study on a wider scale to determine whether

the expectations and perceptions of this group of respond-

ents are reflected by lecturers employed in other preregis-

tration nursing courses.

Conclusions

This study has shown that lecturers involved in nursing

education regard pharmacology as an important part of the

preregistration nursing curriculum. However, there was some

dissatisfaction with the preparation of graduates with respect

to their pharmacology knowledge base. Indeed, there was

great variation across the State in what students were offered

in their pharmacology education with respect to course

contact time and teaching approach. A review of the

curriculum is required to improve the knowledge base of

graduates and facilitate skills in life-long learning. The review

should include the development of guidelines which identify

the appropriate and sufficient pharmacology content, both

theoretical and practical, required for nursing practice at

graduation.

Nurses who have a strong knowledge base in pharmacol-

ogy would be better prepared to fulfil their roles in the

management of patients’ drug therapies and medication

education. A stronger pharmacology knowledge base would

also contribute to increased confidence in the capacity

of Registered Nurses to assume extended prescribing rights.

Acknowledgements

This study was funded by the Commonwealth Government of

Australia through the Australian Research Council (ARC)

Small Grant Scheme. We are grateful to Marianne Moran

and Roberta Stead for their assistance in completing this

study.

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The educational preparation of undergraduate nursing students in pharmacology: a survey of lecturers' perceptions and experiences