Biology is a key subject for Nursing studies and has an important contribution to the cut-off mark of the university entry exam (PAU) for this degree. However, the results obtained in the PAU do not always reflect the knowledge acquired by students in this subject. This raises the need to study whether the preparation received during the last year of secondary school is exclusively oriented towards the requirements of the PAU or whether it really favours the consolidation of the knowledge necessary to successfully undertake higher studies. Therefore, the aim of this study was to analyse the relationship between the scores obtained in the PAU, pre-existing knowledge at the beginning of the Biology and Biochemistry subjects in the first year of the Nursing degree, and the final performance of students in both subjects. For this purpose, data were collected by surveys and questionnaires of knowledge in Biology and Biochemistry, comparing the results obtained with the final scores in each subject. The results show that, despite 76% of students obtaining scores above 7 in the PAU in Biology, students' pre-existing knowledge in Biology and Biochemistry has a mean score of 6. This difference could be due to the fact that although students may have obtained a high score in the PAU, this does not necessarily reflect a deep knowledge base of the fundamental concepts of Biology, but could be more related to memorisation and strategic preparation for the exam. When comparing these data with the final performance in the degree, it was observed that 36.4% of the students in Biochemistry and 59.2% in Biology obtained scores above 7 in their final exams in the first year, values lower than the results of the 76% of the PAU. This suggests that, despite having achieved a sufficient level to pass the PAU, students have difficulties in applying this knowledge in the university context, where the demands are higher and deeper learning is required. This discrepancy between pre-existing knowledge and final scores can be attributed to the adaptation to new cognitive demands at university. In conclusion, in both secondary and university education, there is a need for a more integrative approach focusing on the development of deeper cognitive skills that not only contribute to better academic achievement, but also to a more solid and applied training for professional performance.

Keywords: University Entrance Exam (PAU), Nursing Degree, Higher Education, Learning Outcomes.