Professional nurse training in South Africa (SA) takes place within public nursing colleges, which are spread over the nine provinces. There are 14 such public nursing colleges in SA, with 34 sub-campuses. Professional nurse training is offered in terms of regulation R425 of the Nursing Act No. 50 of 1978, leading to registration as a nurse (general, psychiatry and community) or midwife. Anatomy and physiology (A&P) is a core subject taught in the first year of training. [1] The expectation is that on completion of education and training, students should have good observational, analysis and problem-solving skills, since modern nursing requires awareness of interactions between anatomical and physiological systems in pathological processes. [2] A background in A&P for the 4-year comprehensive basic nursing course is part of strict entry requirements for nursing students. Life sciences entail basic terminology that is used in human anatomy and physiology, and therefore form part of the admission requirements for the 4-year comprehensive basic nursing course. Without passes in life sciences, nursing colleges in SA do not admit applicants, regardless of their grade 12 score, to ensure that all students have at least a foundation in A&P. [3] The entry requirements for nurse training at the public nursing colleges in SA also include a grade 12 certificate with a minimum score of 25. Admission requirements in Australia are similar to those in the colleges under study, as mathematics, science and English are the prerequisite subjects for admission. [4] In Ghana, English, mathematics, science and some age restrictions are basic requirements for admission. Unlike in SA, applicants must be between the ages of 18 and 35 years. This means that applicants under or over the stipulated age categories are excluded from the applications even if they meet the other requirements for admission. [5] Background. Student nurses in South Africa view anatomy and physiology (A&P) as the most complex subject in the nursing curriculum. Objective. To describe the factors contributing toward inconsistent and fluctuating performance among student nurses doing A&P as a subject. Methods. The study adopted a quantitative descriptive design. Census sampling was used to draw a sample size of 114 respondents. A structured self-administered questionnaire with close-ended questions was used to collect data from the six nursing campuses under study. Raw data were captured using Excel spreadsheets, and descriptive and inferential statistics were used to analyse data. Results. The key findings were: (i) poor teaching strategies contributed to subject failure; (ii) lack of after-class sessions had an impact on failure; (iii) a shorter study period for examinations contributed to failure; and (iv) a language barrier also played an important role in students' failure in A&P. Conclusion. Student nurses struggle with and find A&P in nursing programmes challenging and anxiety-provoking. Nurse educators need to come up with innovative teaching strategies that w...