Safety in numbers 3: Authenticity, Building knowledge & skills and Competency development & assessment: The ABC of safe medication dosage calculation problem-solving pedagogy

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Abstract

When designing learning and assessment environments it is essential to articulate the underpinning education philosophy, theory, model and learning style support mechanisms that inform their structure and content. We elaborate on original PhD research that articulates the design rationale of authentic medication dosage calculation problem-solving (MDC-PS) learning and diagnostic assessment environments. These environments embody the principles of authenticity, building knowledge and skills and competency assessment and are designed to support development of competence and bridging of the theory-practice gap. Authentic learning and diagnostic assessment environments capture the features and expert practices that are located in real world practice cultures and recreate them in authentic virtual clinical environments. We explore how this provides students with a safe virtual authentic environment to actively experience, practice and undertake MDC-PS learning and assessment activities. We argue that this is integral to the construction and diagnostic assessment of schemata validity (mental constructions and frameworks that are an individual's internal representation of their world), bridging of the theory-practice gap and cognitive and functional competence development. We illustrate these principles through the underpinning pedagogical design of two online virtual authentic learning and diagnostic assessment environments (safeMedicate and eDose™).

Introduction

In Weeks et al. (2013b), we questioned the value of mechanistic and teacher-centric practices that treat students as passive recipients of decontextualised and symbolic (word & number-based) knowledge. These practices isolate the process of knowledge construction from its application in clinical practice and perpetuate a theory-practice gap. Rather than continue with a system which has met with limited success, we propose a curriculum underpinned by Authenticity, Building knowledge & skills and Competency assessment… an ABC of medication dosage calculation problem-solving (MDC-PS). This paper:

  • 1.

    Describes a model of education underpinned by constructivist, cognitive apprenticeship and situated pedagogical approaches which supports the active building of MDC-PS knowledge and skills.

  • 2.

    Illustrates the design features of a web-based authentic MDC-PS learning and diagnostic assessment environment.

Section snippets

Building knowledge and skills

There are a number of theoretical perspectives that inform the pedagogical design of the safeMedicate and eDose authentic virtual learning and diagnostic assessment environments and these are illustrated in Fig. 1. In this section we outline these perspectives, and how they have contributed to the development of the environments.

Authenticity: a fundamental shift in pedagogical design

Authentic MDC-PS environments are designed to represent and support authentic learning, building and diagnostic assessment of cognitive competence (knowledge) and sensitization to the fundamental requirements of functional competence (know-how and skills). This pedagogical approach sits in stark contrast to the learning and competency assessment process typically used in analogous word-based problems illustrated in Fig. 8 (Lum, 2004).

Word-based problems are not conceptually articulated like

Conclusion

The problem of medication dosage calculation error has a long global history, and its solution has evaded nursing for over 70 years. To resolve this multi-factorial problem we present the premise that traditional pedagogical approaches have not been fit for purpose for supporting the learning of all nursing students. We must be willing to promote a culture of education that is reflexive and adaptive to the requirements of rapidly evolving clinical environments, and also to the needs and

Conflict of interest statement

Professor Keith W Weeks, Norman Woolley & Lester Lewis are Directors of Authentic World Ltd, a spin-out company of the University of Glamorgan & Cardiff University. safeMedicate and eDose are trademarks of the MDC-PS authentic web-based virtual environments distributed respectively by Authentic World Ltd (UK and Ireland) and CAE Healthcare (International).

Dr B Meriel Hutton has no commercial interest in Authentic World Ltd or CAE Healthcare.

Professor Diana Coben has no commercial interest in

Acknowledgements

Graphics & Animations ©Authentic World Ltd: Matt Brown & Norman Woolley. Supervision of the original PhD programme of research: Professor Colin Torrance and Dr Sandy Kirkman. Advancement of eDose™ principles and pedagogy in the USA and Canada: Tom Doyle.

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