Safety in numbers 2: Competency modelling and diagnostic error assessment in medication dosage calculation problem-solving
Section snippets
Past, present & future challenges in medication dosage calculation problem-solving (MDC-PS) education
When children are presented with information that is divorced from their experience, they strive to connect it with the most approximate reality with which they are familiar. Eric Midwinter gives a memorable example of this,
Some time ago I inspected a child's drawing of ‘Silent night; Holy night’. As well as the traditional complement of holy family, wise men, shepherds, oxen and asses, there was also a cheerful, stout fellow in a brown jerkin gazing benignly into the crib. “Who is that?” we
Methodology
In this paper we explore the problem assessment and framing phase of a 20-year programme of medication dosage calculation problem-solving (MDC-PS) education action research. In Weeks et al. (2013a) we explain the basis of the education action research process, and here we describe the fieldwork that preceded a PhD research programme undertaken at a large UK university. This work took place in the early years of the programme and describes the work with nursing students who had mostly been
Defining competence in MDC-PS
Facilitating the construction of professional knowledge and its application to professional competence development, performance, assessment and evaluation is a key mission of professional healthcare education and lies at the heart of professional registration and maintaining patient safety in clinical practice. However, in nursing education we have traditionally made a distinction between the teaching and assessment of knowledge and the teaching and assessment of competent and skilled
The classroom environment
Our classroom-focused fieldwork at the study site revealed that students were taught via traditional classroom-based ‘chalk and talk’ pedagogies using word-based dosage calculation problems, formulae and number-based equations via (see Fig. 4) and assessed via word-based problems of the type illustrated in Fig. 5.
Traditional classroom-based pedagogies attempt to transmit knowledge of the medication dosage calculation problem-solving (MDC-PS) process, yet these abstractions (words and numbers)
Conclusion
The definition, articulation, development, assessment and evaluation of competence are central to maintaining patient safety and education practice in the domain of medication dosage calculation problem-solving (MDC-PS). As the first component of the education action research process we have presented a MDC-PS competence model that illustrates the relationship between conceptual competence (dosage problem-understanding), calculation competence (dosage-computation) and technical measurement
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 Meriel Hutton has no commercial interest in Authentic World Ltd or CAE Healthcare.
Dr Simon Young has no commercial interest in Authentic
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.
References (64)
Numeracy needs of the beginning registered nurse
Nurse Education Today
(1996)- et al.
Numeracy skills of nursing students
Nurse Education Today
(2011) - et al.
Concerns about numeracy skills of nursing students
Nurse Education in Practice
(2006) - et al.
Safety in numbers 6: tracking pre-registration nursing students’ cognitive and functional competence development in medication dosage calculation problem-solving: the role of authentic learning and diagnostic assessment environments
Nurse Education in Practice
(2013) - et al.
The relationship between nursing students' mathematics ability and their performance in a drug calculation test
Nurse Education Today
(2010) - et al.
Safety in numbers 5: evaluation of computer-based authentic assessment and high fidelity simulated OSCE environments as a framework for articulating a point of registration medication dosage calculation benchmark
Nurse Education in Practice
(2013) - et al.
Safety in numbers: an introduction to the nurse education in practice series
Nurse Education in Practice
(2013) - et al.
Safety in Numbers 3: authenticity, building knowledge & skills and Competency development & assessment: the ABC of safe medication dosage calculation problem-solving pedagogy
Nurse Education in Practice
(2013) - et al.
Safety in numbers 4: the relationship between exposure to authentic and didactic environments and nursing students' learning of medication dosage calculation problem solving knowledge and skills
Nurse Education in Practice
(2013) - et al.
Safety in numbers 7: veni, vidi, duci: a grounded theory evaluation of nursing students’ medication dosage calculation problem-solving schemata construction
Nurse Education in Practice
(2013)
The strive for clinical effectiveness in medication dosage calculation problem solving skills: the role of constructivist learning theory in the design of a computer based ‘Authentic World’ learning environment
Clinical Effectiveness in Nursing
Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach
Clinical Effectiveness in Nursing
The assessment and development of drug calculation skills in nurse education – a critical debate
Nurse Education Today
The assessment of drug calculation skills – time to rethink the whole process
Nurse Education Today
Safety in Numbers 1: essential numerical and scientific principles underpinning medication dose calculation
Nurse Education in Practice
Refinements in the dimensional analysis method of drug calculation problem solving
Nurse Educator
Recent Research in Mathematics Education
Medication calculation skills of registered nurses
The Journal of Continuing Education in Nursing
Drug calculation errors of baccalaureate nursing students
Nurse Educator
From Novice to Expert. Excellence and Power in Clinical Nursing
Discriminating types of medication errors in nursing practice
Nursing Research
Assessing Student Learning in Higher Education
At the sharp end of education for an ethical, equitable and numerate society: working in a safety-critical context – numeracy for nursing
Benchmark Assessment of Numeracy for Nursing: Medication Dosage Calculation at Point of Registration
Comparison of medication errors in an American and a British hospital
American Journal of Health-system Pharmacy
An Organisation with a Memory, Report of an Expert Group on Learning from Adverse Events in the NHS
Building a Safer NHS for Patients: Improving Medication Safety
Developing Professional Knowledge and Competence
The European Qualifications Framework for Lifelong Learning (EQF)
The European Qualifications Framework for Lifelong Learning (EQF) Glossary
Eliminating errors in medication
American Journal of Nursing
Cited by (25)
Nurse education leaders’ perspectives on the teaching of numeracy to undergraduate nursing students: A qualitative research study
2023, Nurse Education in PracticeEffect of blended learning on nursing students’ medication dosage calculation skills
2023, Teaching and Learning in NursingCitation Excerpt :The researchers prepared the course content according to the extant literature (Hutton et al., 2010; Weeks et al., 2013a). Developed in line with the model by Weeks et al. (2013b), the course content aimed to help students acquire three MDC competencies: conceptual competence, calculation competence, and technical measurement competence. For this purpose, the students were initially provided with the concepts regarding the MDC, e.g., ‘ordered/available dose’ referring to SI units.
Undergraduate nursing curricula: Numeracy and accreditation
2021, CollegianEffects of Digital Learning Materials on nursing students’ mathematics learning, self-efficacy, and task value in vocational education
2020, Nurse Education in PracticeCitation Excerpt :Nurses are expected to have an accurate knowledge of how to administer medication, especially the mathematical knowledge needed for the safe calculation of medication dosages (Weeks et al., 2000, Weeks et al., 2013).
Evaluation of Swedish nursing students’ experience of a web-based platform for drug calculation
2019, Nurse Education in Practice