Nursing students' confidence in medication calculations predicts math exam performance

Relationship between digital capabilities and academic performance: the mediating effect of self-efficacy

AIMS

To assess digital capabilities and academic performance among nursing students and investigate the mediating role of students' self-efficacy.

BACKGROUND

In the context of education and technology, digital capabilities, self-efficacy, and academic performance among nursing students are interconnected concepts. Students who use their digital capabilities and competencies combined with their belief in the ability to efficiently perform learning tasks could improve their academic endeavors. Nevertheless, insufficient consideration has been placed on research understanding of the mediating roles and broad elements that influence their relationships.

METHODS

A cross-sectional, correlational, descriptive, and quantitative study was established. During the 2022-23 academic year, data were gathered from 200 students. The Hayes Process Model 4 macro was employed to investigate the role of students' self-efficacy mediating effect on the association between digital capabilities and academic performance.

RESULTS

The digital capability level and self-efficacy level were high. Additionally, the academic performance level was moderate. The mediation analysis revealed that the direct effect of digital capabilities on student performance in the presence of the mediator was significant (b = 0.0063, p = 0.022). Hence, self-efficacy partially mediated the relationship between digital capabilities and student performance.

CONCLUSION

The study emphasized the importance of improving students' digital capabilities that enhance their confidence and self-actualization. In addition, nursing students are encouraged to improve their sense of self-efficacy throughout their tenure in college because it is a predictor of future success.

Adaptation Process of the Mathematic Self-Efficacy Survey (MSES) Scale to Mexican-Spanish Language

Trained professionals in science, technology, engineering, and mathematics (STEM) are needed for a robust, science-based economy that incorporates various technologies’ design, construction, and commercialization to address societal problems. However, keeping students interested in STEM subjects and achieving optimal performance is a challenging task. Math self-efficacy has shown to be one of the most important factors affecting students’ interest in STEM majors and assessing this factor has been a great challenge for education researchers around the world due to the lack of calibrated and culturally adapted instruments. Observing this need, this seminal study conducted psychometric validation tests and cultural adaptations to the Mathematic Self-Efficacy Survey (MSES) aiming to measure this instrument in Spanish-speaking students in different STEM areas in Mexico. Data collected from 877 students were tested for validity using sequential exploratory factor analyses, and contextual modifications were performed and analyzed aiming to achieve cultural equivalency. Suggestions for continuing the adaptation and validation process of the MSES to Spanish language and STEM students’ context are presented with the results of the exploratory factor analyses.

First year undergraduate nursing students' perceptions of the effectiveness of blended learning approaches for nursing numeracy

The ability to safely calculate and administer medications are indispensable, core nursing skills in nursing education and practice. Therefore, it is imperative that nursing students are adequately prepared with the necessary numeracy skills during their undergraduate nursing studies. The focus of this study, conducted at a single multi-campus university in the western Sydney region of Australia, was to determine the effectiveness of a suite of blended learning approaches on numeracy self-efficacy from the students' perspective. Surveys were administered as part of the study and included open-ended questions. 525 students provided open-ended responses that were analysed by the research team. Four main themes were identified from the open-ended responses: (i) Self-realisation; (ii) Practice, practice, practice; (iii) Boosting confidence; and (iv) Wanting more. The themes captured students' perceptions of the benefits of having a rigorous learning design in blended learning approaches. The study showed that a structured pedagogical approach to nursing numeracy in undergraduate programs improved students' self-reported self-efficacy with mathematics and assisted students in realising the importance of learning and applying these skills as nursing clinicians.

Medication error encouragement training: A quasi-experimental study

BACKGROUND

Medication errors are the most common clinical errors in healthcare practice and can lead to serious consequences. Medication error encouragement training (MEET) brings students face-to-face with potential errors in the medication process, in a safe environment where they are encouraged to understand both the error and the context in which it occurred.

OBJECTIVES

The study aimed to examine the effects of a MEET intervention on medication safety confidence among nursing undergraduates.

DESIGN

This was a quasi-experimental study with a nonequivalent control group design.

PARTICIPANTS

Our sample was recruited from the nursing education department of a university, with 47 participants randomly assigned to the experimental group, and 50 to the control group.

METHODS

Both groups received theoretical training, followed by applied training. The experimental group received the MEET intervention developed specifically for this study, while the control group received traditional error avoidance training. Participants' medication administration confidence was measured pre- and post-intervention.

RESULTS

Following training, the experimental group's confidence was significantly higher than that of the control group. With regard to individual medication administration procedures, the experimental groups' medication safety confidence increased significantly after training compared to the control group in patient identification, drug information confirmation, and drug preparation.

CONCLUSIONS

Introducing MEET into nursing curricula could reduce medication errors and related complications in healthcare institutions. Further studies are needed to investigate the long-term effects of MEET interventions, as well as the generalizability of our findings.

Determination of Senior Nursing Students' Mathematical Perception Skills and Pediatric Medication Calculation Performance

Aim

Math skills in the health field are often used to calculate drug dosage and liquid quantity, body mass and cost analysis. The aim of this research is to determine the senior nursing students' mathematical perception skills and pediatric medication calculation performance.

Method

The population of this descriptive cross-sectional research is composed of 103 nursing students in attending a state university in Izmir, Turkey. Of the 103 nursing students, 97 who answered all the questions comprised the study sample. All the participants took one-month training in the pediatric clinics during the last year of their education. The data were collected using the "Personal Information Form and Mathematics Perception, Information and Pediatric Drug Calculator Skills Survey" developed by the researchers by reviewing the literature.

Results

The mean age of the study participants was 22.24±0.89. Of them, 76.3% were female, 23.7% completed their Pediatric Internship Training in the pediatric inpatient units or the Pediatric Intensive Care Unit (PICU), 68% thought that their basic mathematics knowledge was adequate, and %30 stated that their dosage calculation, solution preparation and drug preparation skills were insufficient. In addition, the rate of the correct answers they gave to the questions on percentages, fractions and conversions was low.

Conclusion

In the drug application process; not only practical skills, but also the theoretical knowledge should be considered. A nurse's responsibility does not end once he/she administers medication. Being careful throughout the entire process is one of the nurse's legal and ethical responsibilities. In this study, the students' drug calculation skills were inadequate.

Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior

BACKGROUND

Medication errors are common among nursing students. Nonetheless, these errors are often underreported.

OBJECTIVES

To examine factors related to nursing students' intention to report medication errors, using the Theory of Planned Behavior, and to examine whether the theory is useful in predicting students' intention to report errors.

DESIGN

This study has a descriptive cross-sectional design.

SETTINGS

Study population was recruited in a university and a large nursing school in central and northern Israel.

PARTICIPANTS

A convenience sample of 250 nursing students took part in the study.

METHODS

The students completed a self-report questionnaire, based on the Theory of Planned Behavior.

RESULTS

The findings indicate that students' intention to report medication errors was high. The Theory of Planned Behavior constructs explained 38% of variance in students' intention to report medication errors. The constructs of behavioral beliefs, subjective norms, and perceived behavioral control were found as affecting this intention, while the most significant factor was behavioral beliefs. The findings also reveal that students' fear of the reaction to disclosure of the error from superiors and colleagues may impede them from reporting the error.

CONCLUSIONS

Understanding factors related to reporting medication errors is crucial to designing interventions that foster error reporting.

Increasing nursing students' understanding and accuracy with medical dose calculations: A collaborative approach

BACKGROUND

Accurate calculation of medication dosages can be challenging for nursing students. Specific interventions related to types of errors made by nursing students may improve the learning of this important skill.

OBJECTIVE

The objective of this study was to determine areas of challenge for students in performing medication dosage calculations in order to design interventions to improve this skill.

DESIGN

Strengths and weaknesses in the teaching and learning of medication dosage calculations were assessed. These data were used to create online interventions which were then measured for the impact on student ability to perform medication dosage calculations.

SETTING

The setting of the study is one university in Canada.

PARTICIPANTS

The qualitative research participants were 8 nursing students from years 1-3 and 8 faculty members. Quantitative results are based on test data from the same second year clinical course during the academic years 2012 and 2013.

METHODS

Students and faculty participated in one-to-one interviews; responses were recorded and coded for themes. Tests were implemented and scored, then data were assessed to classify the types and number of errors.

RESULTS

Students identified conceptual understanding deficits, anxiety, low self-efficacy, and numeracy skills as primary challenges in medication dosage calculations. Faculty identified long division as a particular content challenge, and a lack of online resources for students to practice calculations. Lessons and online resources designed as an intervention to target mathematical and concepts and skills led to improved results and increases in overall pass rates for second year students for medication dosage calculation tests.

CONCLUSION

This study suggests that with concerted effort and a multi-modal approach to supporting nursing students, their abilities to calculate dosages can be improved. The positive results in this study also point to the promise of cross-discipline collaborations between nursing and education.

Performance of Clinical Nurse Educators in Teaching Pharmacology and Medication Management: Nursing Students' Perceptions

Background

Pharmacological knowledge and medication management skills of student nurses greatly depend on the clinical nurse educators’ performance in this critical issue. However, the Iranian nurse educators’ performance in teaching pharmacology and medication management are not adequately studied.

Objectives

The current study aimed to investigate the nursing students’ perceptions on the status of clinical pharmaceutical and medication management education.

Materials and Methods

A cross-sectional study was conducted on all 152 nursing students registered in the seventh and eighth semesters at the Qom and Naragh branches of Islamic Azad University, and Kashan University of Medical Sciences in 2013 - 2014 academic year. The students’ perceptions on the performance of clinical nurse educators in teaching pharmacology and medication management were assessed using a researcher made questionnaire. The questionnaire consisted of 31 items regarding clinical educators’ performance in teaching pharmacology and medication management and two questions about students’ satisfaction with their level of knowledge and skills in pharmacology and medication management. Descriptive statistics was employed and analysis of variance was performed to compare the mean of scores of teaching pharmacology and medication management in the three universities.

Results

Among a total of 152 subjects, 82.9% were female and their mean age was 22.57 ± 1.55 years. According to the students, instructors had the weakest performance in the three items of teaching pharmacology and medication management based on the students’ learning needs, teaching medication management through a patient-centered method and teaching pharmacology and medication management based on the course plan. The students’ satisfaction regarding their own knowledge and skill of pharmacology and medication management was at medium level.

Conclusions

Nursing students gave a relatively low score in several aspects of their instructors’ performance regarding teaching pharmacology and medication management. It seems that many clinical nurse educators in the studied settings were incompetent especially in teaching pharmacology and medication management, while these are critical areas and need special attention.

Relationship between High School Mathematics Grade and Number of Attempts Required to Pass the Medication Calculation Test in Nurse Education: An Explorative Study

In Norwegian nurse education, students are required to achieve a perfect score in a medication calculation test before undertaking their first practice period during the second semester. Passing the test is a challenge, and students often require several attempts. Adverse events in medication administration can be related to poor mathematical skills. The purpose of this study was to explore the relationship between high school mathematics grade and the number of attempts required to pass the medication calculation test in nurse education. The study used an exploratory design. The participants were 90 students enrolled in a bachelor’s nursing program. They completed a self-report questionnaire, and statistical analysis was performed. The results provided no basis for the conclusion that a statistical relationship existed between high school mathematics grade and number of attempts required to pass the medication calculation test. Regardless of their grades in mathematics, 43% of the students passed the medication calculation test on the first attempt. All of the students who had achieved grade 5 had passed by the third attempt. High grades in mathematics were not crucial to passing the medication calculation test. Nonetheless, the grade may be important in ensuring a pass within fewer attempts.

Educational strategies aimed at improving student nurse's medication calculation skills: a review of the research literature

Medication administration is an important and essential nursing function with the potential for dangerous consequences if errors occur. Not only must nurses understand the use and outcomes of administering medications they must be able to calculate correct dosages. Medication administration and dosage calculation education occurs across the undergraduate program for student nurses. Research highlights inconsistencies in the approaches used by academics to enhance the student nurse's medication calculation abilities. The aim of this integrative review was to examine the literature available on effective education strategies for undergraduate student nurses on medication dosage calculations. A literature search of five health care databases: Sciencedirect, Cinahl, Pubmed, Proquest, Medline to identify journal articles between 1990 and 2012 was conducted. Research articles on medication calculation educational strategies were considered for inclusion in this review. The search yielded 266 papers of which 20 meet the inclusion criteria. A total of 5206 student nurse were included in the final review. The review revealed educational strategies fell into four types of strategies; traditional pedagogy, technology, psychomotor skills and blended learning. The results suggested student nurses showed some benefit from the different strategies; however more improvements could be made. More rigorous research into this area is needed.

Identifying strategies to assist final semester nursing students to develop numeracy skills: a mixed methods study

BACKGROUND

It remains a grave concern that many nursing students within tertiary institutions continue to experience difficulties with achieving medication calculation competency. In addition, universities have a moral responsibility to prepare proficient clinicians for graduate practice. This requires risk management strategies to reduce adverse medication errors post registration.

AIM

To identify strategies and potential predictors that may assist nurse academics to tailor their drug calculation teaching and assessment methods. This project builds on previous experience and explores students' perceptions of newly implemented interventions designed to increase confidence and competence in medication calculation.

METHODS

This mixed method study surveyed students (n=405) enrolled in their final semester of study at a large, metropolitan university in Sydney, Australia. Tailored, contextualised interventions included online practice quizzes, simulated medication calculation scenarios developed for clinical practice classes, contextualised 'pen and paper' tests, visually enhanced didactic remediation and 'hands-on' contextualised workshops. Surveys were administered to students to determine their perceptions of interventions and to identify whether these interventions assisted with calculation competence. Test scores were analysed using SPSS v. 20 for correlations between students' perceptions and actual performance. Qualitative open-ended survey questions were analysed manually and thematically.

RESULTS

The study reinforced that nursing students preferred a 'hands-on,' contextualised approach to learning that was 'authentic' and aligned with clinical practice. Our interventions assisted with supporting students' learning and improvement of calculation confidence. Qualitative data provided further insight into students' awareness of their calculation errors and preferred learning styles. Some of the strongest predictors for numeracy skill performance included (1) being an international student, (2) completion of an online practice quiz, scoring 59% or above and (3) students' self-reported confidence.

CONCLUSION

A paradigm shift from traditional testing methods to the implementation of intensive, contextualised numeracy teaching and assessment within tertiary institutions will enhance learning and promote best teaching practices.

Using simulation to improve the medication administration skills of undergraduate nursing students

AIM

This quasi-experimental pilot study examined simulation methods to improve nursing students' medication calculation and administration abilities.

BACKGROUND

Approximately 25 percent of junior-level students in the nursing program who took a medication administration exam (MAE) failed in their first attempt. It was theorized that simulation could facilitate their success.

METHOD

Students in the control group (n = 79) attended a didactic medication administration review session; students in the intervention group (n = 79) participated in a medication administration simulation review session. All students took the MAE within a week of their review.

RESULTS

The intervention group scored significantly higher (M = 95 percent, SD = 6.8) on the MAE than the control group (M = 90 percent, SD = 12.9) at the p = .004 level.

CONCLUSION

The simulation facilitated student success by giving students a state-of-the-art contextual reference to apply when taking the MAE.

Constructivist philosophy and nursing student medication calculations

Prelicensure nursing students often have difficulty performing medication calculations (MCs). Faculty at one baccalaureate nursing program wanted to use nursing theory to guide the development of a teaching-learning approach related to MC's. Finding little theory related to the topic of MCs, a constructivist-based teaching-learning approach was used instead. The purpose of the study was to assess whether nursing students who received an MC review class that used a teaching-learning approach based on constructivist philosophy had better results on an MC examination than students who received their review via traditional teaching-learning methods. The study participants consisted of two cohorts of first-semester junior-level nursing students from one university-based school of nursing in the Midwestern United States. The results indicated that students in the simulation review class had higher mean scores on an MC examination than students who received their review via more traditional means. Teaching-learning strategies related to MCs based on constructivist philosophy have the potential to improve student learning outcomes, but more research is needed before middle-range theory related to this critically important area of nursing education can be developed.

Enhancing student nurses' medication calculation knowledge; integrating theoretical knowledge into practice

BACKGROUND

Accurate calculation of dosages and safe administration of medications in clinical practice is an essential skill for the registered nurse. Appropriate educational preparation of student nurses is the key to ensuring they become safe practitioners in the workforce. A review of the literature on different approaches for teaching and assessing medication calculation with student nurses revealed three main factors that influenced student nurses' ability to calculate medications accurately and identify mistakes. These factors include mathematical ability, particularly around multiplying with decimals, understanding medication formulas, and conceptualising medication dose.

OBJECTIVES

This study evaluated teaching interventions that focused on improving the students' understanding of mathematical calculations, medication formulas and conceptualising medication doses.

DESIGN

Evaluation study with teaching interventions and Time 1 and Time 2 medication tests.

PARTICIPANTS

156, 2nd year Bachelor of Nursing students from an Australian University.

METHOD

The teaching interventions over 8 weeks included teaching decimals and basic mathematical skills, using the correct mathematical formula for the medication and linking the medication to the patient case study. Time 1 and Time 2 medication tests out of ten, student demographics and reasons for attending tutorials were collected to evaluate the effectiveness of the teaching interventions.

RESULTS

For Time 1 medication test pre interventions, the mean was 7.3 with a mode of 8 out of ten. Maths and incorrect medication formula were the most common mistake. For Time 2 medication test post interventions, the mean was 9.3 with a mode of 10. The most common reason for incorrect answer Time 2 was incorrect medication formula. The students identified that the smaller tutorial sizes and remediation of errors was the main reason for continued attendance.

CONCLUSIONS

The teaching intervention improved the accuracy of students' medication calculation, specifically, understanding the correct formula to use and identifying errors of calculation.

Factors influencing nursing students' academic and clinical performance and attrition: an integrative literature review

Predicted workforce shortages have resulted in government initiatives to increase student numbers in preregistration nursing education. In tandem schools of nursing need to ensure students' progress and complete. The aim of this review was to identify factors that influence preregistration nursing students' academic performance, clinical performance and attrition. An integrative review of both quantitative and qualitative literature was conducted using validated appraisal checklists. The review included studies published from 1999 to 2011 in the databases: MEDLINE, CINAHL, Proquest nursing, Proquest Education (via Proquest 5000), ERIC, Journals@Ovid, PsychINFO and ScienceDirect. Studies were categorised according to their impact on academic progression, clinical progression and attrition. Forty four studies were found; most used quantitative methodologies. The review identified that few studies explored factors that impact on students' clinical performance. The four categories that potentially impact on nursing students' academic performance and attrition were: demographic, academic, cognitive and personality/behavioural factors. The challenge for universities committed to students' success is to develop strategies aimed at addressing these factors that are appropriate to specific contexts and student cohorts.

Nurse students' medication competence--an integrative review of the associated factors

AIM

The aim of this review was to identify factors associated with nurse students' medication competence.

BACKGROUND

Registered nurses play an important role in safe and effective medication management. Previous nursing literature has highlighted deficiencies in nurse students' medication competence, yet little is known about specific factors which are associated with their medication competence.

METHOD

Integrative literature review.

RESULTS

Nineteen articles met the selection criteria for this review. The main competence area the reviewed articles focused on was medication calculation skills of nurse students. However, a total of twelve factors were identified to be associated with nurse students' medication competence. They constitute three main categories: factors associated with individual nurse students' particular circumstances, the clinical learning environment, and the educational institution. Individual factors such as students' attitudes towards mathematics and their self-confidence seem to be associated most strongly with medication competence.

CONCLUSION

First, based on this review, the focus in medication competence research has been strongly on nurse students' medication calculation skills. Therefore, in future research and practice, attention needs to be paid to other competency areas as well, such as medication administration and patient medication education skills. Second, overall, only a limited amount of research exists that explores what factors are associated with medication competence.

Math anxiety, self-efficacy, and ability in British undergraduate nursing students

Nurses need to be able to make drug calculations competently. In this study, involving 229 second year British nursing students, we explored the influence of mathematics anxiety, self-efficacy, and numerical ability on drug calculation ability and determined which factors would best predict this skill. Strong significant relationships (p < .001) existed between anxiety, self-efficacy, and ability. Students who failed the numerical and/or drug calculation ability tests were more anxious (p < .001) and less confident (p ≤ .002) in performing calculations than those who passed. Numerical ability made the strongest unique contribution in predicting drug calculation ability (beta = 0.50, p < .001) followed by drug calculation self-efficacy (beta = 0.16, p = .04). Early testing is recommended for basic numerical skills. Faculty are advised to refresh students' numerical skills before introducing drug calculations.

Effectiveness of a computer based medication calculation education and testing programme for nurses

The aim of the study was to evaluate the effect of an on-line, medication calculation education and testing programme. The outcome measures were medication calculation proficiency and self efficacy. This quasi-experimental study involved the administration of questionnaires before and after nurses completed annual medication calculation testing. The study was conducted in two hospitals in south-east Queensland, Australia, which provide a variety of clinical services including obstetrics, paediatrics, ambulatory, mental health, acute and critical care and community services. Participants were registered nurses (RNs) and enrolled nurses with a medication endorsement (EN(Med)) working as clinicians (n=107). Data pertaining to success rate, number of test attempts, self-efficacy, medication calculation error rates and nurses' satisfaction with the programme were collected. Medication calculation scores at first test attempt showed improvement following one year of access to the programme. Two of the self-efficacy subscales improved over time and nurses reported satisfaction with the online programme. Results of this study may facilitate the continuation and expansion of medication calculation and administration education to improve nursing knowledge, inform practise and directly improve patient safety.

Contextualism adds realism: nursing students' perceptions of and performance in numeracy skills tests

This project investigated nursing students' perceptions of and performance in a de-contextualised diagnostic maths paper (i.e. questions only) and a contextualised diagnostic maths paper (i.e. visual pictures along with questions). Sampling was purposive, the criteria being that participants would be from the population of student nurses (n=700) in their second year, of a three-year Bachelor of Nursing course, undertaking a Unit 'Medical-Surgical Nursing 1' (MSN1) at one of four campuses across the University of Western Sydney (UWS), NSW, Australia. The numerical test scores for both papers were analysed with the assistance of SPSS software and a Professional Development Officer. The survey data were analysed manually and thematically by the researcher. There was a substantive improvement in scores from Test 1 (de-contextualised) to Test 2 (contextualised). It is uncertain whether the change occurred because Test 2 is a genuinely better presentation than Test 1 or just a practice effect. Nevertheless, the contextualised paper was preferred by the majority of students (80%). Students preferred the visual images and revealed that it led to a "deeper learning" of numeracy skills, reduced stress and anxiety levels and simulated 'the real life' clinical setting, thus adding "an element of realism" to the situation.

Nursing students' pharmacological knowledge and calculation skills: ready for practice?

OBJECTIVES

To evaluate graduating students' pharmacological knowledge and calculation skills and describe their self-rated readiness to safe medication care in practice on two nurse educational levels. Additionally, the study describes some characteristics of pharmacology in nurse education in Flanders, Belgium.

METHODS

Thirty-eight nursing schools (bachelor's degree in nursing [N=18] and diploma in nursing [N=20]) were asked to provide details on their pharmacology curriculum and to let their graduating students participate in a cross-sectional survey using the Medication Knowledge and Calculation test in February/March 2009.

RESULTS

The 29 participating schools showed a large diversity in pharmacology curricula. Mean scores on the pharmacology section and calculation section were 55% and 66%, respectively, for bachelor's degree and 52% and 53% for diploma students. On a scale of 1-10, 27% had a self-rated readiness perception≤5. Results differed significantly between schools.

CONCLUSIONS

Just before graduation, nursing students' pharmacological knowledge and calculation skills are limited. Apart from the test results, students did not perceive themselves able to deliver safe medication care in practice. Schools need to address the shortcomings. In practice, awareness is needed regarding possible limitations of the newly graduated.

Value of Web-based learning activities for nursing students who speak English as a second language

There is an increasing need to address the educational needs of students with English as a second language. The authors assessed the value of a Web-based activity to meet the needs of students with English as a second language in a bioscience subject. Using telephone contact, we interviewed 21 Chinese students, 24 non-Chinese students with English as a second language, and 7 native English-speaking students to identify the perception of the value of the intervention. Four themes emerged from the qualitative data: (1) Language is a barrier to achievement and affects self-confidence; (2) Enhancement intervention promoted autonomous learning; (3) Focusing on the spoken word increases interaction capacity and self-confidence; (4) Assessment and examination drive receptivity and sense of importance. Targeted strategies to promote language acculturation and acquisition are valued by students. Linking language acquisition skills to assessment tasks is likely to leverage improvements in competence.