Written drug dosage errors made by students: The threat to clinical effectiveness and the need for a new approach

Abstract

This paper forms part of a series concerned with the establishment of the mathematical competence necessary for the safe calculation of medication dosages and hence for safe and clinically effective nursing practice. It describes the preliminary work that led up to the development of a new computer based constructivist approach to teaching medication dosage calculation problem solving skills. This arose from observations of the errors committed by novice nursing students in a large UK School of Nursing during written assessments of dosage calculation ability. The paper begins by describing the nature of conceptions which underlie the computation errors observed during initial student selection and early studies at the school. Examples of arithmetic and miscomputation errors are documented. The nature of these errors revealed the need for a new approach to initial numeracy assessment and teaching of computation skills. This was further borne out by analysis of conceptual errors, which contested the usefulness of the existing teaching approach based on didactic methods and abstract word problems. The paper concludes by introducing the constructivist view which informed the development of new computer based learning materials. The nature of these materials and their evaluation in the college and clinical settings are described in the subsequent papers. © 2000 Harcourt Publishers Ltd.