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Meeting the mathematical demands of the safety-critical workplace: medication dosage calculation problem-solving for nursing

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Abstract

This article addresses a key issue for mathematics educators preparing students for work: How should teaching, learning and assessment be designed to meet the mathematical demands of the workplace, especially when those demands are safety-critical? We explore this question through a discussion of our interdisciplinary research on numeracy for nursing, focusing in particular on the characterization and authentic assessment of competence in medication dosage calculation problem-solving, where errors can and do cause patient morbidity and mortality.

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Notes

  1. Adverse drug events (ADEs) are characterized by Bates et al. (1995, p. 29) as “an injury resulting from medical intervention related to a drug”.

  2. Work by the Reference Group towards the establishment of evidence-based criteria for the assessment of numeracy for nursing is summarized more fully in Coben et al. (2008).

  3. http://www.authenticworld.co.uk/

  4. safeMedicate is ©Authentic World Ltd.

References

  • Aleccia, J. (2011, 27 June). Nurse’s suicide highlights twin tragedies of medical errors. NBCNews.com. Retrieved from http://www.nbcnews.com/id/43529641/#.UpDMuBiE5JQ.

  • Bakker, A., & Akkerman, S. F. (2013). A boundary-crossing approach to support students’ integration of statistical and work-related knowledge. Educational Studies in Mathematics. doi:10.1007/s10649-013-9517-z.

  • Bakker, A., Hoyles, C., Kent, P., & Noss, R. (2006). Improving work processes by making the invisible visible. Journal of Education and Work, 19(4), 343–361. doi:10.1080/13639080600867133.

    Article  Google Scholar 

  • Bakker, A., Kent, P., Noss, R., Hoyles, C., & Bhinder, C. (2006). “It’s not just magic!”: Learning opportunities with spreadsheets in the financial sector. British Society for Research into Learning Mathematics Proceedings, 26(1), 17–22.

    Google Scholar 

  • Bates, D. W., Cullen, D. J., Laird, N., Petersen, L. A., Small, S. D., Servi, D., et al. (1995). Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA, 274(1), 29–34.

    Article  Google Scholar 

  • Bernstein, B. (2000). Pedagogy, symbolic control and identity: Theory, research, critique (Revised ed.). Lanham, MD: Rowman & Littlefield.

  • Black, P., & Wiliam, D. (1998). Inside the black box: Raising standards through classroom assessment. Phi Delta Kappan, 80(2), 139–148.

    Google Scholar 

  • Blackwell, A. F., Wilson, L., Street, A., Boulton, C., & Knell, J. (2009). Radical innovation: Crossing knowledge boundaries with interdisciplinary teams (Technical Report Number 760). Cambridge: University of Cambridge.

    Google Scholar 

  • Bonotto, C. (2009). Working towards teaching realistic mathematical modelling and problem posing in Italian classrooms. In L. Verschaffel, B. Greer, W. V. Dooren, & S. Mukhopadhyay (Eds.), Words and worlds: Modelling verbal descriptions of situations (pp. 297–314). Rotterdam, Netherlands: Sense.

    Google Scholar 

  • Brown, J. S., Collins, A., & Duguid, P. (1989). Situated cognition and the culture of learning. Educational Researcher, 18(1), 32–42.

    Article  Google Scholar 

  • Bruner, J. S. (1975). Toward a theory of instruction. Cambridge: Belknap/Harvard.

    Google Scholar 

  • Byrnes, J. P. (1996). Cognitive development and learning in instructional contexts. Boston, MA: Allyn & Bacon.

    Google Scholar 

  • Casey, H., Jupp, T., Grief, S., Hodge, R., Ivanič, R., Lopez, D., et al. (2006). “You wouldn’t expect a maths teacher to teach plastering…” Embedding literacy, language and numeracy in post-16 vocational programmes—the impact on learning and achievement. London: National Research and Development Centre for Adult Literacy and Numeracy (NRDC).

    Google Scholar 

  • Coben, D. (2000). Numeracy, mathematics and adult learning. In I. Gal (Ed.), Adult numeracy development: Theory, research, practice (pp. 33–50). Cresskill, NJ: Hampton Press.

    Google Scholar 

  • Coben, D., Colwell, D., Macrae, S., Boaler, J., Brown, M., & Rhodes, V. (2003). Adult numeracy: Review of research and related literature. London: National Research and Development Centre for Adult Literacy and Numeracy (NRDC).

    Google Scholar 

  • Coben, D., Hall, C., Hutton, B. M., Rowe, D., Sabin, M., Weeks, K., et al. (2008). Numeracy for nursing: The case for a benchmark. In T. Maguire, N. Colleran, O. Gill, & J. O’Donoghue (Eds.), The changing face of adults mathematics education: Learning from the past, planning for the future. Proceedings of ALM-14, the 14th international conference of Adults Learning Mathematics - A Research Forum (ALM) (pp. 88–102). Limerick: University of Limerick in association with ALM.

    Google Scholar 

  • Coben, D., Hall, C., Hutton, M., Rowe, D., Weeks, K., & Woolley, N. (2010). Research report: Benchmark assessment of numeracy for nursing: Medication dosage calculation at point of registration. Edinburgh: NHS Education for Scotland (NES).

    Google Scholar 

  • Coben, D., Hodgen, J., Hutton, B. M., & Ogston-Tuck, S. (2009). High stakes: Assessing numeracy for nursing. Adult Learning, 19(3–4), 38–41. doi:10.1080/14794800903063620.

    Article  Google Scholar 

  • Commission of the European Communities. (2005). Towards a European qualifications framework for lifelong learning (Commission Staff Working Document). Brussels: Commission of the European Communities.

    Google Scholar 

  • Cumming, J. J., & Maxwell, G. S. (1999). Contextualising authentic assessment. Assessment in Education, 6(2), 177–194. doi:10.1080/09695949992865.

    Article  Google Scholar 

  • Daily Mail Reporter. (2011, 23 February). Mother-of-four dies after blundering nurse administers TEN times drug overdose. Daily Mail. Retrieved from http://www.dailymail.co.uk/health/article-1359778/Mother-dies-nurse-administers-TEN-times-prescribed-drug.html.

  • Eastwood, K. J., Boyle, M. J., Williams, B., & Fairhall, R. (2011). Numeracy skills of nursing students. Nurse Education Today, 31(8), 815–818. doi:10.1016/j.nedt.2010.12.014.

    Article  Google Scholar 

  • Eraut, M. (2004). Transfer of knowledge between education and workplace settings. In H. Rainbird, H. Fuller, & H. Munro (Eds.), Workplace learning in context (pp. 201–221). London: Routledge.

    Google Scholar 

  • Evans, J. (2000). The transfer of mathematics learning from school to work, not straightforward but not impossible either. In A. Bessot & J. Ridgway (Eds.), Education for mathematics in the workplace (pp. 5–15). Dordrecht, NL: Kluwer Academic Publishers.

    Google Scholar 

  • Farra, S., Miller, E., Timm, N., & Schafer, J. (2012). Improved training for disasters using 3-D virtual reality simulation. Western Journal of Nursing Research, 35(5), 655–671. doi:10.1177/0193945912471735.

    Article  Google Scholar 

  • FitzSimons, G. E. (2002). What counts as mathematics? Technologies of power in adult and vocational education (Vol. 28, Mathematics Education Library). Dordrecht, NL: Kluwer Academic Publishers.

    Book  Google Scholar 

  • FitzSimons, G. E., & Coben, D. (2009). Adult numeracy for work and life: Curriculum and teaching implications of recent research. In R. Maclean & D. Wilson (Eds.), UNESCO-UNEVOC International handbook of technical and vocational education and training. Bridging academic and vocational education (Vol. 6, pp. 2731–2745). Dordrecht, NL: Springer.

    Google Scholar 

  • FitzSimons, G. E., Mlcek, S., Hull, O., & Wright, C. (2005). Learning numeracy on the job: A case study of chemical handling and spraying. Final report. Adelaide: National Centre for Vocational Education Research. Retrieved from http://www.ncver.edu.au/publications/1609.html.

  • FitzSimons, G. E., & Wedege, T. (2007). Developing numeracy in the workplace. Nordic Studies in Mathematics Education, 12(1), 49–66.

    Google Scholar 

  • Frankenstein, M. (2009). Developing a critical mathematical numeracy through real real-life word problems. In L. Verschaffel, B. Greer, W. V. Dooren, & S. Mukhopadhyay (Eds.), Words and worlds: Modelling verbal descriptions of situations (pp. 111–130). Rotterdam, NL: Sense.

    Google Scholar 

  • Grandell-Niemi, H., Hupli, M., Leino-Kilpi, H., & Puukka, P. (2003). Medication calculation skills of nurses in Finland. Journal of Clinical Nursing, 12(4), 519–528. doi:10.1046/j.1365-2702.2003.00742.x.

    Article  Google Scholar 

  • Gulikers, J. T. J., Bastiaens, T. J., & Kirschner, P. A. (2004). A five-dimensional framework for authentic assessment. Educational Technology Research and Development, 52(3), 67–85. doi:10.1007/BF02504676.

    Article  Google Scholar 

  • Hodgen, J., & Wiliam, D. (2006). Mathematics inside the black box: Assessment for learning in the mathematics classroom. London: nferNelson.

    Google Scholar 

  • Hoogland, K., A. Bakker, De Koning, J., & Gravemeijer, K. (2012). Comparing students’ results on word problems with their results on image-rich numeracy problems. 12th International Congress on Mathematical Education 8 July – 15 July, 2012, COEX, Seoul, Korea. Retrieved from http://igitur-archive.library.uu.nl/math/2013-0308-200845/UUindex.html.

  • Hoyles, C., Noss, R., & Pozzi, S. (2001). Proportional reasoning in nursing practice. Journal for Research in Mathematics Education, 32(1), 4–27.

    Article  Google Scholar 

  • Hoyles, C., Wolf, A., Molyneux-Hodgson, S., & Kent, P. (2002). Mathematical skills in the workplace. Final report to the Science, Technology and Mathematics Council. Foreword and executive summary. London: Institute of Education, University of London; Science, Technology and Mathematics Council.

    Google Scholar 

  • Hutton, B. M. (1997). The acquisition of competency in nursing mathematics. PhD thesis, University of Birmingham, Birmingham.

  • Jukes, L., & Gilchrist, M. (2006). Concerns about numeracy skills of nursing students. Nurse Education in Practice, 6(4), 192–198. doi:10.1016/j.nepr.2005.12.002.

    Article  Google Scholar 

  • Lave, J. (1992). Word problems: A microcosm of theories of learning. In P. Light & G. Butterworth (Eds.), Context and cognition: Ways of learning and knowing (pp. 74–92). Hemel Hempstead: Harvester Wheatsheaf.

    Google Scholar 

  • Lum, G. (2009). Vocational and professional capability: An epistemological and ontological study of occupational expertise. London: Continuum International Publishing Group.

    Google Scholar 

  • Macdonald, K., Weeks, K. W., & Moseley, L. (2013). 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. doi:10.1016/j.nepr.2012.10.015.

    Article  Google Scholar 

  • Morgan, C. (2003). Criteria for authentic assessment of mathematics: Understanding success, failure and inequality. Quadrante, 12(1), 37–51.

    Google Scholar 

  • Mueller, J. (2005). The authentic assessment toolbox: Enhancing student learning through online faculty development. Journal of Online Teaching and Learning, 1(1), 1–7.

    Google Scholar 

  • NMC. (2010a). Final: Standards for Pre-registration nursing education – Annexe 3. Essential skills clusters (2010) and guidance for their use (guidance G7.1.5b). London: Nursing and Midwifery Council.

    Google Scholar 

  • NMC. (2010b). Advice and supporting information for implementing NMC standards for pre-registration nursing education. London: Nursing and Midwifery Council.

    Google Scholar 

  • Noss, R., Hoyles, C., & Pozzi, S. (2000). Working knowledge: Mathematics in use. In A. Bessot & J. Ridgway (Eds.), Education for mathematics in the workplace (pp. 17–35). Dordrecht, NL: Kluwer.

    Google Scholar 

  • OECD. (2005). The definition and selection of key competencies. Paris: Organisation for Economic Cooperation and Development.

    Google Scholar 

  • Rainboth, L., & DeMasi, C. (2006). Nursing students’ mathematic calculation skills. Nurse Education Today, 26(8), 655–661. doi:10.1016/j.nedt.2006.07.022.

    Article  Google Scholar 

  • Sabin, M. (2001). Competence in practice­based calculation: Issues for nursing education. A critical review of the literature. Occasional paper 3. London: Learning and Teaching Support Network (LTSN) Centre for Health Sciences and Practice.

    Google Scholar 

  • Sabin, M., Weeks, K. W., Rowe, D., Hutton, B. M., Coben, D., Hall, C., et al. (2013). 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. doi:10.1016/j.nepr.2012.10.009.

    Article  Google Scholar 

  • Slaven, G. (1995). Competence frameworks in safety critical industries. Executive Development, 8(6), 21–22. doi:10.1108/09533239510095501.

    Article  Google Scholar 

  • Spelt, E. J. H., Biemans, H. J. A., Tobi, H., Luning, P. A., & Mulder, M. (2009). Teaching and learning in interdisciplinary higher education: A systematic review. Educational Psychological Review, 21, 365–378. doi:10.1007/s10648-009-9113-z.

    Article  Google Scholar 

  • Steen, L. A. (2004). Data, shapes, symbols: Achieving balance in school mathematics. In B. Madison & L. A. Steen (Eds.), Quantitative literacy: Why numeracy matters for schools and colleges (pp. 53–74). Washington, DC: Mathematical Association of America.

    Google Scholar 

  • Todd, P. M., & Gigerenzer, G. (2000). Précis of simple heuristics that make us smart. Behavioral and Brain Sciences, 23, 727–741.

    Article  Google Scholar 

  • Verschaffel, L., Greer, B., & De Corte, E. (2000). Making sense of word problems. Lisse, NL: Swets & Zeitlinger Publishers.

    Google Scholar 

  • Wake, G. D., & Williams, J. S. (2001). Using college mathematics in understanding workplace practice: Summative report of the research project funded by the Leverhulme Trust. Manchester: University of Manchester.

    Google Scholar 

  • Weeks, K. W. (2001). Setting a foundation for the development of medication dosage calculation problem solving skills among novice nursing students. The role of constructivist learning approaches and a computer based’Authentic World’ learning environment. Doctoral thesis, University of Glamorgan, Pontypridd, Wales.

  • Weeks, K. W., Higginson, R., Clochesy, J. M., & Coben, D. (2013). 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. doi:10.1016/j.nepr.2012.10.014.

    Article  Google Scholar 

  • Weeks, K. W., Hutton, B. M., Coben, D., Clochesy, J. M., & Pontin, D. (2013a). Safety in numbers 2: Competency modelling and diagnostic error assessment in medication dosage calculation problem-solving. Nurse Education in Practice. doi:10.1016/j.nepr.2012.10.013.

    Article  Google Scholar 

  • Weeks, K. W., Hutton, B. M., Coben, D., Clochesy, J. M., & Pontin, D. (2013b). Safety in numbers 3: Authenticity, building knowledge and skills and competency development and assessment: The ABC of safe medication dosage calculation problem-solving pedagogy. Nurse Education in Practice. doi:10.1016/j.nepr.2012.10.011.

    Article  Google Scholar 

  • Weeks, K. W., Lyne, P., Moseley, L., & Torrance, C. (2001). 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, 5, 18–25.

    Article  Google Scholar 

  • Weeks, K. W., Lyne, P., & Torrance, C. (2000). Written drug dosage errors made by students: The threat to clinical effectiveness and the need for a new approach. Clinical Effectiveness in Nursing, 4, 20–29. doi:10.1054/cein.2000.0101.

    Article  Google Scholar 

  • Weeks, K. W., Sabin, M., Pontin, D., & Woolley, N. (2013). Safety in numbers: An introduction to the nurse education in practice series. Nurse Education in Practice. doi:10.1016/j.nepr.2012.06.006.

    Article  Google Scholar 

  • Wiggins, G. (2011). A true test: Toward more authentic and equitable assessment. Kappan Classic. KAPPAN digital edition exclusive, 92(7), 81–93. (Originally published as: Wiggins, G. (1989). A true test: Toward more authentic and equitable assessment. Phi Delta Kappan, 70(9), 703–713).

    Article  Google Scholar 

  • Wiliam, D. (2006). Does assessment hinder learning? Retrieved from http://www.uk.etseurope.org/home-corpo-uk/news-home/?print=1&news=136&view=detail&no_cache=1

  • Williams, J. S., & Wake, G. D. (2007). Black boxes in workplace mathematics. Educational Studies in Mathematics, 64(3), 317–343. doi:10.1007/s10649-006-9039-z.

    Article  Google Scholar 

  • Wright, K. (2010). Do calculation errors by nurses cause medication errors in clinical practice? A literature review. Nurse Education Today, 30(1), 85–97. doi:10.1016/j.nedt.2009.06.009.

    Article  Google Scholar 

  • Wright, M., Turner, D., & Horbury, C. (2003). Competence assessment for the hazardous industries. London: Health and Safety Executive.

    Google Scholar 

  • Young, S., Weeks, K. W., & Hutton, B. M. (2013). Safety in numbers 1: Essential numerical and scientific principles underpinning medication dosage calculation. Nurse Education in Practice. doi:10.1016/j.nepr.2012.10.012.

    Article  Google Scholar 

  • Zevenbergen, R., & Zevenbergen, K. (2009). The numeracies of boatbuilding: New numeracies shaped by workplace technologies. International Journal of Science and Mathematics Education, 7(1), 183–206. doi:10.1007/s10763-007-9104-9.

    Article  Google Scholar 

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  1. University of Waikato, Hamilton, New Zealand

    Diana Coben

  2. University of South Wales, Treforest, UK

    Keith Weeks

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  1. Diana Coben
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Coben, D., Weeks, K. Meeting the mathematical demands of the safety-critical workplace: medication dosage calculation problem-solving for nursing. Educ Stud Math 86, 253–270 (2014). https://doi.org/10.1007/s10649-014-9537-3

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