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

  • Keith Weeks

    Student thesis: Doctoral Thesis


    Objective: This study analysed the problems encountered by novice nursing students during the process of learning medication dosage calculation skills via didactic transmission methods and 'word problems'. Subsequently constructivist approaches were applied to the design and development of a computer-based 'Authentic World' learning environment. The relationship between exposure to these two teaching methods and the learning of dosage calculation skills, was evaluated in both college- and clinical-based environments.

    Participants and Setting : 44 novice nursing students following a pre-registration HE Diploma in Nursing Studies programme, within a large UK school of nursing.

    Design : During the college based phase of the investigation, two groups of 22 participants were exposed to a 'cross-over' experimental approach, involving:

    a) tuition via transmission and 'Authentic World' methods, followed by a written dosage calculation assessment.

    b) cross-over to the alternative treatment, followed by a written dosage calculation assessment.

    During the clinical-based phase of the investigation, a nine participant sub-sample were assessed during dosage calculation situations within child, adult and mental health care settings. A thematic analysis of post-assessment interviews was performed to identify participants' perceptions of the efficacy of the teaching strategies in assisting to bridge the theory-practice divide.

    Findings : Evaluations of participants' performance during written assessments revealed three error types: conceptual, arithmetical operation and computation errors. Findings indicated that exposure to the 'Authentic World' environment, assisted participants to develop accurate schema for understanding dosage problems and eliminated all conceptual errors. Development of schema for arithmetical operation and computation skills took a more protracted period of time. On completion of the college-based phase 80% of participants scored 100% on the written assessment, and performance on the written assessments proved to be predictive of dosage calculation performance in clinical practice.

    Conclusions: These results suggest that exposure to constructivist approaches assist novice nursing students to both develop requisite schema and understanding of medication dosage problems, and to bridge the theory-practice divide in this area of practice. Development of schema for arithmetical
    operation and computation methods requires a more protracted time period for assimilation and accommodation to occur.

    Implications for practice : The predictive nature of this education process assists learners scoring 100% on written assessments to enter clinical practice as advanced beginners in this domain; and enables early mobilisation of college support mechanisms to assist learners who manifest arithmetical operation and computation errors, to develop accurate schema for these skills.

    Date of AwardMay 2001
    Original languageEnglish

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