METI eDose Calculate with Confidence

1. METI eDoseCalculate with Confidence Judy Johnson-Russell Ed.D., RN METI Clinical Educator jjohnsonrussell@meti.com

3. The Problem

4. Types of Medication Error

6. Skills required to safely & accurately calculate medication dosages

7. Medication dosage calculations are dependent on the understanding of the two key elements of arithmetic Problem Solving: Understanding the elements and logic of a problem (medication orders and the measurement and delivery devices) and combined into a meaningful whole Computations: Addition, subtraction, multiplication and division of integers, decimals and fractions

13. Pedagogical Design Frameworks for Teaching, Learning and Assessment in Simulated Environments

14. Central Tenets of ConstructivismFundamental Assumptions: Constructivism proposes that understanding is actively built by the individual rather than being built up from received pieces of knowledge (von Glaserfeld 1989, Ernest 1997) As a learning theory it describes understanding as the building of mental structures (called schema), and the restructuring of existing mental structures to accommodate new experiences eDose environments actively engage individuals in the construction and diagnostic assessment of their learning

15. Central Tenets of Constructivism:Schema Construction Constructivism suggests that experience is organized in schemata (a schema is a unit of organized information). These are active mental models, that can both �modify� and be �modified by� experience. This process is based upon the learner experiencing �disequilibrium�, that is when an experience fails to fit the existing knowledge system. Piaget recognized two fundamental cognitive processes that work in a reciprocal fashion. -Accommodation: the construction of a new cognitive structure to incorporate the new information. -Assimilation: a process of incorporating new information into an already existing cognitive structure. eDose environments facilitate ACCOMMODATION (via not assuming any prior knowledge), and ASSIMILATION (via facilitating the deconstruction of currently flawed schema and the incorporation of new knowledge into a modified schema)

17. THE SOLUTION

19. Pre-Registration Medication Dosage Calculation Diagnostic Assessment Programme

20. Facilitating Competency in Nursing Numeracy:A shift from abstract to authentic learning environments�

21. What is Competence in Nursing Numeracy? . .

22. Authenticity: A fundamental shift in thinking and in the design of learning and assessment environments�

23. Three-Phase Orientation

24. Selecting the Administration Vehicle

25. Measuring the Required Dose ..

26. Easy to Administer

27. Well Structured & Diagnostic Rubric

28. Easy to Administer

31. Report Interpretation

33. Initial Student Orientation Facilitated 'walk through' of the process for accessing eDose new user registration key program features navigation principles interpretation of user performance undertaking assessments (including schedules) Delivered to the entire cohort or to smaller groups within a lecture / classroom setting An interactive 'hand's on' version of the above, within a computer teaching laboratory

34. eDose Components Over 200 medications - includes top 100 prescribed medications in the US Various forms and dosages (tablet, capsule, liquid, injection in units, mg, mcg, g, mL) Total of 1634 questions in database Four different levels of difficulty Adult and pediatric dosage questions

35. eDose Summary Most effective, efficient and affordable interactive web-based drug dosage calculation learning tool available Interactive learning teaches students to think, learn and achieve mastery of this vital skills Online assessment component allows for maximizing faculty efficiency Case Western Reserve University using with 350 nursing students beginning Sept. 15, 2008

36. eDose Summary School contracts for X number of seat licenses Free 30 day trial evaluations www.meti.com/products_edose.htm eDose@meti.com

37. References & Bibliography Bath J B, Chinn SJ & Knox DE (1986). Test of Cognitive Style in Mathematics - Manual. East Aurora, NY.: Slosson Educational Publications. Bath J B & Blais K. (1993). Learning style as a predictor of drug calculation ability. Nurse Educator, 18 ( 1, Jan/Feb 93), 33-36. Black, P., & Wiliam, D. (1998). Inside the Black Box: Raising standards through classroom assessment. Phi Delta Kappan, 80(2), 139-148. Bruner, J. S. (1975). Toward a Theory of Instruction. Cambridge: Belknap/Harvard. Bruner, J. S. (1978). The Process of Education. London: Harvard University Press. 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. 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). Coben, D., Hall, C., Hutton, B. M., Rowe, D., Sabin, M., Weeks, K., et al. (in press). Numeracy for nursing: The case for a benchmark. In J. O'Donoghue (Ed.), 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), held at the University of Limerick, Ireland, 26-29 June, 2007. Limerick: University of Limerick in association with ALM. Collins, A., Brown, J. S., & Newman, S. E. (1989). Cognitive apprenticeship: Teaching the crafts of reading, writing, and mathematics. In L. B. Resnick (Ed.), Knowing, Learning, and Instruction: Essays in honor of Robert Glaser (pp. 453-494). Hillsdale, NJ: Lawrence Erlbaum. Condelli, L., Safford-Ramus, K., Sherman, R., Coben, D., Gal, I., & Hector-Mason, A. (2006). A Review of the Literature in Adult Numeracy: Research and conceptual issues. Washington, DC: American Institutes for Research. Das, J. P. (1988). Implications for school learning. In R. R. Schmeck (Ed.), Learning Strategies and Learning Styles (pp. 101-129). New York: Plenum Press. Deforges, C. (1997). A theory of complex learning. In P. Preece & R. Fox (Eds.), Perspectives on Constructivism [Perspectives 56] (pp. 17-22). Exeter: School of Education. University of Exeter. Denvir, B., Stolz, C., & Brown, M. (1983). Low attainers in mathematics 5-16: policies and practices in schools . New York: Methuen Educational. Eraut M (1994) Developing Professional Knowledge and Competence. The Falmer Press, London Ernest, P. (1997). Varieties of constructivism: Their metaphors, epistemologies and pedagogical implications. In P. Preece and R. Fox (Eds.), Constructivism: Perspectives 56 (pp. 73-92). Exeter: School of Education: University of Exeter. Faddis M (1939). Eliminating errors in medication. American Journal of Nursing, 39, 121 Gulikers, J. T. J., Bastiaens, T. J., & Kirschner, P. A. (2004). A five-dimensional framework for authentic assessment. Education Technology Research and Development, 52(3), 67-85.

38. References & Bibliography Hendry, G. D., Frommer, M., and Walker, R. A. (1999). Constructivism and Problem-Based Learning. Journal of Further and Higher Education, 23(3), 359-371. Hodgen, J., Coben, D., & Rhodes, V. (2008, in press). Formative Assessment in Adult Numeracy. London: NRDC. Hodgen, J., & Wiliam, D. (2006). Mathematics Inside the Black Box: Assessment for learning in the mathematics classroom. London: nferNelson. 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. Hutton, B. M. (1997). The Acquisition of Competency in Nursing Mathematics. Unpublished PhD, University of Birmingham, Birmingham. Hutton, B. M. (1998). Should nurses carry calculators? In D. Coben & J. O'Donoghue (Eds.), Adults Learning Maths-4: Proceedings of ALM-4, the Fourth International Conference of Adults Learning Maths - A Research Forum held at University of Limerick, Ireland, July 4-6 1997 (pp. 164-172). London: Goldsmiths College, University of London, in association with ALM. Little, J. (2006). Online support for medicine dosage calculations. British Journal of Nursing, 15(21), 1192-1195. NMC. (2007). Standards of Proficiency for Pre-registration Nursing Education. London: Nursing and Midwifery Council. NMC. (2007). Essential Skills Clusters (ESCs) for Pre-registration Nursing Programmes. Annexe 2 to NMC Circular 07/2007. London: Nursing and Midwifery Council. OECD. (2005). The Definition and Selection of Key Competencies. Executive Summary. Paris: Organisation for Economic Cooperation and Development. Piaget, J. (1954). The Construction of Reality in the Child. New York: Basic Books. Piaget, J. (1983). Piaget's theory. In W. Kessen (Ed.), Handbook of Child Psychology (Vol. 1). New York: Wiley. Pirie, S. (1987). Nurses and Mathematics: Deficiencies in basic mathematical skills among nurses. Development and evaluation of methods of detection and treatment. London: Royal College of Nursing. Sabin, M. (2001). Competence in practice-based 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. Tobias, S. (1976). Math anxiety. Mathematics, 5(3), 56-59; 92.

39. References & Bibliography von Glasersfeld, E. (1987). The Construction of Knowledge: Contributions to Conceptual Semantics. New York: Intersystems Publications. von Glaserfeld, (1989). Constructivism in education. In N. Husen. T. and Postlethwaite (Ed.), International Encyclopedia of Education (Supplementary Vol) (pp. 162-163). Oxford: Pergamon. Wedege, T. (2003). Sociomathematics: Researching adults' mathematics in work. In J. Maa� & W. Schl�glmann (Eds.), Learning Mathematics to Live and Work in Our World. ALM-10. Proceedings of the 10th International Conference on Adults Learning Mathematics in Strobl (Austria) (pp. 38-48). Linz, Austria: ALM and Johannes Kepler Universit�t Linz. 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. Unpublished PhD, University of Glamorgan, Pontypridd. Weeks, K. W. (2007). No more �chalk and talk�: Teaching drug calculation skills for the real world. Safer Healthcare Retrieved 26 August, 2007, from http://www.saferhealthcare.org.uk/IHI/Topics/ManagingChange/SafetyStories/teaching+drug+calculation+skills+for+the+real+world.htm Weeks KW & Lowes L (2006) Researching your own clients/students (pp.133-147) in (Lyne P & Allan D) The reality of nursing research. Routledge Falmer, Oxford Weeks, K. W., Lyne, P., Mosely, L., & Torrance, C. (2001). The strive for clinical effectiveness in medication dosage calculation problem solving skills: The role of constructivist theory in the design of a computer-based �authentic world� learning environment. Clinical Effectiveness in Nursing, 5(1), 18-25. 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. Wiliam, D. (2006). Does Assessment Hinder Learning? [Electronic Version] from http://www.uk.etseurope.org/home-corpo-uk/news-home/?print=1&news=136&view=detail&no_cache=1. Wiliam, D., & Black, P. (1996). Meanings and consequences: A basis for distinguishing formative and summative functions of assessment. British Educational Research Journal, 22(5), 537-548. Williams, J., & Wake, G. (2006). Metaphors and models in translation between College and workplace mathematics. Educational Studies in Mathematics, 64(3), 345-371.