In this latest blog, Hazel Cowls, Lecturer in Adult Nursing at the University of Plymouth explores the issue of numeracy in nursing education from the perspective of the teacher and the learner.
The safe administration of medicines is a key nursing activity, accounting for approximately 40% of registered nurses time (1) and according to the Nursing and Midwifery Council (2) registered nurses need to be able to demonstrate competence in drug calculation skills to provide safe patient care. Teaching numeracy and drug calculations is a compulsory component of the pre-registration nursing degree programme as all pre-registration nursing students must achieve a pass rate of 100% in medication-related calculations prior to registration (3).
Maths anxiety
Prospective students must demonstrate a level of knowledge of skills in numeracy prior to enrolment on to a nursing degree programme. However, some pre-registration nursing students do report feelings of anxiety and apprehension when it comes to practicing drug calculations and preparing for the drug calculation exam. As a nurse lecturer, I understand that students who report a lack of confidence in drug calculations may not perform well when it comes to the exam. I was keen to explore pre-registration nursing students’ experience of learning drug calculations and following ethical approval carried out a small qualitative study. During student interviews I was not surprised to hear that a contributory factor to maths anxiety was having to achieve 100% pass mark by year 3 of their studies. Two of the students interviewed reported a lack of confidence and felt this was due to their age as they had not attended further education recently. One student reported that her dislike of maths had delayed her enrolment onto the nursing degree programme. These findings support earlier studies exploring nursing student’s maths anxiety, for example one study concluded that student nurses did report maths anxiety, but this was due to the maths test (4). Whereas another study published in 2019, recognised that gender and age may lead to negative stereotyping, leading to mature students believing they are weaker at mathematics (5). This negative stereotyping may explain why students report maths anxiety or a lack of confidence in maths despite evidence of mathematical ability.
Understanding maths’ anxiety in nursing students will help Higher Education Institutes (HEI) provide a learning environment that is supportive and positive for students. There are numerous factors that may lead to ‘maths anxiety’ as mentioned above and include prior learning, a lack of confidence in maths ability as well as concern over the maths test (4 and 6).
Teaching and Learning
The aim of teaching numeracy and drug calculations is to increase pre-registration nursing students’ confidence and skills so that they can work safely as registered nurses. It may help to understand how pre-registration nursing students learn numeracy and drug calculations, to provide an authentic learning experience that may help alleviate any anxieties that nursing students may be reporting. For example, some students learn through simulated practice sessions, clinical practice, taught mathematics session or by accessing online resources and workbooks or even a combination of different learning resources. Interestingly, the students interviewed by the author reported different teaching methods to support their learning and all reported simulated and clinical practice increased their confidence and competence.
Final point
It is important that we recognise that one way of teaching may not be appropriate for everyone as we all learn differently and that we need to provide a variety of synchronous and asynchronous resources to support student learning. This blended approach to teaching drug calculations has been shown to be effective and will prepare students for clinical practice (5, 6, 7). The responsibility in teaching pre-registration nursing students’ numeracy and drug calculations lies with both registered nurses working in clinical practice and academia ensuring that nursing students are exposed to opportunities to develop their knowledge and skills.
References
- Meechan, R., Valler-Jones, T. and Jones, H. (2011) Do medicines OSCEs improve drug administration ability? British Journal of Nursing 20, no. 13 https://doi.org/10.12968/bjon.2011.20.13.728
- Nursing and Midwifery Council (2018a) Standards of Proficiency for Registered Nurses. Available online: https://www.nmc.org.uk/globalassets/sitedocuments/education-standards/future-nurse-proficiencies.pdf
- Nursing and Midwifery Council (2018b) Realising professionalism: Standards for education and training. Part 3: Standards for pre-registration nursing programmes Nursing and Midwifery Council. Available online: https://www.nmc.org.uk/globalassets/sitedocuments/education
- Røykenes, K. (2016) “My math and me”: Nursing students’ previous experiences in learning mathematics, Nurse Education in Practice, Volume 16, Issue 1, 2016, Pages 1-7, ISSN 1471-5953, https://doi.org/10.1016/j.nepr.2015.05.009.
- Gregory, L., Villarosa, A.R., Ramjam, et al (2019) The influence of mathematics self‐efficacy on numeracy performance in first‐year nursing students: A quasi‐experimental study. Journal of Clinical Nursing 2019; 28:3651–3659.
- van de Mortel, T.F., Whitehair, L.P. and Irwin, P.M. (2014) A whole curriculum approach to improving nursing students applied numeracy skills. Nurse Education Today 34, 462-467 org/10.1016/j.nedt.2013.04.024
- O’Reilly, R., Ramjam, L., Fatayer, M., et al (2020) First year undergraduate students’ perceptions of the effectiveness of blended learning approaches for nursing numeracy. Nurse Education in Practice 45(2020)