Faculty of Health, University of Plymouth, UK.
Int J Med Inform. 2011 Jun;80(6):421-30. doi: 10.1016/j.ijmedinf.2010.10.021. Epub 2011 Apr 5.
Nurses need to be competent and confident in performing drug calculations to ensure patient safety. The purpose of this study is to compare an interactive e-drug calculations package, developed using Cognitive Load Theory as its theoretical framework, with traditional handout learning support on nursing students' drug calculation ability, self-efficacy and support material satisfaction.
A cluster randomised controlled trial comparing the e-package with traditional handout learning support was conducted with a September cohort (n=137) and a February cohort (n=92) of second year diploma nursing students. Students from each cohort were geographically dispersed over 3 or 4 independent sites.
Students from each cohort were invited to participate, halfway through their second year, before and after a 12 week clinical practice placement. During their placement the intervention group received the e-drug calculations package while the control group received traditional 'handout' support material. Drug calculation ability and self-efficacy tests were given to the participants pre- and post-intervention. Participants were given the support material satisfaction scale post-intervention.
Students in both cohorts randomised to e-learning were more able to perform drug calculations than those receiving the handout (September: mean 48.4% versus 34.7%, p=0.027; February: mean 47.6% versus 38.3%, p=0.024). February cohort students using the e-package were more confident in performing drug calculations than those students using handouts (self-efficacy mean 56.7% versus 45.8%, p=0.022). There was no difference in improved self-efficacy between intervention and control for students in the September cohort. Students who used the package were more satisfied with its use than the students who used the handout (mean 29.6 versus 26.5, p=0.001), particularly with regard to the package enhancing their learning (p=0.023), being an effective way to learn (p=0.005), providing practice and feedback (p<0.001), being accessible (p=0.027), user friendly (p=0.02) and providing learning enjoyment (p=0.022).
It is essential that nurses are educated and supported to become, and remain, confident and competent in performing drug calculations. This study found the e-drug calculations package, based on Cognitive Load Theory, to be significantly more effective than a handout in improving students' drug calculation ability and self-efficacy, with students who used the package being significantly more satisfied with its use than students who used the handout. This package could particularly be useful for the continuing professional development of any healthcare professional involved in drug calculations.
护士需要具备进行药物计算的能力和信心，以确保患者安全。本研究旨在比较一种使用认知负荷理论作为理论框架开发的交互式电子药物计算包与传统的学习支持手册，以评估其对护理学生药物计算能力、自我效能感和支持材料满意度的影响。
采用整群随机对照试验，以 9 月（n=137）和 2 月（n=92）两个学期的二年级护理学生为研究对象，比较电子包与传统学习支持手册。两个学期的学生在地理上分布在 3 到 4 个独立的站点。
在临床实践实习前和实习后，邀请每个队列的学生参与，此时学生已完成第二年的一半学业。实习期间，干预组接受电子药物计算包，而对照组接受传统的“手册”支持材料。在干预前后对参与者进行药物计算能力和自我效能感测试。干预后，参与者对支持材料满意度量表进行评分。
与接受手册的学生相比，两个队列中接受电子学习的学生在药物计算方面的能力更强（9 月：平均 48.4%比 34.7%，p=0.027；2 月：平均 47.6%比 38.3%，p=0.024）。使用电子包的 2 月队列学生在进行药物计算方面的自我效能感更高（自我效能感平均 56.7%比 45.8%，p=0.022）。9 月队列的学生在干预前后自我效能感的改善方面没有差异。与使用手册的学生相比，使用该包的学生对其使用更加满意（平均 29.6 比 26.5，p=0.001），尤其是因为该包增强了他们的学习（p=0.023）、提供了有效的学习方式（p=0.005）、提供了实践和反馈（p<0.001）、易于访问（p=0.027）、用户友好（p=0.02）和学习乐趣（p=0.022）。
教育和支持护士具备并保持进行药物计算的信心和能力至关重要。本研究发现，基于认知负荷理论的电子药物计算包在提高学生药物计算能力和自我效能感方面明显优于手册，使用该包的学生对其使用的满意度明显高于使用手册的学生。对于参与药物计算的任何医疗保健专业人员的持续专业发展，该包都可能特别有用。
