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通过课堂教学或电子学习改善药物剂量计算:一项针对护士的随机对照试验

Improvement of drug dose calculations by classroom teaching or e-learning: a randomised controlled trial in nurses.

作者信息

Simonsen Bjoerg O, Daehlin Gro K, Johansson Inger, Farup Per G

机构信息

Department of Quality and Patient Safety, Innlandet Hospital Trust, Brumunddal, Norway.

Unit for Applied Clinical Research, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

BMJ Open. 2014 Oct 24;4(10):e006025. doi: 10.1136/bmjopen-2014-006025.

Abstract

INTRODUCTION

Insufficient skills in drug dose calculations increase the risk for medication errors. Even experienced nurses may struggle with such calculations. Learning flexibility and cost considerations make e-learning interesting as an alternative to classroom teaching. This study compared the learning outcome and risk of error after a course in drug dose calculations for nurses with the two methods.

METHODS

In a randomised controlled open study, nurses from hospitals and primary healthcare were randomised to either e-learning or classroom teaching. Before and after a 2-day course, the nurses underwent a multiple choice test in drug dose calculations: 14 tasks with four alternative answers (score 0-14), and a statement regarding the certainty of each answer (score 0-3). High risk of error was being certain that incorrect answer was correct. The results are given as the mean (SD).

RESULTS

16 men and 167 women participated in the study, aged 42.0 (9.5) years with a working experience of 12.3 (9.5) years. The number of correct answers after e-learning was 11.6 (2.0) and after classroom teaching 11.9 (2.0) (p=0.18, NS); improvement were 0.5 (1.6) and 0.9 (2.2), respectively (p=0.07, NS). Classroom learning was significantly superior to e-learning among participants with a pretest score below 9. In support of e-learning was evaluation of specific value for the working situation. There was no difference in risk of error between groups after the course (p=0.77).

CONCLUSIONS

The study showed no differences in learning outcome or risk of error between e-learning and classroom teaching in drug dose calculations. The overall learning outcome was small. Weak precourse knowledge was associated with better outcome after classroom teaching.

摘要

引言

药物剂量计算技能不足会增加用药错误的风险。即使是经验丰富的护士在进行此类计算时也可能会遇到困难。学习灵活性和成本考量使得电子学习作为课堂教学的替代方式颇具吸引力。本研究比较了采用这两种方法对护士进行药物剂量计算课程培训后的学习效果和出错风险。

方法

在一项随机对照开放研究中,来自医院和基层医疗保健机构的护士被随机分为电子学习组或课堂教学组。在为期2天的课程前后,护士们接受了药物剂量计算的多项选择题测试:14道题,每题有四个备选答案(得分0 - 14分),以及关于每个答案确定性的陈述(得分0 - 3分)。确定错误答案正确则为高出错风险。结果以均值(标准差)表示。

结果

16名男性和167名女性参与了该研究,年龄为42.0(9.5)岁,工作经验为12.3(9.5)年。电子学习后正确答案数量为11.6(2.0),课堂教学后为11.9(2.0)(p = 0.18,无统计学意义);提高分别为0.5(1.6)和0.9(2.2)(p = 0.07,无统计学意义)。在预测试得分低于9分的参与者中,课堂学习明显优于电子学习。支持电子学习的是对工作场景的特定价值评估。课程结束后两组之间的出错风险没有差异(p = 0.77)。

结论

该研究表明,在药物剂量计算方面,电子学习和课堂教学在学习效果或出错风险上没有差异。总体学习效果较小。课前知识薄弱与课堂教学后更好的学习效果相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b47/4212177/792a09b05f87/bmjopen2014006025f01.jpg

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