Safety in numbers: towards reducing global medication dosage calculation problem-solving (MDC-PS) error through the design and application of virtual authentic learning and assessment environments.

Impact: Other impacts

Description of impact

External need/issue: Medication errors are a global problem e.g. 6k reported monthly in UK, around 1.5 million USA citizens harmed annually. Staff incompetence, & poor training & assessment contribute to errors. Difference made: Over 250k students worldwide have used the programme in 4 continents. Student failure rate has dramatically reduced, student retention on uni nursing programmes increased, reduction in incidents, increase in patient safety. Health care savings.Type of impact: Increases patient safety culture in healthcare delivery organisations. Changes to UK Nursing & Midwifery Council education standards and training regulations. Changes to Uni nursing curricula & assessment strategies. Improves numeracy competency of health care students in their everyday lives. Reduces adverse health economic consequences of drug errors.What has changed: Educational processes, professional education delivery models, regulatory processes, change in awareness that the issue is not just calculation competence, increased health and well-being for health care service users, students and staff. Location of impact: Over 70% of UK university nursing departments use the programme; it is used extensively in the USA, Canada, Australia, New Zealand, Poland, Qatar, Mauritius and the Philippines Impact innovation: This is the only on-line education and assessment programme developed to address this wicked problem. safeMedicate® challenges the ‘chalk and talk’ approach to teaching these skills which has dominated healthcare training for over 70 years. The maths test failure rate on the University of Calgary, Canada, Bachelor of Nursing Accelerated Track fell from 12% to 0% after safeMedicate® was adopted in 2009. safeMedicate® is also used to deliver continuing professional development in the UK, USA and United Arab Emirates, e.g. more than 20 NHS organisations use it as part of their staff update training or audit of medication dosage calculation skills. The programme helps to diagnose individual issues through a fundamental numeracy assessment and provides the means to correct ‘dropped stitches’. It uses the principles of constructivist education to support learners. It is student friendly and available 24 hours a day, 7 days a week. It can be used for both teaching and assessment.

How did your research contribute?

USW researchers developed an on-line environment safeMedicate® to help healthcare students bridge gap between theory (classroom) and practice (‘bedside’). It recreates real-world dosage problems in an authentic on-line environment that supports and assesses healthcare professionals and students to understand dosage problems in context [Conceptual competence]; calculate mathematically correct drug doses [Calculation competence]; accurately measure doses in virtual syringes etc. [Technical Measurement competence].A university spin-out company (Authentic World Ltd) was developed with support from Welsh Government business initiatives. safeMedicate® uses real world features and expert real world practice to link with the maths used to solve dosage calculation problems and transform care. Healthcare students use a virtual world to bridge the gap between theory and practice. This helps them develop their knowledge and skills without harming real people and reduce errors in practice (Weeks et al 2001; 2013d; 2013e; Sabin et al 2013 & McDonald et al 2013). Weeks et al (2013d) evaluated the relationship between exposing nursing students to traditional teaching methods and safeMedicate®, and the development of their dosage calculation skills. Nursing students’ calculation skills are statistically significantly different after using the authentic learning environment compared with using traditional ‘chalk and talk’ methods. Exposing students to authentic learning environments is an essential first step in developing their competence. McDonald et al (2013) found that 1st year nursing students had a 33% error rate on a safeMedicate® numeracy test. This changed after using safeMedicate® linked with exposure to clinical practice. All of the students demonstrated 100% cognitive competence in the safeMedicate® assessments and 100% functional competence in practice based assessments. Sabin et al (2013) compared the reliability and validity of safeMedicate® against a commonly used simulated practice assessment, i.e. an Objective Structured Clinical Exam (OSCE). Outcome measures showed that safeMedicate® has extremely high validity and reliability. The research concluded that assessments which combine a virtual environment and clinical practice are a viable, valid and reliable method for gauging student competence in calculating doses.

Who is affected?

Healthcare students, practice based mentors, patients, university lecturers, health care delivery personnel, statutory regulators, healthcare delivery organisations, universities, wider society
Category of impactOther impacts
Impact levelIn progress