University of Essex Nursing programmes embed several TEL methods for supporting numeracy skills for drug calculations. Our ‘Numeracy in Context’ approach to drug calculation and administration is particularly popular with students. The sessions are team-taught: I teach the first part, covering the underpinning calculation skills required to solve medication dosage problems. Students then move to the Skill Labs to work through several drug administration activities with the Registered Nurse Teachers.
Screencasts & Worked Examples
I often use the Worked Example Principle (Renkl, 2005; Sweller, 2006) in my instruction. Worked examples were presented in a range of TEL and traditional formats, including:
- Screencasts
- Student volunteers transcribing problems to be solved by their peers, using direct/scaffolded questioning
- Printed workbook contains all examples and further problems.
Jordan et al (2012) assert that screencasts can improve student learning of mathematics. While many open resources, such as Khan Academy and MathsCasts provide screencasts for generic mathematical similar resources for nursing calculations are harder to find. One such example is Queen’s University Belfast’s Numeracy Skills for Drug Calculations site. The interactive questions are ideal for consolidating underpinning numeracy skills. However, students need to be aware that the examples are not clinically realistic, and therefore risk de-sensitising them to context clues that indicate a serious drug error (Wright, 2011).
In order to address this, I have begun to create my own bank of screencasts to demonstrate worked solutions to a range of problems. I use the Explain Everything iPad app for this. The app is intuitive, and suitable for novice users. I eventually plan to move to a more professional screencasting method, possibly Camtasia or the Adobe software when the University is ready to roll this out beyond the specialist Technology Enhanced Learning team.
The screencasts are readily available to students via Moodle; however, during teaching, I often mute the recorded audio and talk through the problems in order to foster engagement and rapport.
Moodle
To support numeracy skills off-campus, I have developed a Moodle meta-course – Numeracy Skills for BSc Nursing, which offers a step-by-step approach, from refresher materials on basic arithmetic, to preparation for NHS recruitment tests. A difference in Moodle versions currently prevents me from duplicating the course to our open MoodleX site, but I hope to be able to do this in June. The site is very much a work in progress, requiring investigation into which resources are most likely to have impact before I spend time developing them.
In the week following the session, about 27% of the cohort accessed the online session materials; this is encouraging as our students tend to have a track record of accessing only resources relevant to imminent summative assessment.
The Answer Pad
I included a ‘stretch and challenge’ question to test the most able students.
I informed the students that this question appeared on the Year 3 exam paper in December 2015, and challenged them, as a cohort, to obtain a higher pass rate than their peers in Year 3. They were encouraged to submit their attempts to me via The AnswerPad.
This approach was intended to build on my use of Kahoot! quizzes which, while popular with students, do not allow response collection.
In theory, this approach would allow me to test the app with a limited number of students, to assess its usefulness as a BYOD tool. In practice, it diverted attention towards those students, as I had to help them navigate the site to input their answers. This did not have an adverse effect on the less able students, but might have done so, if there had been competing priorities for my attention on the day.
I did not have access to the full version for that session, but have subsequently acquired an upgrade until June 2016. This means that I can explore a wider range of strategies and approaches with this package, and attempt to find a satisfactory way of utilising it in sessions without disrupting the provision of targeted support to students who need it.
Conclusion
Embedding TEL in nursing numeracy presents a good opportunity to enhance learning. However, the reality presents several practical challenges. Our student cohorts are large and diverse. Students begin their courses with a variety of educational and digital experiences and readiness to learn at Levels 4. Additionally, many mathematical strategies are apparent, depending on when and where students attended school. It is important that TEL strategies do not seek to impose or dictate a particular way of working, and that all (valid) learning approaches and strategies are encouraged when solving these safety-critical calculations.
References
Ainsworth, H., Gilchrist, M., Grant, C., Hewitt, C., Ford, S., Petrie, M., Torgerson, C. and Torgerson, D. (2012) ‘Computer-based instruction for improving student nurses’ general numeracy: is it effective? Two randomised trials’ Educational Studies 38 2:151-163
Jordan, C., Loch, B., Lowe, T., Mestel, B. and Wilkins, C. (2012) ‘Do short screencasts improve student learning of mathematics?’ MSTOR Connections 12(1): 11-14 Online at: http://stan.cc.swin.edu.au/~lochb/download/Jordan_et_al_2012.pdf
Nursing and Midwifery Council (2007) Standards for Medicines Management Online at: https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-for-medicines-management.pdf [Accessed on 8 February, 2016]
Renkl, A. (2005) ‘The Worked-Out Examples Principle in Multimedia Learning’ In: Mayer, R.E. (editor) The Cambridge Handbook of Multimedia Learning Cambridge: Cambridge University Press
Sweller, J. (2006) ‘The worked example effect and human cognition’ In: Learning and Instruction 16: 165 – 169
Wright, K. (2011) Drug Calculations for Nurses: Context for Practice Basingstoke: Palgrave Macmillan
Literacy, Numeracy & TEL in Nurse Education & Training 