Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach
TL;DR: The preliminary work that led up to the development of a new computer based constructivist approach to teaching medication dosage calculation problem solving skills arose from observations of the errors committed by novice nursing students in a large UK School of Nursing.
About: This article is published in Clinical Effectiveness in Nursing.The article was published on 2000-03-01. It has received 90 citations till now. The article focuses on the topics: Constructivist teaching methods.
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01 Jan 2002
TL;DR: In this article, Gale et al. discuss the relationship between social constructivism and social constructionism in the context of education and the role of the teacher in assisting the learner's construction of cultural knowledge.
Abstract: Contents: J. Gale, Preface. Part I:Radical Constructivism and Social Constructionism. E. von Glasersfeld, A Constructivist Approach to Teaching. K.J. Gergen, Social Construction and the Educational Process. J. Shotter, In Dialogue: Social Constructionism and Radical Constructivism. J. Richards, Construct[ion/iv]ism: Pick One of the Above. Part II:Information-Processing Constructivism and Cybernetic Systems. F. Steier, From Universing to Conversing: An Ecological Constructionist Approach to Learning and Multiple Description. R.J. Spiro, P.J. Feltovich, M.J. Jacobson, R.L. Coulson, Cognitive Flexibility, Constructivism, and Hypertext: Random Access Instruction for Advanced Knowledge Acquisition in Ill-Structured Domains. K. Tomm, Response to Chapters by Spiro et al. and Steier. P.W. Thompson, Constructivism, Cybernetics, and Information Processing: Implications for Technologies of Research on Learning. Part III:Social Constructivism and Sociocultural Approaches. H. Bauersfeld, The Structuring of the Structures: Development and Function of Mathematizing as a Social Practice. J.V. Wertsch, C. Toma, Discourse and Learning in the Classroom: A Sociocultural Approach. C. Konold, Social and Cultural Dimensions of Knowledge and Classroom Teaching. J. Confrey, How Compatible Are Radical Constructivism, Sociocultural Approaches, and Social Constructivism? Analysis and Synthesis I: Alternative Epistemologies. M.H. Bickhard, World Mirroring Versus World Making: There's Gotta Be a Better Way. Part IV:Alternative Epistemologies in Language, Mathematics, and Science Education. R. Duit, The Constructivist View: A Fashionable and Fruitful Paradigm for Science Education Research and Practice. G.B. Saxe, From the Field to the Classroom: Studies in Mathematical Understanding. N.N. Spivey, Written Discourse: A Constructivist Perspective. T. Wood, From Alternative Epistemologies to Practice in Education: Rethinking What It Means to Teach and Learn. E. Ackermann, Construction and Transference of Meaning Through Form. D. Rubin, Constructivism, Sexual Harassment, and Presupposition: A (Very) Loose Response to Duit, Saxe, and Spivey. Part V:Alternative Epistemologies in Clinical, Mathematics, and Science Education. E. von Glasersfeld, Sensory Experience, Abstraction, and Teaching. R. Driver, Constructivist Approaches to Science Teaching. T. Wood, P. Cobb, E. Yackel, Reflections on Learning and Teaching Mathematics in Elementary School. P. Lewin, The Social Already Inhabits the Epistemic: A Discussion of Driver Wood, Cobb, and Yackel and von Glasersfeld. J. Becker, M. Varelas, Assisting Construction: The Role of the Teacher in Assisting the Learner's Construction of Preexisting Cultural Knowledge. E.H. Auerswald, Shifting Paradigms: A Self-Reflective Critique. Analysis and Synthesis II: Epsitemologies in Education. P. Ernest, The One and the Many. Analysis and Synthesis III: Retrospective Comments and Future Prospects. L.P. Steffe, Alternative Epistemologies: An Educator's Perspective. J. Gale, Epilogue.
1,030 citations
TL;DR: This literature review has already provided an underpinning framework for a pilot questionnaire to staff who have been involved in drug administration errors and is the basis for curricular input to preregistration students on the subject of risk management and drug administration.
Abstract: Discussions between the children's services manager at an National Health Service trust, and a children's nursing lecturer from the trust's partnering university clarified that there was a need to establish a greater understanding of the local circumstances surrounding adverse events in drug administration - particularly when those events involved nurses. Indeed it is claimed that nurses spend up to 40% of their time administering drugs. It was agreed that a collaborative research study, specifically designed to explore the nature of drug administration errors, could inform future trust policies and procedures around both drug administration and error, as well as the various university curricula concerning drug administration. This study, supported by senior management in the trust, and the chair of the local research ethics committee, has commenced. The first part of this study -- an introductory literature review, is presented here. The work of O'Shea [J Clin Nurs (1999)8:496-504] is significant in structuring the review that bears a number of recurring themes. It is not the intention of this literature review to reappraise O'Shea's original critique but to expand on her work, offer a contemporaneous perspective in the light of studies and reports published since 1999, and reset the topic in the context of clinical governance. This literature review has already provided an underpinning framework for a pilot questionnaire to staff who have been involved in drug administration errors and is also the basis for curricular input to preregistration students on the subject of risk management and drug administration. In conclusion, several recommendations about the shape of future research are offered.
257 citations
TL;DR: Students' prior knowledge should be taken into consideration in instructional design and curriculum planning and the results of prior-knowledge assessments may be used as a tool for student support in addressing areas of deficiency.
Abstract: Objectives. To determine how different types of prior knowledge (declarative and procedural) impact student achievement and how prior-knowledge assessment can be used as an instructional design tool. Methods. A questionnaire was developed based on the prior-knowledge model, which distinguishes between declarative and procedural knowledge. One hundred fifteen pharmacy students were tested prior to beginning 4 successive basic science courses and then prior to beginning a pharmaceutical chemistry course. Regression analysis was used to determine which type of knowledge was the best predictor of student achievement. The 4 course instructors were interviewed and their comments analyzed. Results. Prior knowledge from previous courses significantly influenced student achievement. Procedural knowledge was especially related to student achievement. Instructors and students had mainly positive reactions towards the prior-knowledge tests. Conclusions. Students' prior knowledge should be taken into consideration in ...
191 citations
TL;DR: To prevent deskilling, Registered Nurses should continue to practise and refresh all the different types of drug calculations as often as possible with regular (self-testing of their ability) with regular practice and assessment.
Abstract: Title. Patient safety: numerical skills and drug calculation abilities of nursing students and Registered Nurses. Aim. This paper is a report of a correlational study of the relations of age, status, experience and drug calculation ability to numerical ability of nursing students and Registered Nurses. Background. Competent numerical and drug calculation skills are essential for nurses as mistakes can put patients’ lives at risk. Method. A cross-sectional study was carried out in 2006 in one United Kingdom university. Validated numerical and drug calculation tests were given to 229 second year nursing students and 44 Registered Nurses attending a non-medical prescribing programme. Results. The numeracy test was failed by 55% of students and 45% of Registered Nurses, while 92% of students and 89% of nurses failed the drug calculation test. Independent of status or experience, older participants (‡35 years) were statistically significantly more able to perform numerical calculations. There was no statistically significant difference between nursing students and Registered Nurses in their overall drug calculation ability, but nurses were statistically significantly more able than students to perform basic numerical calculations and calculations for solids, oral liquids and injections. Both nursing students and Registered Nurses were statistically significantly more able to perform calculations for solids, liquid oral and injections than calculations for drug percentages, drip and infusion rates. Conclusion. To prevent deskilling, Registered Nurses should continue to practise and refresh all the different types of drug calculations as often as possible with regular (self)-testing of their ability. Time should be set aside in curricula for nursing students to learn how to perform basic numerical and drug calculations. This learning should be reinforced through regular practice and assessment.
141 citations
Cites background from "Written drug dosage errors made by ..."
...Studies have shown that 30–40% of medication administration errors are related to drug calculation errors (Schulmeister 1999), and that this might even be an under-representation (Weeks et al. 2000)....
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TL;DR: An online interactive multimedia-learning tool is a realistic and creative method of teaching medication dosage calculations and students in the interactive multimedia group were more satisfied with the method of learning, reported the technique to be enjoyable and more interesting, and provided sufficient feedback.
Abstract: The use of online learning tutorials to provide instruction in schools of nursing is growing in popularity; however, the outcomes associated with this method of instruction are not well documented. The focus of this experimental study, conducted at 2 universities in northern California, was to determine the effectiveness of an online interactive multimedia-learning tool versus text only, text and images, and multimedia learning explanations on math achievement, math self-efficacy, and student satisfaction. Compared to students in the control groups, students in the interactive multimedia group demonstrated equal posttest and retest knowledge of math; their math self-efficacy scores were also the same. Interactive multimedia group students were more satisfied with the method of learning, reported the technique to be enjoyable and more interesting, and provided sufficient feedback. An online interactive multimedia-learning tool is a realistic and creative method of teaching medication dosage calculations.
109 citations
References
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Book•
01 Jan 1983
TL;DR: In this paper, a reflection cycle and guiding questions are designed to assist licensure candidates in the reflection process and enable them to better understand the process and address the question; "How does this piece of evidence demonstrate my knowledge and skill level in this activity?".
Abstract: The reflection that accompanies the evidence a candidate presents in the performance-based product is a critical part of the candidate's development. Through reflection the candidate begins the ongoing process of blending the art and science of good teaching practice. Reflection requires thoughtful and careful reporting and analysis of teaching practice, philosophy, and experience. Understanding why an activity or practice was productive or nonproductive in the classroom is a key element in the progression from novice to master teacher. The reflection cycle and the guiding questions included in this packet are designed to assist licensure candidates in the reflection process. They will enable candidates to better understand the reflection process and address the question; "How does this piece of evidence demonstrate my knowledge and skill level in this activity?". The following reflection cycle offers a prescriptive structure while allowing the flexibility necessary for candidates to demonstrate their knowledge, skill, and ability in the unique context of their area and environment. The reflections of the novice teacher are also vital to the assessors charged with the responsibility for judging whether the teacher has met the required level of performance for each standard based activity. Through their responses to the guiding questions, candidates will better be able to put evidence into perspective for the review team members by explaining how the evidence or artifact addresses the standard through the activity.
9,821 citations
Book•
01 Jan 1966
TL;DR: Bruner's "Toward a Theory of Instruction" as mentioned in this paper is an illuminating examination of how mental growth proceeds, and the ways in which teaching can profitably adapt itself to that progression and can also help it along.
Abstract: This country's most challenging writer on education presents here a distillation, for the general reader, of half a decade's research and reflection. His theme is dual: how children learn, and how they can best be helped to learn--how they can be brought to the fullest realization of their capacities. Mr. Bruner, "Harper's" reports, has "stirred up more excitement than any educator since John Dewey." His explorations into the nature of intellectual growth and its relation to theories of learning and methods of teaching have had a catalytic effect upon educational theory. In this new volume the subjects dealt with in "The Process of Education" are pursued further, probed more deeply, given concrete illustration and a broader context. "One is struck by the absence of a theory of instruction as a guide to pedagogy," Mr. Bruner observes; "in its place there is principally a body of maxims." The eight essays in this volume, as varied in topic as they are unified in theme, are contributions toward the construction of such a theory. What is needed in that enterprise is, inter alia, "the daring and freshness of hypotheses that do not take for granted as true what has merely become habitual," and these are amply evidenced here. At the conceptual core of the book is an illuminating examination of how mental growth proceeds, and of the ways in which teaching can profitably adapt itself to that progression and can also help it along. Closely related to this is Mr. Bruner's "evolutionary instrumentalism," his conception of instruction as the means of transmitting the tools and skills of a culture, the acquired characteristics that express and amplify man's powers--especially thecrucial symbolic tools of language, number, and logic. Revealing insights are given into the manner in which language functions as an instrument of thought. The theories presented are anchored in practice, in the empirical research from which they derive and in the practical applications to which they can be put. The latter are exemplified incidentally throughout and extensively in detailed descriptions of two courses Mr. Bruner has helped to construct and to teach--an experimental mathematics course and a multifaceted course in social studies. In both, the students' encounters with the material to be mastered are structured and sequenced in such a way as to work with, and to reinforce, the developmental process. Written with all the style and e lan that readers have come to expect of Mr. Bruner, "Toward a Theory of Instruction" is charged with the provocative suggestions and inquiries of one of the great innovators in the field of education.
4,148 citations
Book•
01 Jan 1994
TL;DR: The context for professional education and development is discussed in this paper, where the authors discuss the influence of context on knowledge use and its character, development and use in the context of professional education.
Abstract: The Context for Professional Education and Development. Part 1 - Professional Knowledge - Its Character, Development and Use: The Influence of Context on Knowledge Use - What is Learned from Continuing Professional Education and How Kinds of Professional Knowledge - Modes of Knowledge Use and Knowledge Creation The Acquisition and Use of Theory by Beginning Teachers Headteachers Learning about Management - Types of Management Knowledge and the Role of the Management Course Learning Professional Processes - Public Knowledge and Personal Experience Theories of Professional Expertise. Part 2 - Professional Competence and Qualifications: Concepts of Competence and their Implications Competence in the NVQ/SVQ System The Assessment of Competence in the Professions. Part 3 - Professional Accountability: Professional Accountability and Client Outcomes.
3,529 citations
TL;DR: This paper used a critical evaluation of research on student misconceptions in science and mathematics to articulate a constructivist view of learning in which student conceptions play productive roles in the acquisition of expertise, and argued that this view overemphasizes the discontinuity between students and expert scientists and mathematicians.
Abstract: This article uses a critical evaluation of research on student misconceptions in science and mathematics to articulate a constructivist view of learning in which student conceptions play productive roles in the acquisition of expertise. We acknowledge and build on the empirical results of misconceptions research but question accompanying views of the character, origins, and growth of students' conceptions. Students have often been viewed as holding flawed ideas that are strongly held, that interfere with learning, and that instruction must confront and replace. We argue that this view overemphasizes the discontinuity between students and expert scientists and mathematicians, making the acquisition of expertise difficult to conceptualize. It also conflicts with the basic premise of constructivism: that students build more advanced knowledge from prior understandings. Using case analyses, we dispute some commonly cited dimensions of discontinuity and identify important continuities that were previously igno...
1,577 citations
01 Jan 1995
TL;DR: In this article, Gale et al. discuss the relationship between social constructivism and social constructionism in the context of education and the role of the teacher in assisting the learner's construction of cultural knowledge.
Abstract: Contents: J. Gale, Preface. Part I:Radical Constructivism and Social Constructionism. E. von Glasersfeld, A Constructivist Approach to Teaching. K.J. Gergen, Social Construction and the Educational Process. J. Shotter, In Dialogue: Social Constructionism and Radical Constructivism. J. Richards, Construct[ion/iv]ism: Pick One of the Above. Part II:Information-Processing Constructivism and Cybernetic Systems. F. Steier, From Universing to Conversing: An Ecological Constructionist Approach to Learning and Multiple Description. R.J. Spiro, P.J. Feltovich, M.J. Jacobson, R.L. Coulson, Cognitive Flexibility, Constructivism, and Hypertext: Random Access Instruction for Advanced Knowledge Acquisition in Ill-Structured Domains. K. Tomm, Response to Chapters by Spiro et al. and Steier. P.W. Thompson, Constructivism, Cybernetics, and Information Processing: Implications for Technologies of Research on Learning. Part III:Social Constructivism and Sociocultural Approaches. H. Bauersfeld, The Structuring of the Structures: Development and Function of Mathematizing as a Social Practice. J.V. Wertsch, C. Toma, Discourse and Learning in the Classroom: A Sociocultural Approach. C. Konold, Social and Cultural Dimensions of Knowledge and Classroom Teaching. J. Confrey, How Compatible Are Radical Constructivism, Sociocultural Approaches, and Social Constructivism? Analysis and Synthesis I: Alternative Epistemologies. M.H. Bickhard, World Mirroring Versus World Making: There's Gotta Be a Better Way. Part IV:Alternative Epistemologies in Language, Mathematics, and Science Education. R. Duit, The Constructivist View: A Fashionable and Fruitful Paradigm for Science Education Research and Practice. G.B. Saxe, From the Field to the Classroom: Studies in Mathematical Understanding. N.N. Spivey, Written Discourse: A Constructivist Perspective. T. Wood, From Alternative Epistemologies to Practice in Education: Rethinking What It Means to Teach and Learn. E. Ackermann, Construction and Transference of Meaning Through Form. D. Rubin, Constructivism, Sexual Harassment, and Presupposition: A (Very) Loose Response to Duit, Saxe, and Spivey. Part V:Alternative Epistemologies in Clinical, Mathematics, and Science Education. E. von Glasersfeld, Sensory Experience, Abstraction, and Teaching. R. Driver, Constructivist Approaches to Science Teaching. T. Wood, P. Cobb, E. Yackel, Reflections on Learning and Teaching Mathematics in Elementary School. P. Lewin, The Social Already Inhabits the Epistemic: A Discussion of Driver Wood, Cobb, and Yackel and von Glasersfeld. J. Becker, M. Varelas, Assisting Construction: The Role of the Teacher in Assisting the Learner's Construction of Preexisting Cultural Knowledge. E.H. Auerswald, Shifting Paradigms: A Self-Reflective Critique. Analysis and Synthesis II: Epsitemologies in Education. P. Ernest, The One and the Many. Analysis and Synthesis III: Retrospective Comments and Future Prospects. L.P. Steffe, Alternative Epistemologies: An Educator's Perspective. J. Gale, Epilogue.
1,311 citations