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Idea 1 - Medical Professions, Nursing and Numeracy

An exploration of a possible solution to the problem of numeracy and drug calculations in nursing and medicine

Cloud created by:

Derek Harding
23 September 2009

Background

A while back I worked with a colleague on a small project to simplify assessment of drug calculations amongst student nurses using Questionmark.  This was fairly straightforward, didn't take long and taught us some useful things about doing assessment that way and also raised some problems which needed dealing with.  However, it also became apparent that many students were struggling with the numeracy required to do drug calculations.  I later learned that this is a general problem not just in nursing undergraduates but in other medical professions too.  Some time later I was musing about various things as one does and thought that the question of "how to teach drug calculations" might need a bit of lateral thinking.  That is if we try to teach students to get it right all the time we might not be getting them to understand the deeper aspects of drug administration and it might actually be helpful to try doing it in a deeper way.  This led me to think that maybe we should teach them to get it wrong first.

Obviously this presents an ethical problem but provided we don't do it with real patients maybe it might be a way forward.  A possible solution then would be the Drug game.

The Drug Game

There are two ways to do this.  Either as a traditional paper based game or an online game could be devised in two parts as outlined below:

Part 1

In this phase of the game students answer multiple choice questions about drug dosages for certain conditions and the available choices will include the right answer but the objective is not to get it right.  In fact getting it right would attract a zero score.  The objective is to get it wrong and the highest mark would be for the answer which most efficiently kills the patient or worsens the condition.

The idea is that the students will learn most effectively from being allowed, even encouraged to get things wrong.  In doing so they will learn the serious consequences of errors in a medical setting.  It will also appeal to the sense of the macabre which young students seem to have.  However, there may be an ethical question here because they will by the end of it have a pretty comprehensive murder manual.

Phase 2

In this phase of the game we simply suggest that the authorities have noticed the rising mortality rates and we have to actually help the patients so the answers now have to be the correct ones with the wrong answers attracting zero scores and the right answer getting a positive score.

Implementation

In order to do this as an 'e' tool we would need:

  • a game designer/s
  • graphics for the responses - as gory as possible
  • Nurse Practitioner/Lecturer as advisor
  • Pharmacist as advisor
  • General Physician as advisor
  • Learning Advisor

The advisors could compile questions to cover most scenarios and the games people could put it together as an interactive game which students could play over and over again until they felt comfortable with drug calcualtions and then take the appropriate assessment.  It could be deployed alongside a course or as part of a general support package.

Would it fail to get support for ethical reasons?

Contact details: Derek.Harding@tees.ac.uk

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