Safety in numbers 5: Evaluation of computer-based authentic assessment and high fidelity simulated OSCE environments as a framework for articulating a point of registration medication dosage calculation benchmark.

This paper reports a key educational initiative undertaken by NHS Education for Scotland (NES), based upon recommendations from a 'Numeracy in Healthcare' consultation. We report here the design of a web-based technical measurement authentic assessment environment evolved from the safeMedicate suite of programs that provided a model for an environment within which a medication dosage calculation problem-solving (MDC-PS) benchmark could be articulated. A sample of 63 third-year pre-registration nursing students was recruited from four participating universities in the UK. A counterbalanced design was employed where the virtual authentic assessment environment was evaluated for internal consistency reliability and criterion-related validity against an objective structured clinical assessment (OSCE) undertaken in high-fidelity simulated clinical environments. Outcome measures indicated an extremely high internal consistency of the web-based environment. It was concluded that the combination of a web-based authentic assessment environment and further assessment of safe technical measurement interpretation and dexterity in a practice/practice simulation setting, populated with a benchmark and a criterion referenced rubric validated by the profession, is an innovative, viable, valid and reliable assessment method for the safe administration of medicines. As a result, the rubric for assessment of the appropriate range of calculation type and complexity informed the NMC's revised Essential Skills Clusters for Medicines Management (NMC, 2010a; NMC, 2010b). This inclusion provides a particularly strong example of both research directly influencing policy and of evidence-based regulation.

Safety in numbers: an introduction to the Nurse Education in Practice series.

This paper introduces this Nurse Education in Practice 'Safety in Numbers' series. We introduce the background and seven papers that explore the outcomes of a 20-year programme of healthcare education translation research and education action research that focuses on medication dosage calculation problem-solving (MDC-PS) education.

Numeracy for nursing, report of a pilot study to compare outcomes of two practical simulation tools--an online medication dosage assessment and practical assessment in the style of objective structured clinical examination.

UNLABELLED: This pilot study compares the results of medications calculations carried out by student nurses using an online assessment tool with the results of the same calculations carried out within simulated practice. The numeracy project, of which this is part, is funded by NHS Education for Scotland (NES). OBJECTIVE: To test the efficacy of a realistic computer-based assessment of pre-registration nurses' medication calculations skills by comparing outcomes from using an online assessment tool with a practical assessment tool in the style of an Objective Structured Clinical Examination OSCE. Both assessment methods used medicine calculations usually presenting authentically in the practice setting. DESIGN: A multi-stage quantitative study using a cross-over design. SAMPLE: Fifty early 3rd year students on the adult branch of a pre-registration nursing programme at a large school of nursing in England. RESULTS: Results showed that, for assessing accuracy of calculation, there was a high level of congruence between the two methods. CONCLUSIONS: Computerised assessment of medications calculations using this particular platform is likely to closely mirror assessment of medication calculations done in a practical setting. As such it could be a useful adjunct to current assessment methods.

Situated cognition and cognitive apprenticeship: a model for teaching and learning clinical skills in a technologically rich and authentic learning environment.

The acquisition of a range of diverse clinical skills is a central feature of the pre-registration nursing curriculum. Prior to exposure to clinical practice, it is essential that learners have the opportunity to practise and develop such skills in a safe and controlled environment under the direction and supervision of clinical experts. However, the competing demands of the HE nursing curriculum coupled with an increased number of learners have resulted in a reduced emphasis on traditional apprenticeship learning. This paper presents an alternative model for clinical skills teaching that draws upon the principles of cognitive apprenticeship [Collins, A., Brown, J.S., Newman, S., 1989. Cognitive Apprenticeship: teaching the crafts of reading, writing and mathematics. In: Resnick, L.B. (Ed.) Knowing. Learning and Instruction: Essays in Honor of Robert Glaser. Lawrence Erlbaum Associates, New Jersey, pp. 453-494] and situated cognition within a technologically rich and authentic learning environment. It will show how high quality DVD materials illustrating clinical skills performed by expert practitioners have been produced and used in conjunction with CCTV and digital recording technologies to support learning within a pedagogic framework appropriate to skills acquisition. It is argued that this model not only better prepares the student for the time they will spend in the practice setting, but also lays the foundation for the development of a clinically competent practitioner with the requisite physical and cognitive skills who is fit for purpose [UKCC, 1999. Fitness for Practice: The UKCC Commission for Nursing and Midwifery Education. United Kingdom Central Council for Nursing Midwifery and Health Visiting, London].

Creating the balance in the nursing curriculum.

This article reports on work underway by a consortium of three Universities to develop case based learning materials from patient's case notes for the education and training of student nurses. Funded through the Fund for Developments in Teaching and Learning (. Creating the Balance in the Nursing Curriculum. Project No: 114/02 Available from: <>) this three-year educational development project will complete in 2005.