Objective: To understand doctors' order for medication, nurses must have strong ability to calculate medication. This study is to develop case-based E-learning program to help nursing students to study medication and dosage calculation and later, to minimize medication errors for patients' safety.
Background: Medication error is one of the major threats to patient safety. To prevent errors, nursing students must fundamentally have drug calculation capabilities before graduation. However, due to the limited time, nursing students have a few opportunities to learn basic dose calculation, not the real cases that they would face at the hospital after graduation. There is a huge gap between what hospital expects from new nurses and what collage teaches.
Method: The most common ADDIE model of the Institutional Systems Design (ISD) to develop and apply the E-learning program to enhance the ability of nursing students to calculate drug doses. Clinical field experts and nursing professors who have worked in the general hospital ward for more than 10 years conducted a demand analysis. They selected the most common medication calculation algorithms, prescription formats, and doctors' orders. The program is designed to create problems by artificial intelligence with various calculation algorithms, forms, and difficulties based on the student's understanding and calculation abilities, to guide the most efficient path to understand the subjects.
Results: The content evaluation of the e-learning program was conducted by an independent expert group of clinical nurses and supervisors, and the nursing professors who has enough clinical experiences as nurses. They evaluated the programs by eight items, including scenario diversity, field coverage, and academic achievement, etc. The field expert group scored 3.9 points and the professor group scored 4.2 points of 5 points Likert scale. In the evaluation of the learning effect, 76 third-year nursing students were randomly divided into 2 groups (experimental group and control group), 38 subjects each. A Total three tests were conducted, including pretest before the study, the 1st post-test after 30 days of study, and a 2nd post-test after 6 months later. While no difference between the two groups in the pre-test before learning, the first post-test averaged 17.5 right answers in the experimental group and 14.4 in the control group. After 6 months, the second post-test averaged 16.7 right answers in the experimental group and 12.6 in the control group, showing statistically significant differences in both the first and second post-test.
Conclusion: To help the nursing students have strong medication calculation abilities, this study designed and verified a web-based medication calculation e-learning program to minimize medication errors, which account for a sizable portion of medical accidents that threaten patient safety. As a result, the developed e-learning program could verify the superior learning effect and the long-term calculation ability persistence effect rather than the traditional printed textbooks and workbooks-oriented learning methods. In the future, it is necessary to continuously develop a scenario for calculating drug doses in actual medical situations and expand it to a medication nursing capability simulation platform that can learn throughout the medication process, such as understanding doctor prescriptions, drug inventory, and medication methods.
Application: This study can be used as basic insight for the development of a medical learning simulation platform.