The benefit of houseofficer education on proper medication dose calculation and ordering.
OBJECTIVE
Drug dosing errors commonly cause morbidity and mortality. This prospective controlled study was performed to determine: 1) residents' understanding of drug dose calculations and ordering; and 2) the short-term effect of a brief educational intervention on the skills required to properly calculate dosages and order medications.


METHODS
The study was conducted at an urban public hospital with a four-year emergency medicine (EM) residency program. The EM residents served as the study group and were unaware of the study design. A written, eight-question test (T1) with clinical situations and factual questions was administered. Immediately following the test, correct answers were discussed for 30 minutes. Key concepts were emphasized. Six weeks later, a repeat test (T2a) with a similar format was administered to the study group. The same test (T2b) was simultaneously administered to a control group, residents of similar training who did not take T1, in order to determine test equivalency (T1 vs T2). Tests were graded using explicit criteria by a single investigator blinded to the order of administration.


RESULTS
Twenty residents completed both tests T1 and T2a. Their mean scores were 48% and 70%, respectively (p < 0.001, paired t-test). The control group of ten residents had a mean score of 49% (T2b), similar to the study group's scores on T1 (T1 vs T2b, p = 0.40, unpaired t-test).


CONCLUSIONS
Emergency medicine residents require specific training in calculating and executing drug ordering. A brief educational intervention significantly improved short-term performance when retested six weeks later. Long-term retention is unknown.
Nelson
L S
LS
Department of Emergency Medicine, Bellevue Hospital Center/New York University School of Medicine, New York, NY, USA. lnelson@pol.net
Gordon
P E
PE
Simmons
M D
MD
Goldberg
W L
WL
Howland
M A
MA
Hoffman
R S
RS
D000328:Adult; D016022:Case-Control Studies; D002983:Clinical Competence; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D004636:Emergency Service, Hospital; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D008505:Medical Staff, Hospital; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D009518:New York; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D011336:Probability; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012016:Reference Values
D004364:Pharmaceutical Preparations