title: Factors associated with nursing students' medication competence at the beginning and end of their education.
abstract: BACKGROUND
  In previous studies, deficiencies in nursing students' medication competence have been highlighted. However, the focus of research has been limited especially to medication calculation competence and factors associated with it. In order to develop undergraduate nursing education and research, an understanding of the individual and learning environmental factors associated with medication competence from a broader approach is warranted. Our aim was therefore to evaluate the theoretical, practical and decision-making competence of nursing students and to identify factors associated with their medication competence at the beginning and end of their education.
  
  
  METHODS
  We used a descriptive, correlational study design with a structured instrument including a set of potential associated factors, knowledge test, medication calculation test and patient vignettes. The participants were nursing students at the beginning (n = 328) and at the end of their education (n = 338). Data were analyzed statistically.
  
  
  RESULTS
  In the evaluation of theoretical medication competence, the students' mean score over the semesters was 72 % correct answers in a knowledge test. In the evaluation of practical medication competence, the mean score was 74 % correct answers in a medication calculation test. In the evaluation of decision-making competence, the mean score was 57 % correct answers on deciding the best action in the situation given in patient vignettes. At the end of their education, students were able to solve patient vignettes significantly better. Individual factors were most evidently associated with medication competence. At the beginning of their education, students' previous academic success had a stronger association with medication competence. However, at the end of the education students' abilities in self-regulated learning and study motivation were more significant factors.
  
  
  CONCLUSIONS
  The core elements of medication competence are significantly interrelated, highlighting the need to provide integrated and comprehensive medication education throughout the undergraduate education. Students' learning style is associated with medication competence. There is a need for methods to identify and support students having difficulties to self-regulate their learning. To increase the safety of medication care of patients, research focusing on the development of effective teaching methods is needed. This study produced information for future nursing education research in this field, especially for interventional studies.
authors.affiliation: Department of Nursing Science, University of Turku, FI-20014, Turku, Finland. virsul@utu.fi.
authors.forename: Virpi
authors.initials: V
authors.lastname: Sulosaari
authors.affiliation: Clinical Pharmacology Unit, Department of Pharmacology, Drug Development and Therapeutics, University of Turku, FI-20014, Turku, Finland. risto.huupponen@utu.fi.
authors.forename: Risto
authors.initials: R
authors.lastname: Huupponen
authors.affiliation: Department of Nursing Science, University of Turku, FI-20014, Turku, Finland. maija.hupli@utu.fi.
authors.forename: Maija
authors.initials: M
authors.lastname: Hupli
authors.affiliation: National Institute for Health and Welfare, PL 57, FI-20521, Turku, Finland. pauli.puukka@thl.fi.
authors.forename: Pauli
authors.initials: P
authors.lastname: Puukka
authors.affiliation: Hospital Pharmacy Hospital Pharmacy, Turku University Hospital, PO Box 52, FI-20521, Turku, Finland. kirsti.torniainen@tyks.fi.
authors.forename: Kirsti
authors.initials: K
authors.lastname: Torniainen
authors.affiliation: Department of Nursing Science, University of Turku, FI-20014, Turku, Finland. helena.leino-kilpi@utu.fi.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003657:Decision Making; D054796:Drug Dosage Calculations; D004508:Education, Nursing, Baccalaureate; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D015402:Nursing Education Research / Q000193:education* / Q000592:standards; D015403:Nursing Evaluation Research / Q000592:standards*; D013223:Statistics as Topic; D013338:Students, Nursing