title: Students who developed logical reasoning skills reported improved confidence in drug dose calculation: Feedback from remedial maths classes.
abstract: BACKGROUND
  The safe administration of drugs is a focus of attention in healthcare. It is regarded as acceptable that a formula card or mnemonic can be used to find the correct dose and fill a prescription even though this removes any requirement for performing the underlying computation. Feedback and discussion in class reveal that confidence in arithmetic skills can be low even when students are able to pass the end of semester drug calculation exam.
  
  
  OBJECTIVE
  To see if confidence in the understanding and performance of arithmetic for drug calculations can be increased by emphasising student's innate powers of logical reasoning after reflection.
  
  
  METHODS
  Remedial classes offered for students who have declared a dislike or lack of confidence in arithmetic have been developed from student feedback adopting a reasoning by logical step methodology. Students who gave up two hours of their free learning time were observed to engage seriously with the learning methods, focussing on the innate ability to perform logical reasoning necessary for drug calculation problems. Working in small groups allowed some discussion of the route to the answer and this was followed by class discussion and reflection.
  
  
  RESULTS
  The results were recorded as weekly self-assessment scores for confidence in calculation. A self-selecting group who successfully completed the end of semester drug calculation exam reported low to moderate confidence in arithmetic. After four weeks focussing on logical skills a significant increase in self-belief was measured. This continued to rise in students who remained in the classes.
  
  
  CONCLUSIONS
  Many students hold a negative belief regarding their own mathematical abilities. This restricts the learning of arithmetic skills making alternate routes using mnemonics and memorised steps an attractive alternative. Practising stepwise logical reasoning skills consolidated by personal reflection has been effective in developing student's confidence and awareness of their innate powers of deduction supporting an increase in competence in drug administration.
authors.affiliation: School of Pre-Registration Nursing, 108 Oxford Road, Uxbridge UB81NA, United Kingdom. Electronic address: chris.shelton@bucks.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Shelton
mesh_terms: D002983:Clinical Competence; D003657:Decision Making; D004506:Education, Nursing / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D007858:Learning; D008433:Mathematics / Q000193:education*; D008508:Medication Errors / Q000517:prevention & control*; D061214:Patient Safety; D011340:Problem Solving; D018794:Problem-Based Learning; D020377:Self Efficacy; D013334:Students / Q000523:psychology*
keywords: Drug calculations; Hospital medicine; Medical education; Nurses; Patient safety