Nurse education leaders’ perspectives on the teaching of numeracy to undergraduate nursing students: A qualitative research study.

Fri, 08 Sep 2023 16:09:12 GMT

Walker C, Pettigrew J, Hunt L, Rylands L & Wilson N (2023) Nurse education leaders’ perspectives on the teaching of numeracy to undergraduate nursing students: A qualitative research study. Nurse Education in Practice, Volume 72, 103754

We were very interested to see this pre-print publication copy of Walker et al’s Australian paper on nurse education leaders’ perspectives on the teaching of numeracy to undergraduate nursing students. As you know, this is a subject close to our hearts and is a prime mover for our work in developing the safeHANDS programme.

The paper is useful in that it echoes the global perspective on nursing numeracy from an Australian perspective, and helps us to broaden our view. When we talk with educators from around the world they often think that their country is somehow different from others regarding healthcare numeracy and nursing, and is the only one facing this problem. Our work suggests that it is a global phenomena not restricted to one country or one school education system.

We were interested to read that Walker et al highlight the lack of standardisation on numeracy standards by Australian nursing regulators and the problems with idiosyncratic teaching and assessment modes. Again, this is something we see in many different settings. This is built on the incorrect assumption that nursing students are numerate on entry to undergraduate/pre-registration nurse education programmes because they’ve reached a set level in their school leaving qualifications. Our work shows that just because a person passed the maths exam at school doesn’t mean that they have the required competence in numeracy to be a safe practitioner.

We agree with Walker et al that there is an urgent need for an international benchmark in nursing/healthcare numeracy and we would suggest that the work we have done in developing safeHANDS would be a good starting point. We acknowledge the problem of nurse educators not being maths educators, yet being required to support nursing numeracy development but we have reservations about handing over this aspect of nurse education to non-nurses. In our conversations with colleagues in the USA from the High-Quality Mathematical Preparation for Nurses Task Force (Dana Center Mathematics Pathways 2019; 2020; Ozimek, Kelch & Zoellner, 2021) we noted that maths educators have a different but equally limited idea of what maths nurses need to be safe and competent.

We look forward to continuing conversations about these issues and welcome contributions from our colleagues from around the world.

Numeric Generics R&D Team

Refs

Dana Center Mathematics Pathways (2020). Creating Mathematics Consistency and

Relevancy in Nursing Programs. https://www.dcpathfinder.org/creatingmathematics-consistency-relevancy-nursing/

Dana Center Mathematics Pathways (2019). Emerging Solutions in Mathematics Education for Nursing (9): https://dcmathpathways.org/sites/default/files/resources/2019-11/DCMP-Emerging-Solutions-Brief-NURSING-20191105.pdf

Ozimek, D., Kelch, B. & Zoellner, J. (2021). Convening Recommendations: Math and statistics education for nurses. Austin, TX: Dana Center. https://dcpathfinder.org

DECODING THE DNA OF HEALTHCARE NUMERACY: Establishing a mathematics and healthcare numeracy benchmark for nursing

Sun, 01 Jan 2023 17:40:55 GMT

Research & Development Briefing Paper: January 2023

AUTHORS: Keith W. Weeks PhD, RN; David Pontin PhD, RN; Diana Coben PhD; Alex Weeks BSc; John M. Clochesy PhD, MA, RN; David Rowe PhD.

ARTWORK: Matt Brown BA; Kirsty Weeks BA

What's the issue?

There is wide agreement that nurses need to be skilled in healthcare numeracy but no consensus on what skills they should have. As a result, teaching and assessment vary from place to place, creating entry barriers to nursing, increasing attrition, restricting Registered Nurse global mobility, and increasing the risk to patients.

What's our solution?

Our world-leading research identifies the healthcare numeracy competence needed for safe and effective nursing practice and regulation [see Fig 1&2].

We have developed a comprehensive taxonomy of healthcare numeracy for nursing and translated it into an authentic virtual clinical environment. This supports in-context learning, competence assessment, and application.

We call this process ‘decoding the DNA of healthcare numeracy’ because, while some healthcare numeracy is self-evident, much of it is deeply embedded in nursing practice. What has become second nature to Registered Nurses appears opaque to new students.

Who is it for?

Our work has implications for nursing regulators, policy makers and educators. It is also relevant to other safety-critical vocations and disciplines.

What is it?

Our Healthcare Numeracy Taxonomy provides a benchmark for safe practice. Our programme includes:

Healthcare Numeracy Assessment
Healthcare Numeracy Performance Fingerprint and
Mathematics and Healthcare Numeracy Learning Support Environment

This provides a standard reference point to measure and support the development and maintenance of competence of students and Registered Nurses:

Students are supported as they move from point of programme entry to point of registration and beyond, while reducing attrition caused by inappropriate forms of assessment

Registered Nurses are supported as they refresh their skills for revalidation, while reducing practice error and increasing patient safety.

How did we create our Healthcare Numeracy Programme?

Identification

We identified the 20 healthcare numeracy skills that form the fundamental mathematical building blocks of safe nursing (see Fig 3). These skills combine in specific sequences to inform 60 common clinical nursing procedures and processes. Click the link for an animated video [7 minute view].

https://drive.google.com/file/d/1tASjLA9XvQKl8A4MENb_2T0lyJNfXbqf/view

Analysis, Transcription and Mapping

We analysed the step-by-step processes of each clinical procedure or process. As each step unfolded, we ‘transcribed’ (identified, externalised, classified and copied) the combination of mathematics skills into a ‘transcription grid’. Each relevant skill is represented by ☑️ in the relevant skill box (see Fig 4):

We confirmed the combinations and sequencing of 20 core cross-cutting healthcare numeracy knowledge and skills in each of the 60 core clinical nursing procedures and processes.

These were mapped and classified into a framework of individual and combinatory Healthcare Numeracy Taxonomies (HNT; cHNT). The outcomes were translated into the:

Healthcare Numeracy Assessment (HNA)
combinatory Healthcare Numeracy Assessment (cHNA)
Healthcare Numeracy Performance Fingerprint (HNPF) and
Mathematics & Healthcare Numeracy Learning Support Environment (M&HNLSE) models.

Relative distribution of mathematics and healthcare numeracy skills

After mapping the HNT, we analysed the distribution and incidence of the 20 skills across nursing practice (see Fig 5). Our analysis revealed that about 40% relate to pharmacology, prescribing, drug dosage calculation and measurement, and medicines management. The remaining 60% relate to wider nursing practice.

This work has implications for nursing regulators, policy makers and educators. It is also relevant to other safety-critical vocations and disciplines. The full paper can be accessed here .

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