Working Together to Develop Mathematical Skills for Practice in One UK School of Nursing

1
Working Together to Develop Mathematical Skills
for Practice in One UK School of Nursing
Dr Carol Hall, Sian Davies,
Christopher Jones, Iain MacDiarmid
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Project Team

• Dr Carol Hall, Senior Health Lecturer,
• School of Nursing, The University of Nottingham
• Sian Davies, ICT Trainer/elearning lead
• Nottingham City Health Informatics Training
  Department
• Christopher Jones, Health Lecturer,
• School of Nursing, The University of Nottingham
• Ian McDiarmid, QMC Learning Centre Lead,
• South Nottingham College

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The Issues

• Competency in mathematics is a key skill in
  offering competent nursing care (ICN 2002
• NMC 2002 NMC 2004)
• HOWEVER..
• Lack of confidence in maths skills remains of
  concern within nursing, both nationally and
  internationally (Kapborg 2001 Grandell Neimi et
  al 2003 Sabin 2003)

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Locally....

• New students entering the Diploma in Nursing are
  tested using a mathematics quiz
• Approximately one-third of the cohort are
  unsuccessful on first attempt
• This equals approximately 50 students every 6
  months at one School of Nursing Centre

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Questions
What about our entry qualifications?
Are we unique?
Is our test valid?
Does it matter in practice?
Is the test environment a problem?
How can we best support our students?
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How can we best support nursing students?

• Offer a wide range of opportunities to develop
  confidence and competence in basic maths skills.
• View learning maths skills in a positive way.
• Ensure students receive follow up support.
• Ensure nurse teachers are knowledgeable about
  available support.

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A Partnership with South Nottingham College

• We approached the local Skills Centre
• run by South Nottingham College at the Queens
  Medical Centre.
• Through a partnership, we facilitated a means by
  which student nurses could opt to enrol to use
  adult numeracy materials as within self directed
  study time. The materials used were predominantly
  produced by learndirect.

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Running the maths programme
Week 1 Week 3 Week 5 Week 7 -13
Diagnostic Review
LD
QUIZ/ENROL
Enter Course
Introduction
ALL
Quiz Feedback Tutorial
Personal Tutorials and
QUIZ
Week 14 to end of Semester One
Continue/complete course work
Optional Support Sessions
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The Evaluation Project - Objectives

• To determine whether student nurses who access
  learndirect materials in the first year of their
  nursing programme score significantly differently
  in the school maths assessment quiz from those
  who do not
• To evaluate student perceptions of effectiveness
  of participating in the scheme in relation to
  developing skills for nursing practice
• To disseminate findings locally and to a wider
  national and international audience

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Methodology

• A mixed methodology approach included
• quantitative analysis of student test scores and
• content analysis of qualitative questionnaire data

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Sample

• 156 students have participated in the project
  from three cohorts.
• Inclusion criteria was an attainment of less than
  14 out of 20 in the school assessment
• Cohort 1 self selected to LD or traditional path,
  Cohorts 2 and 3 have been randomised using a
  random number table (Polgar and Thomas 1991)
• The work is ongoing and interim findings from
  Cohort 1 are being presented today

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Cohort 1

• 56 Students met inclusion criteria
• 35 enrolled to LD, 21 to traditional tutorial
  path
• 28 completed LD diagnostic
• 18 progressed to courses
• All students completed a second test after six
  months on the course

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Key Findings

• At the baseline assessment, no significant
  difference was found between those electing to
  complete LD or traditional paths (Mann Whitney U,
  p0.875)
• At the second test 47 students had improved their
  test score, 2 remained the same and 7 scored
  lower. This improvement was significant (Mann
  Whitney U and Wilcoxon Signed Ranks plt0.001)
• At the post score, there was no significant
  difference between those receiving LD
  intervention and those who did not (Mann Whitney
  U p0.285)

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Evaluation Questionnaires

• 43 Students completed evaluation questionnaires
• 27 Students participated in learndirect
• 16 Followed traditional support methods
  including group and individual tutorial support
  from nurse teachers with experience of
  mathematics applied to nursing

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Main Themes

• Sources of Support Generally
• Views on the learndirect adult numeracy
  programme
• Satisfaction with support offered/identified

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Sources of Support
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Views on learndirect diagnostic

• The diagnostic was enjoyable and helped me
  overcome my fear of facing and addressing my
  maths skills needs.
• It(the diagnostic) highlighted the areas I
  needed to improve
• couldnt see what relevance fences and rolls of
  wallpaper had to do with drug calculations!

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Views on learndirect resource

• after moving onto a relevant course I have
  since re-assessed my skills and I have improved.
• I have gained confidence by practice (of maths
  skills) which has helped me immensely when on
  placement.

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Views on learndirect resource

• I felt there was a lack of personal support. I
  also found that I did not have time to fit it in
  especially whilst on placement
• It helped me on some maths but not really on
  drug calculations. Im a bit quicker on adding up
  but still not very confident with doing maths
  especially on the ward
• Still waiting for my disc and after telling them
  my concerns it has still not arrived

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Summary Discussion Points

• Using learndirect as one example of an adult
  learning resource has not been found to differ
  from other teaching methods in relation to
  nursing student outcomes
• learndirect was perceived positively by many
  students who identify benefits including
  increasing confidence and understanding
• learndirect is a generic learning aid

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Dissemination -How can nursing students be
supported?

• Facilitate a positive cycle of maths learning
• (Ashcraft 2002, Ernest 2000)
• Ensure students receive appropriate diagnostic
  assessment and follow up support (Sabin 2003,
  Engineering Council 2000)
• Ensure nurse teachers are knowledgeable about the
  wide range of available literature, research and
  resources related to maths learning in HE
• Offer a range of opportunities to develop
  confidence and competence in basic maths skills