Examining medication dosage calculation exam scores in undergraduate nursing students: Simulation compared to classroom instruction

Medication administration is a primary responsibility of nurses, and clinical education is critical to preventing medication errors and maintaining patient safety. Nurse educators struggle to determine the most effective teaching strategy related to this skill. This dissertation study aimed to examine the effect of participating in a simulation activity versus a lecture-style review on medication calculation exam scores. A quasi-experimental posttest-only design recruited prelicensure baccalaureate nursing students (n = 93) to participate in a simulation lab activity before taking the medication exam. The new simulation activity was created and facilitated using the Healthcare Simulation Standards of Best Practice as a guide (INACSL, Decker, et al., 2021; INACSL, McDermott, et al., 2021; INACSL, Persico, et al., 2021; INACSL, Watts, et al., 2021). The intervention group’s results were compared to a historical control group (n = 105) who received a lecture-style review session in a classroom environment prior to the exam. An independent samples t-test revealed that students in the intervention group had higher exam scores (M=89.14, SD=14.19) compared to the control group (M=82.29, SD=17.28; t (195) = 3.06, p= .003). Participants in the intervention group were more likely to pass the exam in fewer attempts compared to the control group (X2 = 7.34, p = .007). Independent samples t-tests were also used to analyze exam scores on one-step (“review”) medication calculations versus multi-step (“new”) medication calculations between the intervention and control groups. There was no significant difference in scores on the review items between the intervention and control groups. However, participants in the intervention group scored higher on the new items (M = 70.22, SD = 12.334) as compared to the control group (M = 64.48, SD = 14.410, t (196) = 3.019, p = .003, two-tailed). The findings of this study indicate that undergraduate students who participate in a medication simulation prior to taking their medication exam may perform better than students who only attended a lecture-style review in the classroom.