Previous research highlighted an ongoing concern about numerical competence across healthcare professions (Sabin 2002). In 2006, NHS Education for Scotland noted the need for evaluation of the many resources available for supporting the numeracy needs of healthcare staff and students.
Many students who are enrolled on the nurse training courses in the Department of Health Sciences (University if York) have difficulties with essential numeracy skills. The Department has invested a large amount of money into an online numeracy course known as Authentic World to supplement existing teaching. A systematic review of interventions to promote numeracy and literacy learning in adults found no trial of computer software aimed specifically at the numeracy skills of student nurses and none of this package. (Torgerson et al 2003) There was therefore a need for this package to be evaluating using a randomised controlled trial, without the results of which, we cannot be confident about its effect on the numeracy skills of student nurses.
The aim of the trial is to determine whether the use of a supplementary computer based numeracy training programme (Authentic World) is effective in increasing the numeracy skills of first year student nurses.
Pragmatic Randomised Controlled Trial
The trial, which took place in 2008/09, aimed to recruit as many participants as possible from the current first year nursing student cohort at the University of York (138). Those agreeing to take part completed a consent form and a baseline questionnaire, which asked their highest qualification in maths and how many hours a week they estimated they spent on the computer. The questionnaire also asked about their preference for on-line learning or whether they were indifferent. Those who gave consent were then randomly allocated to either the Intervention or Control Group. The intervention group had access to an online numeracy package known as Authentic World and the usual support offered by staff. The control group received only the usual support offered by staff only.
The student’s scores on the diagnostic general numeracy test, end of term 2 general numeracy test and six additional questions aimed specifically at medication dosage calculations were collected before randomisation and used as baseline data. The dependant variable were the student test scores on the end of year general numeracy test and six additional questions aimed specifically at medication dosage calculation. The students were also asked to complete a follow up questionnaire which asked for their opinion of the online package. The results were analysed using linear regression. A preference term was also included in the analysis to ascertain whether or not those who prefered the on-line course performed better than those who did not.
All students were to be allowed access to the computer software in their second and third years – if it was found to be effective.
This trial was led by the IEE, and subsequently by the University of York Trials Unit. Final report: Ainsworth H, Gilchrist M, Grant C, Hewitt C, Ford S, Petrie M, Torgerson C, and Torgerson D (2011), Computer-based Instruction for Improving Student Nurses’ General Numeracy: Is it Effective? Two Randomised Trials.
NHS Education for Scotland (2006) Identifying and Supporting the Numeracy Needs of Healthcare Staff in Scotland. A Strategy Document. NHS Scotland
Sabin M. (2002) Competence in Practice-Based Calculation: Issues for Nursing Education. A critical review of the literature Centre for Health Science and Practice Occasional Paper No.3
Torgerson CJ, Porthouse J, Brooks G. (2003) A systematic review and meta-analysis of randomised controlled trials evaluating interventions in adult literacy and numeracy. Journal of Research in Reading 26:3, 234–255