Pedagogical approaches to the teaching and assessment of undergraduate nursing numeracy

Abstract

Numeracy skills are critical for patient safety; therefore, it is vital that registered nurses are proficient in performing a variety of calculations, notably medication calculations. However, the literature indicates that a large proportion of undergraduate nursing students and registered nurses are not competent in numeracy, and that this has been a long-standing problem. Undergraduate nursing programs are responsible for ensuring graduates are safe and competent practitioners, therefore it is important to consider how, and the context within which, undergraduate students learn nursing numeracy. The international literature not only reports the widespread problems in nursing numeracy for nursing students and graduates but also reveals that a variety of approaches are used to teach and assess numeracy. Largely missing, however, from the research literature, is evidence about the most effective way to teach and assess nursing numeracy. In addition, there is an absence of research about the skills and attributes of the nurse academics who do the numeracy teaching, and how they teach nursing numeracy. This thesis explored the pedagogical approaches to the teaching and assessment of nursing numeracy within undergraduate nursing education in Australia to inform the development of a future research agenda in nursing numeracy. This would include an evidence-based nursing numeracy teaching and assessment framework to support nurse academics who teach nursing numeracy, and evidence to justify the inclusion of numeracy within the professional standards that shape undergraduate nursing education. This study utilised an exploratory sequential mixed methods design where the results of the qualitative phase informed the development of the quantitative phase. The qualitative findings revealed that the absence of a distinct accreditation standard in relation to numeracy, led to the existence of an array of pedagogical approaches to teaching and assessing undergraduate numeracy. Academics considered themselves good clinicians, but not numeracy educators. It was assumed that students would have proficiency in numeracy skills upon entering university, but this was not the case. Support was required for struggling students to pass high stake assessments which were delivered in various formats, often under conditions incongruent to the clinical setting. The quantitative results revealed that almost 50% of nurse academics self-reported feeling either somewhat or not confident and somewhat or very anxious when teaching nursing numeracy. Developing the teaching capacity of nurse academics seems a necessary next step, which would go a long way to reduce anxiety and increase confidence. Teachers with greater capacity could enhance student competence and contribute to patient safety. Furthermore, aiming for a national standard or benchmark for nursing numeracy, with an independent external numeracy assessment, would potentially improve the quality of nursing numeracy education, and go a long way to ensuring better patient outcomes.

Date of Award	2025
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Nathan Wilson (Supervisor)