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Original Article
- Development and Effectiveness of a Drug Dosage Calculation Training Program using Cognitive Loading Theory based on Smartphone Application
- Myoung Soo Kim1, Jung Ha Park1, Kyung-Yeon Park2
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Journal of Korean Academy of Nursing 2012;42(5):689-698.
DOI: https://doi.org/10.4040/jkan.2012.42.5.689
Published online: October 12, 2012
1Department of Nursing, Pukyong National University, Busan, Korea
2Department of Nursing, Silla University, Busan, Korea
1Department of Nursing, Pukyong National University, Busan, Korea
2Department of Nursing, Silla University, Busan, Korea
- Address reprint requests to : Kim, Myoung Soo Department of Nursing, Pukyong National University, 599-1 Daeyeon 3-dong, Nam-gu, Busan 608-737, Korea Tel: +82-51-629-5782 Fax: +82-51-629-7906 E-mail: kanosa@pknu.ac.kr
• Received: February 1, 2012 • Revised: February 22, 2012 • Accepted: September 23, 2012
Copyright © 2012 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Purpose
- This study was done to develop and evaluate a drug dosage calculation training program using cognitive loading theory based on a smartphone application. Calculation ability, dosage calculation related self-efficacy and anxiety were measured.
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Methods
- A nonequivalent control group design was used. Smartphone application and a handout for self-study were developed and administered to the experimental group and only a handout was provided for control group. Intervention period was 4 weeks. Data were analyzed using descriptive analysis, χ2-test, t-test, and ANCOVA with the SPSS 18.0.
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Results
- The experimental group showed more ‘self-efficacy for drug dosage calculation’ than the control group (t= 3.82, p< .001). Experimental group students had higher ability to perform drug dosage calculations than control group students (t= 3.98, p< .001), with regard to ‘metric conversion’ (t= 2.25, p = .027), ‘table dosage calculation’ (t= 2.20, p = .031) and ‘drop rate calculation’ (t= 4.60, p< .001). There was no difference in improvement in ‘anxiety for drug dosage calculation’. Mean satisfaction score for the program was 86.1.
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Conclusion
- These results indicate that this drug dosage calculation training program using smart-phone application is effective in improving dosage calculation related self-efficacy and calculation ability. Further study should be done to develop additional interventions for reducing anxiety.
Table 1.Principles of the Application Development and Examples of the Questionnaires
Table 2.Homogeneity Test of Study Variables at the Baseline (N=78)
Table 3.Group Comparisons of Dependent Variables at the Posttest (N=78)
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Figure 1. Program development procedure.
Figure 2. Developed smartphone-based drug dosage calculation application.
Figure 1.
Figure 2.
Development and Effectiveness of a Drug Dosage Calculation Training Program using Cognitive Loading Theory based on Smartphone Application
| Principles of the application development | |
|---|---|
| Teaching strategies for reducing cognitive loading | Construction strategies for smartphone based application development |
| Goal-free effect | Construct the learning area and the gaming area. Doesn't display the aim of the lesson in the learning area. |
| Worked example effect | Insert the example tabs on the introduction page in the learning area, which provide solved examples. |
| Completion problem effect | Provide the tips, but make participants write the answers themselves. |
| Split attention effect | Arrange all contents in one page which prevents scrolling to see the cut screen. |
| Variability practice effect | Construct gaming area in order to help participants solve the questionnaires repeatedly. |
| Modality effect | Provide the screen changes and auditory stimulations at the period of scoring. |
| Redundancy effect | Construct the standardized form of questionnaire to prevent cognitive loading resulting from the various information sources. |
| Multi-media effect | Use visual stimuli and auditorial stimuli with graphs, illustrations and audio clips. |
| Examples of the questionnaires | |
| Metric conversion | Convert 1.17 g to mg. |
| Tablet calculation | 62.5 mcg of digoxin is prescribed daily. On hand you have 250 mcg tablets. How many tablets will you give? |
| Fluid dosage calculation | 0.75 g of lincomycin hydrochloride IV 8-12 hourly is prescribed. On hand you have 300 mg in 2 mL. How many mL will you administer? |
| Drop rate calculation | 1 L of Lactated Ringer's solution is prescribed over 10 hours. The drop factor is 15. What is the drip rate (drops/minute) required? |
| Variables | Categories (Numbers of items) | Exp. (n=37) | Cont. (n=41) | t/χ2 (p) |
|---|---|---|---|---|
| n (%) or M±SD | ||||
| Age (year) | 20.30±1.51 | 20.15±1.28 | 0.48 (.633) | |
| Gender* | Female | 36 (97.3) | 37 (90.2) | (.362) |
| Male | 1 (0.7) | 4 (9.8) | ||
| Self-efficacy for drug dosage calculation | Confidence for mathematics (6) | 3.30±0.66 | 3.09±0.79 | 1.23 (.211) |
| Confidence for drug dosage calculation (7) | 2.98±0.72 | 2.71±0.75 | 1.64 (.106) | |
| Total (13) | 3.13±0.62 | 2.89±0.72 | 1.58 (.119) | |
| Anxiety for drug dosage calculation | Fear of asking help (4) | 2.97±0.52 | 3.01±0.69 | −0.24 (.812) |
| Self-concept (7) Total (11) | 2.11±0.67 2.42 0.50 | 2.60±0.93 2.75 0.67 | −2.66 (.010) 2.41 (.018) | |
| Total (11) | 2.42±0.50 | 2.75±0.67 | −2.41 (.018) | |
| Calculation ability | Metric conversion (3) | 2.27±0.87 | 1.98±0.69 | 1.67 (.100) |
| Tablet dosage calculation (3) | 0.95±0.23 | 1.07±0.41 | −1.66 (.101) | |
| Fluid amount calculation (3) | 2.76±0.72 | 2.63±0.80 | 0.71 (.481) | |
| Drop rate calculation (3) | 1.43±1.07 | 1.10±0.92 | 1.48 (.144) | |
| Total (12) | 7.40±2.18 | 6.78±1.59 | 1.43 (.156) | |
| Variables | Categories | Exp. (n=37) | Cont. (n=41) | t or F (p) |
|---|---|---|---|---|
| M±SD | M±SD | |||
| Self-efficacy for drug dosage | Confidence for mathematics | 3.48±0.60 | 3.15±0.75 | 2.15 (.035) |
| calculation | Confidence for drug dosage calculation | 3.66±0.64 | 2.95±0.77 | 4.45 (<.001) |
| Total | 3.58±0.57 | 3.04±0.67 | 3.82 (<.001) | |
| Anxiety for drug dosage | Fear of asking help | 3.02±0.67 | 2.90±0.65 | 0.79 (.433) |
| calculation | Self-concept* | 2.14±0.65 | 2.51±0.69 | 0.82 (.684) |
| Total* | 2.46±0.49 | 2.65±0.43 | 0.66 (.862) | |
| Calculation ability | Metric conversion | 2.19±0.91 | 1.78±0.69 | 2.25 (.027) |
| Tablet dosage calculation | 2.54±0.77 | 2.12±0.90 | 2.20 (.031) | |
| Fluid amount calculation | 2.81±0.57 | 2.63±0.70 | 1.23 (.223) | |
| Drop rate calculation | 2.41±0.80 | 1.41±1.09 | 4.60 (<.001) | |
| Total | 9.95±2.31 | 7.95±2.12 | 3.98 (<.001) | |
| Satisfaction for program | Effective way to learn | 4.38±0.72 | − | − |
| Generally appropriate | 4.30±0.57 | − | − | |
| Recommendable | 4.24±0.55 | − | − | |
| Frequency | Visit to learning area (number/week) | 5.45±7.10 | − | − |
| Visit to game area (number/week) | 7.68±10.26 | − | − | |
| Connect hours (min/week) | 21.93±26.61 | − | − |
Table 1. Principles of the Application Development and Examples of the Questionnaires
Table 2. Homogeneity Test of Study Variables at the Baseline (N=78)
Exp.=Experimental group; Cont.=Control group. *Fisher's exact test.
Table 3. Group Comparisons of Dependent Variables at the Posttest (N=78)
Exp.=Experimental group; Cont.=Control group. *ANCOVAs were used to identify group differences at post-test.
