Mathematical and drug calculation abilities of paramedic students Kathryn Eastwood, Malcolm J Boyle, Brett Williams ABSTRACT Aim The objective of this study was to determine if undergraduate paramedics could accurately perform common drug calculations and basic mathematical computations normally required in the workplace. Method A descriptive paper-based questionnaire collecting demographical data, student attitudes regarding their drug calculation performance, and answers to a series of basic mathematical and drug calculation questions was administered to undergraduate paramedic students. Results The mean score was 39.5% with only 3.3% of students (n¼3) scoring greater than 90%, and 63% (n¼58) scoring 50% or less. Conceptual errors made up 48.5%, arithmetical 31.1% and computational 17.4%. Conclusion This study suggests undergraduate paramedics have deficiencies in performing accurate calculations with conceptual errors indicating a fundamental lack of mathematical understanding. INTRODUCTION An alarmingly low level of unaided mathematical calculation accuracy was identified among three cohorts of qualified practicing paramedics in the USA and Canada where average scores of 39.8%e 65% were reported. 1 Similar results have been identified in the nursing discipline in both prereg- istration and postregistration cohorts. 2e5 Medication-related errors cost the Australian public hospital system approximately $380 million annually. Currently no similar prehospital data exist. 6 In Victoria, Australia, there are three levels of mathematics in the final year of secondary educa- tion. 7 Variation exists in mathematical prerequi- sites for the undergraduate paramedic courses at other Victorian universities, from no requirements to any level of maths. 8e10 Mathematics offered during the Bachelor of Emergency Health (Paramedic) (BEH) course at the time of this study was ad hoc, occurring intermit- tently during various subjects and was generally taught by paramedics or nurses. Mathematical errors can be categorised into three distinct groups. Conceptual errors are an inability to formulate the mathematical question correctly from the information given. Arithmetical errors are an inability to operate an equation correctly, and computational errors which involve miscalculation of simple functions such as multiplication, division, subtraction or addition. 5 The objective of this study was to determine if undergraduate paramedics could accurately perform common drug calculations and basic mathematical computations normally required in the workplace. METHODS A cross-sectional methodology was used with a paper-based questionnaire using a series of demographic, drug calculation and mathematical questions. Students enrolled in the BEH course were eligible to participate in the study. Students were not permitted to use a calculator and were advised to show all of their workings, so that errors could be categorised. No time limit was set. Descriptive data analysis was undertaken using SPSS (V.17). Ethics approval was granted. RESULTS A 52.3% response rate was achieved (92 of 176 potential students). Only 5.4% (n¼5) of students had less than a final year level of mathematical education at secondary school. Undergraduate paramedics achieved an overall mean score of 39.5% (table 1). Nearly 24% of the questions were answered incorrectly with just over a third (36.6%) not attempted at all. Conceptual errors were 48.5% of all errors, arithmetical errors 31.1% and computational errors 17.4%. One student achieved 100% accuracy with 3.3% (n¼3) of students achieving 90% or greater. Nearly two- thirds of students, 63% (n¼58), failed to achieve scores of 50% or better. DISCUSSION To our knowledge, this is the first study to investigate the mathematical competence of undergraduate paramedics. Despite this undergraduate paramedic course not requiring final year mathematics, the majority of students had completed this level of mathematical education. These results were reflective of much of the current international paramedic and nursing literature demonstrating that in nearly half of all the errors that occurred (48.5%), students produced conceptual errors whereby they were unable to Table 1 Mathematical performance and error types Correct % Incorrect % No attempt Types of incorrect responses % Unknown Conceptual Arithmetical Computational Mean score 39.5 23.9 36.6 48.5 31.1 17.4 3.0 Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia Correspondence to Kathryn Eastwood, Monash University, Department of Community Emergency Health and Paramedic Practice, Frankston 3199, Victoria, Australia; kathryn.eastwood@ monash.edu Accepted 5 March 2012 Eastwood K, Boyle MJ, Williams B. Emerg Med J (2012). doi:10.1136/emermed-2011-200929 1 of 2 Short report EMJ Online First, published on April 13, 2012 as 10.1136/emermed-2011-200929 Copyright Article author (or their employer) 2012. 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