Academic journal article Nursing Education Perspectives

THE TRIANGLE TECHNIQUE: A New Evidence-Based Educational Tool for Pediatric Medication Calculations

Academic journal article Nursing Education Perspectives

THE TRIANGLE TECHNIQUE: A New Evidence-Based Educational Tool for Pediatric Medication Calculations

Article excerpt


Many nursing student verbalize an aversion to mathematical concepts and experience math anxiety whenever a mathematical problem is confronted. Since nurses confront mathematical problems on a daily basis, they must learn to feel comfortable with their ability to perform these calculations correctly. The Triangle Technique, a new educational tool available to nurse educators, incorporates evidence-based concepts within a graphic model using visual, auditory, and kinesthetic learning styles to demonstrate pediatric medication calculations of normal therapeutic ranges. The theoretical framework for the technique is presented, as is a pilot study examining the efficacy of the educational tool. Statistically significant results obtained by Pearson's product-moment correlation indicate that students are better able to calculate accurate pediatric therapeutic dosage ranges after participation in the educational intervention of learning the Triangle Technique.

Key Words Drug Dosage Calculations - Triangle Technique - Nursing Theory - EBP Cycle of Learning Model - Learning Styles - Mathematical Comprehension - Math Anxiety

Performing drug calculations accurately is an essential skill for practicing nurses and a vital learned skill for nursing students. However, like the significant number of people who experience math anxiety when confronting mathematical problems (1,2), many nursing students feel overwhelmed by the number of drugs and the amount of information they are expected to assimilate and apply to clinical practice (3). Complaints regarding the confusion brought on by math anxiety tend to focus on three major problem areas: multiplicity of mathematical formulas; students' inability to distinguish among and choose the right formula for a problem or situation; and verbalized feelings of professional ineptness. Whether real or imagined, the anxiety experienced by nursing students may be triggered by the mere mention of equations, variables, or other foreign (to them) vocabulary (1). The situation may become so stressful that students experience physical symptoms such as stomach discomfort, hand perspiration, and dry mouth as well as psychological symptoms, including temporary amnesia and an impending sense of failure or dread (1).

Gardner identified mathematics as one of the 10 "ways of knowing" (4,5). However, one reason for math anxiety cited by researchers is that mathematics is a language unto itself (1), a language comprised of a "confusing array of (seemingly) disconnected facts, rules, and definitions" (6, p. 437). As math anxiety can lead to the abandonment of formerly accepted rules, educators must be able to provide a rational cohesiveness to the subject of mathematics as it applies to clinical situations.

(The importance of this problem cannot be overemphasized. If the student does not perform a mathematical computation correctly in a classroom setting, his or her self-esteem is affected. If the student does not perform the mathematical computation correctly in a clinical setting, the patient is affected. In pediatric settings, accurate doses are especially important. Even small discrepancies can be dangerous because of the small size of patients (7). As Meyer stated, "There is no permissible level of error" (8).

The Learning Needs of Students The Triangle Technique for the computation of safe therapeutic-range medication dose estimates for pediatrics was developed as a response to student concerns about math anxiety and problems performing accurate computations prior to medication administration. The therapeutic level of a medication is defined as "the concentration of a drug that is needed to elicit desired clinical response without causing toxic effects" (9, p. 3). With this technique, an isosceles triangle is used to visually represent the concept and enhance memory (2,10-12).

The technique was developed according to evidence-based process by applying the results of research into the nursing student's learning milieu, learning styles, and learning strategies. …

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