Topic outline

  • General

  • Connecting for confidence: a peer-support basic numeracy program (for medication calculations) to build confidence and connectedness for nursing students with basic numeracy and English language anxiety.

    Difficulties with basic numeracy skills and the inability to apply them in the clinical context affect the progress of study and employment prospects of some beginning university students, as does English language anxiety in international students (McMullan, Jones & Lea 2012; Zhang & Mi 2013). Numeracy skills are needed for safe medication calculations and nursing care. The incidence of medication errors and adverse drug events were reported high by the Australian Institute of Health & Welfare (2013). Anxiety is compounded by the need to achieve 100% proficiency in medication calculations to undertake clinical placement and successfully move through their nursing program.


    Many international students, new to Australia and university, tend to have very good math skills (Ramjan et al. 2014), but often lack confidence in interacting with fellow local students. This can affect their success in progressing through their nursing program, especially on clinical placement. Students beginning nursing Health Science courses may feel overwhelmed by their proposed studies, university transition and relocation, especially international students.

    Early identification of students who may be struggling in one or more study areas is essential for their psychosocial wellbeing and how they view their time at university (Schelle et al. 2011). Currently, UniSA nursing students struggling with numeracy, are not formally identified until their first mid-year exam although tutors spend time in tutorials guiding numeracy and medication activities. However, anxious students may `slip through the cracks'. The challenge is how to achieve competence, reduce anxiety and improve students' confidence and learning experience (Galligan, Loch & Lawrence 2008). International students are confronted with profound and challenging circumstance of adjusting to, both the higher education institutions, to new societal norms and values (Zhang & Mi 2013).

    One major challenge is mastering the English language and international students experience psychosocial effects of English language anxiety, embarrassment, frustration, homesickness, isolation and loneliness (Sawir et al. 2008). Newly arrived international students may also find themselves in `relational deficit' that affects their sense of connectedness, belonging, security and acceptance which, in turn influences, their engagement with peers and subsequent satisfaction with university. Engagement between the international students and their English speaking peers has the potential to set foundations for lasting connections (friendships) and fosters a sense of belongingness through the harmony between professional and/or personal values. Furthermore, Humphries (2011) suggests that friendships and developing a sense of belonging helps diminish English language anxiety. Yates & Wahid (2013) suggest universities need to be proactive in creating novel ways to facilitate interaction that are more than just social interaction between groups. Peer program participation and its relationship to international students adjustment into universities have received limited exploration and the understanding of these student' sense of connectedness and belongingness remains poorly understood (Levett-Jones & Lathlean 2008).

    This pilot project creates a novel way to facilitate an active learning experience by enabling such interaction, in nursing students and will address a gap in the existing literature.

     

    References:

     Australian Institute of Health & Welfare 2013, Australian Hospital Statistics 2011-2012. Health series no. 50. Cat. no. HSE 134. Canberra: AIHW.

    Galligan, L. Loch, B & Lawrence, J. 2008  'Building academic numeracy in a first year nursing course using an evaluative model of program development' Learning, Media and Technology, vol. 33 no.3 pp.169-189.

    Humphries, R 2011 Language Anxiety in International Students: How can it be overcome? Griffith Working Papers in Pragmatics and intercultural Communication, 4 (1/2), 65-77.

    Levett-Jones T & Lathlean 2008. Belongingness: A prerequisite for nursing students’ clinical learning Nurse Education in Practice 8, 103–111.

    McMullan, M., Jones, R & Lea, S. 2012 Math Anxiety, self-efficacy and Ability in British Undergraduate Nursing Students’ Research in Nursing & Health, vol.35, pp.178-186

    Sander, T. & Cleary, S. 2004 ‘Medication mathematics competency for bachelor of nursing students: results and challenges of a first year screening test’ Studies in Learning, Evaluation. Innovation and Development vol. 1, no. 2, pp45-52.

    Sawir, E., Marginson, S., Deumert, A. Nyland, C & Ramia, G. 2007. 'Loneliness and International Students: An Australian Study', Journal of studies in international education, 1028-3153, vol. 12, no. 2, p 148-181.

    Schelle, T., Pruitt, R Johnson, A., & Xu, Y. 2011. What do we know about educating Asian ESL nursing students? A literature review.  Nursing Education Perspectives, 32 (4), 244-249.

    Yates L & Wahid R 2013 Challenge to Brand Australia: international students and the problem with speaking Higher Education Research & Development 32 (6),1037-1050.

     

     

    • Researchers

      Ms. Deryn Thompson MN, PC Allergy Ng, BN, RN

      Principal Investigator

      Phone: + 61 8 8302 1166  

      Email: deryn.thompson@unisa.edu.au

      Dr Sandra Ullrich PhD, BSc (Hons), Grad Dip. (Geront), BN, RN

      Phone: + 61 8 8302 2974   

      Email: Sandra.Ullrich@unisa.edu.au

      Ms Emma Thompson BA (psych), Grad Dip Applied Statistics

      Research assistant

      Email: emma.thompson@unisa.edu.au

      • Project Reference Group

        Prof. Esther May 
        Dean: Health and Clinical Education 
        Division of Health Sciences 
        University of South Australia

        Professor Carol Grech

        Head of School of Nursing & Midwifery

        University of South Australia

        Assoc Professor Rachael Vernon

        Associate Head of School Nursing & Midwifery

        University of South Australia

        Dr David Birbeck
        Lecturer: Academic Development
        Health Sciences Divisional Office
        Division of Health Sciences
        University of South Australia

        Kirstin Marks

        Teaching & Learning Unit

        University of South Australia

        • Referenced literature associated with project

          Andrew, S, Salamonson, Y, & Halcomb, E 2009 Nursing students’ confidence in medication calculations predicts math exam performance Nurse Education Today, 29, 217-223.

          Australian Institute of Health & Welfare 2013, Australian Hospital Statistics 2011-2012. Health series no. 50. Cat. no. HSE 134. Canberra: AIHW.

          Bai H. 2011 Cross-Validating a Bidimensional mathematics Anxiety Scale Assessment 18 (1),115-122.

          Burns, N. & Grove, S. K. 2005 The Practice of Nursing Research: Conduct, Critique, and Utilization, Missouri, Elsevier Saunders.

          Galligan, L., Loch, B & Lawrence, J. 2008  'Building academic numeracy in a first year nursing course using an evaluative model of program development' Learning, Media and Technology, 33 (3),169-189

          Greene- Ryan, J.G. & Dogbey, E 2012 Seven strategies for international nursing student success: A review of the literature. Teaching and Learning in Nursing, 7, 103-7.

          Humphries, R 2011 Language Anxiety in International Students: How can it be overcome? Griffith Working Papers in Pragmatics and intercultural Communication, 4 (1/2), 65-77.

          Hunter, S & McCurry M (2013) Effective pedagogies for teaching math to nursing students- a literature review Nurse Education Today 33; 1352-1356.

          Lambert V.A. & Lambert C. E. 2012 Qualitative Descriptive Research: An Acceptable Design. Pacific Rim International Journal of Nursing Research. 16 (4), 255-6.

          Levett-Jones T & Lathlean 2008. Belongingness: A prerequisite for nursing students’ clinical learning Nurse Education in Practice 8, 103–111.

          McMullan, M., Jones, R & Lea, S. 2012 Math Anxiety, self-efficacy and Ability in British Undergraduate Nursing Students’ Research in Nursing & Health, 35, 178-186.

          National Medical Health & Research Council The National Statement on Ethical Conduct in Human Research (2007) Canberra Updated, viewed October 19th 2014 <https://www.nhmrc.gov.au/guidelines/publications/e72>

          Ramjan, L., Stewart, L, Salamonson, Y, Morris, M., Armstrong, L, Sanchez, P & Flannery, L. 2014 Identifying strategies to assist final semester nursing students to develop numeracy skills: A mixed methods study Nurse Education Today, 34, 405-412.

          Ritchie, J., Spencer, L. & O'Connor, W. 2003 Carrying out Qualitative Analysis. in Ritchie, J. & Lewis, J. (Eds.)

          Sawir, E., Marginson, S., Deumert, A., Nyland, C. & Ramia, G 2007 Loneliness and International Students:  An Australian Study. Journal of Studies in International Education, 20 (10), 1-33.

          Schelle, T., Pruitt, R Johnson, A., & Xu, Y. 2011. What do we know about educating Asian ESL nursing students? A literature review.  Nursing Education Perspectives, 32 (4), 244-249.

          University of South Australia Crossing the Horizon 2013-2015

          <http://www.unisa.edu.au/PageFiles/64561/Strategic-Plan.pdf>

          Varghese, M & Brett, K, & Universities Australia & Australian Educational International 2011 International student barometer project 2010 National Report Universities Australia, Canberra

          Yates L & Wahid R 2013 Challenge to Brand Australia: international students and the problem with speaking Higher Education Research & Development 32 (6),1037-1050.

          Zhang, Y. & Mi, Y. (2013) Another Look at the Language Difficulties of international Students Journal of Studies in International Education, 14 (4), 371-388.

          • Mid Project report submission

            Connecting for confidence:  a peer-support basic numeracy program (for medication calculations) to build confidence and connectedness for nursing students with basic numeracy and English language anxiety.

            July 2015 Deryn Thompson deryn.thompson@unisa.edu.au 

            Sandra Ullrich and Emma Thompson

            We undertook a mixed method study to identify the level of maths anxiety and/or foreign language anxiety in beginning first year nursing students at an Australian University.

            Ethics approval was obtained.

            The aim of the study was to identify if a face to face intervention of weekly maths tutorial classes decreased maths anxiety for students with maths anxiety. It also wanted to determine the impact of international students acting as peer mentors and helpers in the same maths sessions, to see if this influenced foreign language anxiety levels.

            Timelines have been met within those presented in original application despite early technical difficulties that were beyond the control of the researchers.

            Technical difficulties:

            In week 1 SP2 2015 we alerted the UniSA IT department that emails containing links were being automatically sent to the junk mail box of most students. Official notification made to IT and they were to report to SAS

            This impacted slightly on the project as the initial email sent out in week 1 alerting all being a Health professional students to the project, went to the junk mail box. The link as to the online survey consent and tools.  Majority of student reported, in class, that they had deleted the junk mail without reading any content. Tutors needed to highlight to student to find this email. Emails were re- sent, by the academic services officer (not the researchers) to all students in two parts. Firstly an email, containing no attachment, being sent to alert students to the fact that an important email was to follow. This was mostly successful, although it may have impacted on the respondent numbers. The demographic online surveys, demographic information, maths anxiety, nursing self-efficacy maths survey (skills) and the foreign language anxiety survey for international students) attracted 141 participant responses.  (124 female and 17 male). 29 were international students and 112 non-international

            Meeting of timelines are on schedule:

            Stage 1:

            Pre-intervention data collection

            a)      Quantitative survey tools: Math Anxiety scale, Nursing Self-Efficacy Maths and Foreign Language Anxiety scale administered. Data collection occurred in weeks 1, 2, 3 of the course

             

            b)      Qualitative interviews:  with students who consented to face to face interviews (about maths anxiety and/or foreign language anxiety) occurred in the first 3 weeks of the course until data saturation was reached.

             

            All BHP students undertake a Foundation Numeracy activity (FNA maths) in week 1. It is a series of 20 multiple choice questions (grade 7 standard basic maths concepts of decimals, fractions, rations and percentages). This aims to identify students who are struggling with these basic concepts. We can then direct them to a number of self-directed study tools to help them. There are no maths tutors at UniSA. 104/608 students gained less than 13/20 for the foundation numeracy activity (FNA) in week 1 of being a health professional. Mean score was 13.30. Maximum score was 20/20 and minimum was 4/20. This highlights a problem with numeracy skills in the IBNU commencing cohort.

            Stage 2:

            The students invited to participate in stage 2 of the project were students who gained 12/20 or less for the FNA or international students who gained 19-20/20 who would act as helpers. These face to face maths tuition sessions commenced on 26th March, in line with the original timeline.

            Intervention

            • 8 weeks basic numeracy tuition (maths) was provided by a maths teacher.

            (An amendment to ethics allowed 8 sessions instead of 10 as students had two weeks where their attendance would have been affected by practical assessment preparation).

             

            • Peer numeracy support to practice the skills taught by the tutor was provided by international students acting as ‘study skills peer helpers’. This was to try to help their language skills development with peer interaction.

             

            Post-intervention data collection

            a)      The Quantitative Survey tools Math Anxiety scale, Nursing Self-Efficacy Maths and Foreign Language Anxiety scale were administered again, in face to face format in final session after 8 weekly sessions. Analysis is underway to determine relationships between the variables and foreign language anxiety in the international students.

             

            b)      Qualitative data face to face interviews with students who participated in the initial face to face interviews have been completed. Data analysis is underway and with themes emerging from the narratives. Trustworthiness of the data was addressed at these interviews when the researcher revisited responses from the initial interview content.

             

            Analysis of the qualitative descriptive data has determined themes in the data with value of the face to face maths sessions well represented.

            It is anticipated that the data analysis will be completed within the original timeline.  Submission of an abstract is currently underway for the International Nurse Teachers Education Conference (NETNEPS) Brisbane 2016.