Abstract:

Introduction: Medication errors may be the most common type of medical errors. These errors are related to various human factors and procedures e.g. time and omissions of medication, stress, wrong drug, wrong dose and dose miscalculations.
Background: Medication calculation skills among nurse students seem to be a global challenge possibly due to low numeracy competence, test anxiety and low self confidence and self efficacy. Based on the possibilities in digital solutions it is therefore reasonable to look into new didactic tools to compensate for these challenges. Digital games may be such a tool by promoting active learning, offer immediate feedback, provide the opportunity to work in a controlled atmosphere, promote motivational learning and reduce anxiety and stress, monotonous lessons and increase relaxation in the learning environment. We therefore developed The Medication Game (TMG) that aims to i) drill simple mathematical and medical calculations and ii) make the students familiar with and drill standard medical units and expressions.
Game Software: The front-end of the game was developed in Adobe® Flash Professional® and run in Adobe® Flash Player® as a browser based application. For the back-end a Microsoft® server in correlation with Tomcat® and Sun Java® is being used.
The Game: The concept of TMG is to make an intuitive and simple computer based game that is without the need for instruction and special preparations. The structure of TMG is divided into three parts; 1) a training section, 2) a self testing section and 3) a section of exam questions. In the training section the players become acquainted with different types of tasks, and have the opportunity to train on specific topics. This section is divided into three categories; numeracy, where the player trains basic mathematics, conversion, that deals with conversion between units, and practical medication calculation. The players have 60 seconds to answer as many problems as they can with a score awarded afterwards. In the self testing section the students receive random tasks drawn from the three categories, receiving an immediate feedback of a collective point score upon completion. The last part of the game, exam questions, is conceived to give students examples of previous exam questions in order to gain some understanding of a real exam. Rewards are a fundamental aspect of game playing. In TMG the basic reward is a point score visualized, in the training section, by stars to give students an idea how they do. The players’ highest scores are saved, so that the players have an incentive to play again to improve their scores. In the self testing section the players’ progressions are logged on a graph giving a representation of their own progress over time. Whereas the scores from the training sections cannot be seen or compared with other players’, the results from the self test section are logged by nick names in a top 50 high score rank. Importantly, for the sake of re-playability and reducing monotonous lessons work TMG is constructed so that the tasks are generated by the game itself.
Summary: TMG seeks to utilize the positive aspects of games in learning to improve the nurse students’ medication calculation drilling and lower test anxiety and low self confidence on the topic. Our next step is to scientifically test the effect of the game.