The benefit of houseofficer education on proper medication dose calculation and ordering

Objectives: Drug dosing errors commonly cause morbidity and mortality. This prospective controlled study was performed to determine: 1) residents' und erstanding of drug dose calculations and ordering; and 2) the short-term ef fect of a brief educational intervention on the skills required to properly calculate dosages and order medications. Methods: The study was conducted at an urban public hospital with a four-year emergency medicine (EM) reside ncy program. The EM residents served as the study group and were unaware of the study design. A written, eight-question test (T1) with clinical situat ions and factual questions was administered. Immediately following the test , correct answers were discussed for 30 minutes. Key concepts were emphasiz ed. Six weeks later, a repeat test (T2a) with a similar format was administ ered to the study group. The same test (T2b) was simultaneously administere d to a control group, residents of similar training who did not take T1, in order to determine test equivalency (T1 vs T2). Tests were graded using ex plicit criteria by a single investigator blinded to the order of administra tion. Results: Twenty residents completed both tests T1 and T2a. Their mean scores were 48% and 70%, respectively (p < 0.001, paired t-test). The cont rol group of ten residents had a mean score of 49% (T2b), similar to the st udy group's scores on T1 (T1 vs T2b, p = 0.40, unpaired t-test). Conclusion : Emergency medicine residents require specific training in calculating and executing drug ordering. A brief educational intervention significantly im proved short-term performance when retested six weeks later. Long-term rete ntion is unknown.