Details of the seven recommendations are given below. A link to references and discussion for each recommendation is included.
1: IDENTIFY the quantitative skills and competencies necessary for quality and safe nursing practice
In order to develop appropriate learning outcomes, educational curricula, and professional development needs, an updated inventory of essential quantitative skills and competencies should be constructed to reflect current nursing practices.
It is essential that an updated inventory also differentiates between the quantitative skills and competencies specific to a particular degree or certification level (e.g., LPN, ADN, BSN, NP, DNP) with those that are universal for all practicing nurses.
2: INVESTIGATE the most appropriate sequencing of mathematics, statistics, and nursing educational offerings to ensure students acquire essential quantitative skills and competencies for quality and safe nursing practice.
A recent survey by the High-Quality Mathematics Education for Nurses Task Force identified significant variation in how mathematics and statistics content is delivered in nursing programs across the United States.
These variations point to a critical need to establish an evidence-based rationale behind specific mathematics and statistics course offerings, the timing and delivery of quantitative instruction throughout the nursing curriculum, and the selection of faculty responsible for teaching the content (faculty from a mathematics, statistics, or nursing department).
3: INCORPORATE recommendations and best practices in nursing, mathematics, and statistics education in the design of learning outcomes, instruction, materials, and assessments.
National organizations such as the Mathematical Association of America (MAA), American Mathematical Association of Two-Year Colleges (AMATYC), and the American Statistical Association (ASA) have published documents designed to improve the teaching and learning of mathematics and statistics. These documents equip educators with effective, evidence-based instructional strategies and provide recommendations for creating rich and engaging material.
Similarly, organizations such as the National League for Nursing (NLN), Quality and Safety Education for Nurses (QSEN), National Council of State Boards of Nursing (NCSBN), Organization for Associate Degree Nursing (OADN), the American Association of Colleges of Nursing (AACN), and the National Association for Healthcare Quality (NAHQ) have published recommendations, competencies, position statements, collaborative reports, and other resources to aid in the development of nursing curricula.
Evidence-based strategies and recommendations from these national organizations should guide the development of quantitative educational practices in nursing programs.
4: INTEGRATE learning experiences throughout the nursing curriculum that provide learners an opportunity to develop sound quantitative reasoning, data reasoning, and clinical judgment.
It is important to reject a “once-and-done” mentality with respect to quantitative education in the nursing curriculum. A student’s quantitative education should not be defined by passing a mathematics or statistics course; rather, it should include quantitative learning experiences that are explicitly embedded throughout the curriculum.
As students progress through their programs and experience the increasing complexities of nursing practice, they should be provided with opportunities for learning (e.g., simulations, case studies, clinical based activities) that go beyond simply obtaining a numerical solution to a decontextualized mathematics or statistics problem. Instead, students should be prompted to notice, interpret, operate with, and reflect upon quantitative information within complex and authentic clinical environments.
5: INCLUDE an ongoing analysis and discussion of ethical and effective communication of mathematical and statistical data, results, and recommendations.
Communicating quantitative information and results to patients, their families, and the community involves careful consideration of factors that extend beyond purely abstract calculations. For example, it is important for nurses to understand and discuss false positives and negatives of diagnostic tests, communicate differences between relative and absolute risk, and clearly articulate dosage administration guidelines.
An additional focus should be placed on the ethical considerations and critical analyses of quantitative information presented in research, publications, and in the media, including the identification and impact of misleading statistics and graphical displays.
6: INCORPORATE assessment measures that reflect changing licensure/certification requirements, integrate quantitative and data reasoning with components of clinical judgment, and provide learners the opportunity for continuous improvement (rather than serving only as a high-stakes benchmark for academic progression).
It is common for nursing programs to utilize high-stakes, quantitative proficiency exams consisting of decontextualized multiple-choice and short-answer problems. These assessments are often used for admission into nursing programs and as a benchmark prior to clinical experiences in order to identify learners who are “safe” for clinical practice. Given that these assessments often become barriers for academic progression, there is a need to (1) critically assess the reliability and validity of these assessments, and (2) establish an evidence-based rationale for their use.
To foster a culture of continuous improvement, educators should regularly incorporate valid, competency based assessments, especially those that require learners to use critical thinking and psychomotor skills necessary for safe nursing practice. For example, simulations, case studies, and clinical-based activities can provide a safe and controlled environment for learners to build confidence and develop sound quantitative reasoning, data reasoning, and clinical judgment.
7: INFORM the community through collaborative engagements and professional development opportunities that integrate best practices from nursing, mathematics, and statistics education.
Effective quantitative education in the nursing curriculum requires the integration of mathematics, statistics, and nursing concepts and skills. Through collaboration, educators from these fields can develop a deeper understanding of these unique connections, and thus construct more meaningful quantitative learning opportunities throughout the nursing curriculum.
In order to support these collaborative efforts, it is essential that national nursing, mathematics, statistics, and education organizations continue to partner with one another to share expertise, develop professional development opportunities, disseminate resources, and advance best practices.