Associations Between Numeracy, Mathematics Anxiety, Perceived Teaching Quality and Medication Calculation Competence Among Undergraduate Nursing Students: A Cross-Sectional Study.

Authors

Tamer Al-Ghraiybah, Zainab Zahr, Sanmei Chen, Chiara Torrelli, Jacqueline Pich, Leila Gholizadeh

Published in

Nursing open. Volume 13. Issue 7. Pages e70679.

Abstract

To explore the associations of basic numeracy, mathematics anxiety and perceived quality of mathematics teaching with medication calculation competence among undergraduate nursing students.
A cross-sectional survey design.
A cross-sectional survey among 111 undergraduate nursing students who had completed at least one semester of study was conducted at a metropolitan university in Sydney, Australia. Participants completed an anonymous online survey comprising the Drug Calculation Assessment Tool (DCAT), the Short Mathematics Anxiety Rating Scale, the Lipkus Numeracy Scale, and items assessing the perceived quality of mathematics teaching. Fractional logistic regression with robust standard errors was used to model medication-calculation competence.
Higher basic numeracy was associated with better medication calculation competence (adjusted average marginal effects [AME]: 0.033, 95% confidence interval [CI]: 0.002-0.063, p = 0.037). Compared with students who rated teaching as poor or fair, those who rated it good or higher had significantly higher medication-calculation competence (adjusted AME [95% CI]: 0.12 [0.036-0.198], p = 0.005). Mathematics anxiety was significantly associated with medication calculation competence in unadjusted analysis (AME [95% CI]: -0.027 [-0.053 to -0.001], p = 0.041), but this association was attenuated and became non-significant after adjustment for numeracy (p = 0.363).
Basic numeracy and perceived quality of mathematics teaching were the modifiable factors most consistently associated with medication calculation competence, whereas the association with mathematics anxiety was attenuated after adjustment for numeracy. These exploratory associations require confirmation in larger, multi-site studies before firm conclusions can be drawn.
Strengthening foundational numeracy and the quality of mathematics instruction in undergraduate nursing curricula may support the development of safe medication-calculation skills. Early numeracy screening and targeted, curriculum-embedded support warrant evaluation as strategies to enhance graduates' clinical readiness and medication safety.
The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.
No Patient or Public Contribution.

PMID:
42453005
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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