While teaching nursing in both associate and baccalaureate nursing programs, we discovered that while some students are very comfortable and competent with math, others are not. Even when a dosage calculation course or math proficiency is a requirement for admission to a nursing program, testing at the start of each semester in a nursing program reveals that some students need continued support and remediation to perform dosage calculations.

Students weak in long division and basic math rely on calculators to problem solve. They appear to have lost the understanding of numerical values and thus are not able to discern whether or not a solution is realistic. An example of a common error: If the dose is 5 mg, and the patient is supplied 10 mg tablets, the student might suggest administering two tablets (20 mg) instead of half a tablet (5 mg). This answer is yielded when the problem is set up incorrectly and the student fails to estimate a reasonable amount to administer.

Students observe staff nurses' reliance on technology to establish infusion rates and determine amounts to administer without performing calculations. "Smart pumps" generate infusion rates after the nurse inputs the volume and time, and electronic medication administration records (eMAR) include (computer-­generated) amounts to administer. While these devices assist the nurse and reduce medication error potential, they may provide a false sense of security, prompting the nurse to eliminate double-checking via calculation. Thus, we set out to write a text that would strengthen students' and nurses' comfort with performing calculations in the clinical setting.

This text offers a step-by-step approach to basic math and dosage calculation. We have included approximation as a critical thinking step to evaluate the calculated answer. Believing students have different learning styles, we have color-coded steps to appeal to visual learners, provided narrated PowerPoint slides to appeal to auditory learners, and provided suggested activities for clinical instructors to support kinesthetic learners. Student engagement is supported through questions inserted in each chapter in PowerPoint. Adult learners may recognize the relevance of the material presented, as each chapter begins with a case study. In addition to demonstrating three different dosage calculation techniques side-by-side, we provide tips for performing dosage calculation efficiently in the clinical setting. Learning activities and practice problems are designed in response to actual clinical errors or common student errors, in addition to reinforcing the content presented. Faculty will appreciate this practical text, which students can use throughout the nursing program and into professional practice.