Introduction: Anxiety has a significant impact on undergraduate learning and attrition rates. Learning pharmacology is a potentially significant area of anxiety among healthcare students, particularly paramedic students, but there is a lack of education literature addressing the way these students learn this material. This study aimed to determine the level of anxiety experienced by 2nd year paramedic students in relation to applied pharmacology concepts.
Methods: Using a cross-sectional survey, students were asked regarding their perceived levels of anxiety related to applied pharmacology concepts. Students ranked areas of anxiety from highest to lowest and were able to respond with short answers to questions regarding what was easy or hard to learn about pharmacology and their beliefs regarding how the teaching of pharmacology could be improved.
Results: A 140 students completed the two-part survey. Dosages (69%) and mechanism of action (70%) were ranked by students to be topics that generated the most anxiety. Additionally, dose calculations, rote learning and the number of medications were shown to be other areas of higher anxiety. Students reported feeling less anxious about concepts such as indication or contraindications.
Conclusion: Specific areas of applied pharmacology such as mechanism, dosages and memorisation produced feelings of anxiety in paramedic students. It is accepted that anxiety can interfere with both the acquisition and consolidation phases of learning in addition to disrupting the recall of learned information. Therefore, the results of this study indicate that strategies to reduce the stress levels of paramedic students could improve outcomes in pharmacology subjects.
Biggs J, Tang C. Teaching for quality learning. McGraw-Hill House: Berkshire, England; 2011.
Ambrose S, Bridges MW, DiPietro M, Lovett MC, Norman MK. How learning works. 7 research-based principles for smart teaching. Jossey-Bass; 2015.
Naveh-Benjamin M, McKeachie WJ, Lin Y-g. Two types of test-anxious students: support for an information processing model. J Educ Psychol 1987;79:131–6.
Rosenfeld RA. Anxiety and learning. Teach Sociol 1978;5:151.
Mandler G, Sarason SB. A study of anxiety and learning. J Abnorm Soc Psychol 1952;47:166–73.
Kuhlmann S. Impaired memory retrieval after psychosocial stress in healthy young men. J Neurosci 2005;25:2977–82.
Cassady JC. The impact of cognitive test anxiety on text comprehension and recall in the absence of external evaluative pressure. Appl Cogn Psychol 2004;18:311–25.
Bandura A. Self-efficacy: toward a unifying theroy of behavioral change. Psychol Rev 1977;84:191–215.
Mallow JV. Reading science. Journal of Reading 1991:324–38.
Mallow JV. Science anxiety: research and action. In: Mintzes JJ, editor. Handbook of College Science Teaching: National Science Teachers Association 2006. p. 3–14.
Udo MK, Ramsey GP, Mallow JV. Science anxiety and gender in students taking general education science courses. J Sci Educ Technol 2004;13:435–46.
Gaytan J. Comparing faculty and student perceptions regarding factors that affect student retention in online education. Am J Distance Educ 2015;29:56–66.
Davidson-Wall N. Law students learn to manage stress. 7 August 2015. Available at: www.uq.edu.au/news/article/2015/04/law-students-learn-manage-stress
O'Keeffe P. A sense of belonging: Improving student retention. Coll Stud J 2013;47:605–13.
Mallow JV. Science anxeity: fear of science and how to overcome it. Clearwater. FL H & H Publ; 1986.
Udo MK, Ramsey GP, Reynolds-Alpert S, Mallow JV. Does physics teaching affect gender-based science anxiety. J Sci Educ Technol 2001;10:237–47.
Craft J, Hudson P, Plenderleith M, Wirihana L, Gordon C. Commencing nursing students perceptions and anxiety of bioscience. Nurse Educ Today 2013;33:1399–405.
King RL. Nurses' perceptions of their pharmacology educational needs. J Adv Nurs 2004;45:392–400.
Manias E, Bullock S. The educational preparation of undergraduate nursing students in pharmacology: clinical nurses' perceptions and experiences of graduate nurses' medication knowledge. Int J Nurs Stud 2002;39:773–84.
Eastwood KJ, Boyle MJ, Williams B. Mathematical and drug calculation abilities of paramedic students. Emerg Med J 2013;30:241–2.
Science anxiety and gender in students taking general education science courses. (2004). Available at: http://link.springer.com/article/10.1007/s10956-004-1465-z
Cox JL, Crane JW. Shifting the focus: increasing engagement and improving performance of nursing students in bioscience subjects using faceto-face workshops to reduce anxiety. International Journal of Innovation in Science and Mathematics Education 2014;22:11–2.
Nicoll L, Butler M. The study of biology as a cause of anxiety in student nurses undertaking the common foundation programme. J Adv Nurs 1996;24:615–24.
Hembree R. The nature, effects, and relief of mathematics anxiety. J Res Math Educ 1990;21:33–46.
Everson HT, Tobias S, Harman H, Gourgey A. Test anxiety and the curriculum: the subject matters. Anxiety Stress Coping 1993;6:1–8.
McKeachie WJ. Does anxiety disrupt information processing or does poor information processing lead to anxiety? Appl Psychol 1984;33:187–203.
Crane JW, Cox J. More than just a lack of knowledge: A discussion of the potential hidden-impact of poor pre-enrolment science background on nursing student success in bioscience subjects. International Journal of Innovation in Science and Mathematics Education 2013;21:26–36.
Dixon SK, Robinson SE. Depression and college stress among university undergraduates: do mattering and self-esteem make a difference? J Coll Stud Dev 2008;49:412–24.
Hudd SS, Dumlao J, Erdmann-Sager D, et al. Stress at college: effects on health habits, health status and self-esteem. Coll Stud J 2000:217–27.
Regehr C, Glancy D, Pitts A. Interventions to reduce stress in university students: a review and meta-analysis. J Affect Disord 2013;148:1–11.
Ramirez G, Beilock SL. Writing about testing worries boosts exam performance in the classroom. Science 2011;331:211–3.
Herreid CF. Start with a story: the case study method of teaching college science. Herreid CF, editor. Arlington, Virginia: National Science Teachers Association; 2007.
Michaelsen L, Parmelee D, McMahon K, Levine RE. Team-based learning for health professions education. Sterling, VA: Stylus Publishing, 2007.
McDade SA. Case study pedagogy to advance critical thinking. Teach Psychol 1995;22:1–3.
Magnussen L, Amundson MJ. Undergraduate nursing student experience. Nurs Health Sci 2003;5:261–7.
Rahman NIA, Ismail S, Seman TNABT, et al. Stress among preclinical medical students of University Sultan Zainal Abidin. Journal of Applied Pharmaceutical Science 2013;3:0768–1.
Qureshi A, Rizvi F, Syed A, Shahid A, Manzoor H. The method of loci as a mnemonic device to facilitate learning in endocrinology leads to improvement in student performance as measured by assessments. Adv Physiol Educ 2014;38:140–4.
Ofstad W, Brunner LJ. Team-based learning in pharmacy education. Am J Pharm Educ 2013;77:70.
Pudelko B, Young M, Vincent Lamarre P, Charlin B. Mapping as a learning strategy in health professions education: a critical analysis. Med Educ 2012;46:1215–25.
Barry OP, Sullivan E, McCarthy M. Periodic review sessions contribute to student learning across the disciplines in pharmacology. Journal of the Scholarship of Teaching and Learning 2015;15:38–56.
Bigham BL, Buick JE, Brooks SC, et al. Patient safety in emergency medical services: a systematic review of the literature. Prehosp Emerg Care 2012;16:20–35.
Cosby KS. A framework for classifying factors that contribute to error in the emergency department. Ann Emerg Med 2003;42:815–23.
Vilke GM, Tornabene SV, Stepanski B, et al. Paramedic self-reported medication errors. Prehosp Emerg Care 2006;10:457–62.
Dennison RD. A medication safety education program to reduce the risk of harm caused by medication errors. J Contin Educ Nurs 2007;38:176–84.
Bates D W, Gawande A. Improving safety with information technology. N Engl J Med 2003;348:2526–34.
Kaushal R, Barker KN, Bates DW. How can information technology improve patient safety and reduce medication errors in children's health care? Arch Pediatr Adolesc Med155:1002–7.
Kaji AH, Gausche-Hill M, Conrad H, et al. Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting. Pediatrics 2006;118:1493–500.