The correlation between mathematics anxiety, numerical ability and drug calculation ability of paramedic students: An explanatory mixed method study

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Introduction: Numeracy is the ability to reason and to apply simple numerical concepts. Numerical and drug calculation skills are essential for patient safety. Health-care providers who perform drug calculation in their work required good math skills, especially numerical ability. The aims of this study were to explore the relationship between numerical ability, math anxiety and drug calculation performance and to explore the factors that contribute to drug calculation ability among paramedic students. Methods: A sequential explanatory mixed-method approach that included a paper-based questionnaire followed by face-to-face interviews was used in this study. The participants completed a 30-minute survey that is composed of demographics, the 10-item Mathematics Anxiety Rating Scale (MARS), a 12-question numerical ability test (NAT) and a 9-question drug calculation ability test (DCAT) and then were invited for a structured interview. Results: The mean MARS scores were higher for the second-year students than the third students. The NAT and DCAT scores for the third-year students were higher than the second-year students. There was a significant difference in the mean drug calculation ability test scores (DCAT) (t (106) = 2.13, p = 0.035 and Cohen’s d = 0.43 between males (5.05 (2.32)) and females (4.03 (2.43))). Math education prior joining the university (beta = 0.862, p = 0.030) made the strongest unique contribution when controlling for the other variables followed by numerical ability (beta =0.25, p <0.001). The themes that emerged from the interviews included the impact of technology, classmates’ impact, mathematics competence and the mental block. Conclusion: Drug calculation is fundamental in paramedic practice. It is affected by the numerical ability of the students and is negatively and indirectly impacted by mathematics anxiety. Modifications of a paramedic program curriculum can improve student’s ability to think critically and to overcome medication dosage problems.

Original languageEnglish
Pages (from-to)869-878
Number of pages10
JournalAdvances in Medical Education and Practice
Publication statusPublished - 2020


  • Allied health personnel
  • Anxiety
  • Drug dosage calculation
  • Gender
  • Paramedics

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