A meta-analysis JAK-STAT Signaling from 2009 summarised more than 200 studies in health professions education, and concluded that e-learning is associated with large positive effects compared with no intervention, but compared with other interventions the effects are generally small.12 There is a lack of drug dose calculation studies where different didactic methods are compared. The objective of this study was to compare the learning outcome, certainty and risk of error in drug dose calculations after courses with either self-directed e-learning or conventional classroom teaching. Further aims were to study factors associated with

the learning outcome and risk of error. Methods Design A randomised controlled open study with a parallel group design. Participants Registered nurses working in two hospitals and three municipalities in Eastern Norway were recruited to participate in the study. Inclusion criteria were nurses with at least 1 year of work experience in a 50% part-time job or more. Excluded were nurses working in outpatient

clinics, those who did not administer drugs and any who did not master the Norwegian language sufficiently. The study was performed from September 2007 to April 2009. Interventions At inclusion, all participants completed a form with relevant background characteristics, and nine statements from the General Health Questionnaire (GHQ 30).13 Quality of Life tools are often used to explore psychological well-being. The GHQ 30 contains the dimensions of a sense of coping and self-esteem/well-being, and was used to evaluate to what extent the nurses’ sense of coping affected their calculation skills. The nurses performed a multiple choice (MCQ) test in drug dose calculations. The questions were standard calculation tasks for bachelor

students in nursing at university colleges. The test was taken either on paper or on an internet website. The time available for the test was 1 h, and the participants were allowed to use a calculator. After the test, the nurses were randomised to one of two 2-day courses in drug dose calculations. One group was Batimastat assigned to a self-directed, interactive internet-based e-learning course developed at a Norwegian university college. The other was assigned to a 1-day conventional classroom course and a 1-day self-study. The content of the two courses was the same: a review of the basic theory of the different types of calculations, followed by examples and exercises. The topics covered were conversion between units; formulas for dose, quantity and strength; infusions; and dilutions. The e-learning group continued with interactive tests, hints and suggested solutions. They had access to a collection of tests with feedback on answers, and a printout of the compendium was available. The classroom group had 1 day lecture covering the basic theory; exercises in groups; discussion in a plenary session and an individual test at the end of the day.