Methods: After institutional approval, we recruited 138 international nurse participants via social media. After obtaining informed consent, we assessed pharmacology knowledge of baccalaureate degree (BSN) level prepared nurses and associate/diploma degreed (ADN) nurses. Knowledge was assessed via 19 psychometrically-sound basic pharmacology questions addressing commonly-encountered pharmacotherapies and pathophysiological states related to the same. Demographic questions included clinical specialty, educational background, and years of experience. All participants had to be current in nursing practice to participate.
Results: Participants with more experience had the poorest scores on pharmacology questions, indicating attrition of knowledge over time. Significant differences were found in nearly every category and question (all p < .05); significant differences exist between pharmacology knowledge among participants’ educational levels; in several instances, baccalaureate-prepared nurses demonstrated deeper pathophysiological comprehension, although new graduates outperformed experienced nurses (p < .05). Critical care nurses outperformed (p < .05) all other specialties. In questions specific to pharmacodynamics and detrimental side effects of medications, baccalaureate-prepared outperformed associate-degree nurses (p < .05). Overall, both groups’ performance was disappointing regarding basic pharmacology knowledge, raising pertinent questions about preparation for practice and knowledge retained over time. Post-hoc analyses indicate preparation in and comprehension of underlying pathophysiology may influence pharmacological aptitude beyond conventional curricular wisdom.
Conclusion: Participant attrition was considerable (> 50%) when they reached the pharmacology portion of the study, suggesting insecurity with that aspect of their nursing knowledge. Despite the majority of participants reporting taking both pathophysiology and pharmacology, most performed poorly overall. This research refutes common assumptions of curricular differences in nursing educational preparation and adds to the body of evidence, as previous studies focused on particular pharmacological pedagogies versus specific knowledge outcomes. Furthermore, experienced nurses’ pharmacology knowledge was woefully inadequate, indicating subpar continuing education in practice and opportunities for improvement.
We aim to disseminate this crucial nursing research to report these deficits in pharmacological knowledge, as addressing deficits in nursing competencies in pharmacology is vital to preventing errors as well as negative patient outcomes. The pandemic problem of medication errors has lingered for decades, and poor pharmacological aptitudes could negatively affect society’s perceptions of the nursing profession. Our review of the literature found some previous evidence of pharmacologic knowledge differences between nurses prepared at baccalaureate versus associate levels. This study expands on the body of knowledge regarding nurses’ pharmacological acumen among differing demographic strata.
We recommend all nursing educators critically appraise their programs’ approaches to pharmacology teaching and consider radical changes to curricula by mandating a rigorous stand-alone combined pathophysiology/pharmacology course that is at least one academic year in duration. We further recommend consistent post-licensure testing for practicing nurses to determine dangerous gaps in practicing nurses’ knowledge and to mitigate attrition of pharmacology knowledge over time.