Award Date

May 2018

Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Lori Candela

Second Committee Member

Tricia Gatlin

Third Committee Member

Alona Angosta

Fourth Committee Member

LeAnn Putney

Number of Pages



Adverse drug events affect up to 5% of inpatients; half of these events are caused by preventable medication errors (Agency for Healthcare Research and Quality, 2015). Nurses are the final checkpoint between a medication being ordered and the patient taking it. This profound responsibility requires nurses to possess well-developed pharmacology knowledge, skills, and attitudes (KSAs). To acquire these abilities, they must not only receive pharmacology content as part of their educational preparation, but also translate what they have learned during student clinical experiences. This is important in bridging the gap between what is learned in the

classroom and clinical practice.

The Quality and Safety Education for Nurses (QSEN) project initiated six competencies to help improve nursing education (Cronenwett et al., 2007). However, since the inception of the QSEN competencies, little knowledge has been generated about their integration into nursing programs' pharmacology education. The purposes of this study were to explore how nursing instructors cultivate and evaluate student pharmacology KSAs in the clinical setting and explore how QSEN competencies are integrated into clinical pharmacology education.

This study utilized a multiple case study approach. A convenience sample of six clinical nursing instructors from three different nursing programs in the southwest United States were interviewed, and their course materials pertaining to pharmacology were reviewed. Data were analyzed via a cross-case analytic technique and by utilizing the Complementary Analysis Research Matrix Application (CARMA). The CARMA tool allows the investigator to compare what is expected in clinical pharmacology education to what actually happens. This juxtaposition allows the investigator to explore whether evidenced practices are congruent or divergent from expected practices.

The findings of this study indicated that, in some cases, pharmacology was not purposefully included in clinical course curricula. However, clinical instructors use a variety of teaching and evaluation methods to cultivate students’ pharmacology KSAs, with questioning being the most commonly utilized teaching and evaluating technique. Regarding the alignment of QSEN competencies to pharmacology, instructors did not explicitly incorporate QSEN into their course documents or language with students. Additionally, each instructor chose which competencies to focus on and how to implement them into their teaching.

The implications of the inconsistent manner in which students are taught pharmacology KSAs in the clinical setting may include inadequate medication administration abilities, as described in the literature. The recommendations include pedagogical training for all clinical nursing instructors, the implementation of evidence-based clinical teaching and evaluation strategies, and increased education about the incorporation of QSEN competencies into clinical pharmacology KSAs. The initiation of these recommendations is one way to answer the call to improve nursing education and practice, and, thus, patient outcomes.


clinical setting; nursing; pharmacology KSAs; QSEN competencies


Education | Nursing

File Format


Degree Grantor

University of Nevada, Las Vegas




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