Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department


Major Professor

John Clochesy, Ph.D.

Committee Member

Constance Visovsky, Ph.D.

Committee Member

Teresa Gore, Ph.D.

Committee Member

Keith Weeks, Ph.D.


drug dosage calculation, education, mathematics, nursing, students, virtual


Medication related errors are a significant cause of morbidity and mortality. In Brazil, most errors are related to prescribing, preparing, and administering medications. One way to deal with this barrier to safe care is through assessment and education of medication calculation dosage skills. Considering the Brazilian reality, this dissertation is a context and language adaptation of an evidence-based intervention called safeMedicate, a program that reinforces learning synthesis in crucial elements of medication dosage problem solving and provides the foundation for development in remaining levels of the hierarchy of learning. A guideline for medication calculation skills development or improvement based on the seven research-based principles for smart teaching was developed. Teaching approaches are beneficial for multiple methods of learning by addressing cognitive, motivational, and developmental goals. Web-based software would be a strong ally on adopting those approaches by complementing the class practice and providing opportunities for practice learning. The two-phases of adaptation and preliminary evaluation of safeMedicate for use in Brazil were guided by the Participatory and Iterative Process Framework for Language Adaptation (PIPFLA) cross-cultural equivalence model. A triangulation method of face validity survey, journaling, and multiple focus groups was used. The focus groups were (1) language adaptation team, (2) panel of experts, and (3) student panel. In order to analyze focus group data, a systematic coding procedure was performed through an iterative process, solving any differences between coders in order to guarantee internal consistency. The main themes were language, visual, content, programing, and data while discussing necessary adaptations of safeMedicate for use in Brazil.