Milestone map
Milestone map
3 milestones
Pass a medicine calculation competency assessment
2–4 weeks (preparation + assessment)
Under supervision of a registered pharmacist or registered nurse with medicine administration sign-off authority, complete a formal pharmaceutical calculation competency assessment covering: oral dose (tablets and liquids), IV infusion rate and volume, weight-based dosing (mg/kg and mcg/kg/min), reconstitution and dilution, and concentration calculations (mg/mL, %w/v, molar concentrations). Minimum 30 questions across all five calculation types. All workings must be shown. You must score 100% — pharmaceutical calculations are a zero-error domain.
Proof required
Submit your completed assessment (with all workings shown), the assessor's signature confirming the 100% score was achieved independently under observation, and a note of which calculation type was most challenging.
What gets checked
- Score is 100% — pharmaceutical calculations require zero errors; the assessment does not pass at lower scores.
- All five calculation types are represented in the assessment — IV rate and concentration calculations are often omitted.
- Workings are shown for all calculations — a correct answer without workings cannot be verified.
Common mistakes
- Assessment completed without a supervisor present — pharmaceutical calculations must be assessed under direct observation.
- Assessment limited to oral dose calculations only — IV and concentration calculations are required.
- Assessment passed at less than 100% — pharmaceutical calculations are a zero-error domain.
Resources
Foundationstart here
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What a verifier looks for
- Confirm 100% score and independent supervised completion — pharmaceutical calculations have no acceptable error rate.
- Ask the student to demonstrate a concentration calculation from memory.
- Ask what the clinical consequence would be of a 10-fold calculation error in the most complex calculation type on the assessment.
Apply calculations in 5 supervised clinical scenarios
4–8 weeks (dependent on clinical placement)
Under direct supervision of a registered pharmacist or registered nurse, perform and document real pharmaceutical calculations required in 5 clinical encounters — dose verification, IV rate confirmation, weight-based dose checking, preparation of an IV infusion, or equivalent. For each encounter, record: the calculation type, the medicine name, the calculation performed (with working), the result and whether it matched the prescribed dose, and supervisor sign-off confirming the calculation was correct. All patient data must be anonymised.
Proof required
Submit 5 anonymised calculation records with workings, results, and supervisor countersignatures. At least 3 different calculation types must be represented.
What gets checked
- All workings are shown for each calculation — the proof of competency is in the method, not the answer alone.
- Supervisor countersignature confirms the calculation was verified as correct.
- At least 3 different calculation types are represented.
Common mistakes
- Calculation records without workings — showing only the final answer does not demonstrate the calculation method.
- All 5 encounters using only oral dose calculations.
- Patient identifiers not fully anonymised.
Resources
Foundationstart here
What a verifier looks for
- Check that workings are shown for all 5 encounters — a correct answer without working cannot be verified.
- Ask the student to explain one calculation from memory in the clinical records.
- Verify that at least 3 different calculation types appear across the 5 records.
Reflect on a pharmaceutical calculation error or near-miss
1–2 weeks
With your clinical supervisor, review a real pharmaceutical calculation error or near-miss that occurred in your clinical setting (from an incident report, dispensing error log, or direct clinical experience). Write a structured reflection (2 pages): what the error was, what type of calculation was involved, what contributed to the error, what harm resulted or could have resulted, and what system or individual change would reduce the risk of recurrence. The reflection must be countersigned by your clinical supervisor confirming it is based on a real case.
Proof required
Submit your 2-page reflection countersigned by your registered clinical supervisor confirming it is based on a real case. All patient and staff identifiers anonymised.
What gets checked
- Error type is specific — 'a calculation error occurred' is not a reflection; the specific calculation type, the error magnitude, and the clinical context must be described.
- Harm analysis includes both actual harm and potential harm — many near-misses cause no actual harm but high potential harm.
- System change proposal is specific and implementable — 'be more careful' is not a system change.
Common mistakes
- Reflection based on a hypothetical or published case rather than a real clinical case — supervisor countersignature is required.
- Harm analysis that only describes the error without addressing the potential consequences.
- System change that places all responsibility on individual practitioners.
Resources
Foundationstart here
What a verifier looks for
- Confirm the supervisor countersignature states the reflection is based on a real clinical case.
- Ask the student what system change would have the greatest impact on preventing similar errors.
- Ask what the maximum safe dosing error margin would be for the medicine involved — tests clinical consequence awareness.
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