Nothing in this world is to be feared, it is only to be understood – Marie Curie

Hi, my name is Rhiannon and I have maths anxiety. According to the Maths Anxiety Trust, as many as 1 in 4 adults in the UK are affected by “Maths Anxiety” (MA) which is defined as:

“…a negative emotional reaction to mathematics, leading to varying degrees of helplessness, panic and mental disorganisation that arise among some people when faced with a mathematical problem, whether in ordinary life or in an academic situation.”

Statistically speaking, it will take an average of 1.2 minutes for 80% of you to lose interest in this blog post (p=<0.05). Ok, the stats here are totally fictional, but the sentiment remains. If the idea of numeracy and statistics fills you with the kind of unease and dread that you usually get after a 3am kebab, then I urge you to read on.

In 2012, a study by Devine at al. looked at the gender divide in MA and found some worrying trends. Firstly, females reported statistically significant higher levels of MA than boys and secondly, there was a correlation between MA and mathematics performance under test conditions that wasn’t present under non-test conditions. So, whilst there was no gender difference in actual mathematics performance, despite females reporting a higher level of MA than males, there did appear to be a correlation between MA, Test Anxiety (TA) and test performance. In short, the more anxious you are about maths, the worse you will do.

Whilst there are many theories as to why MA develops and why it is more prevalent in females, there is a suggestion that socialisation and self-criticism have a lot to do with it. Devine et al. considered that as well as females reporting higher levels of MA than males, they were also much more critical of its presence, suggesting females are much harder on themselves. In a similar way, males reported higher self-efficacy, or self-belief, than females and this could also account for the difference in levels of MA. But, perhaps the most interesting finding is that females showed a strong negative correlation between MA and mathematical performance, which remained even when the TA was controlled for. On the other hand, the males showed only a marginal relationship between MA and test performance and this didn’t change when TA was controlled for. This means that males seem to experience a general test anxiety that most people experience at some point, whereas females experience a specific anxiety with maths tests well above what would normally be expected.

This is pertinent to healthcare because the latest figures from NHS employers show that 80% of Agenda for Change workers in the NHS are female. Our workforce is therefore likely to have high levels of MA, despite numeracy being part of our everyday work. More worrying still, some studies have found that MA is contagious, particularly among females. What does this mean for our NMAHP workforce? Pure, contagious panic.

At this point you might be frowning at the screen and wondering what the big deal is. I mean, you’ve gotten this far and your anxiety with maths hasn’t caused a huge problem, so what’s the big deal? Allow me to elaborate.

Since 2008, the NMC has required nurses to achieve 100% in their medicines exam. Yet, just a few years ago, one London Trust revealed that it had turned away between 40-60% of band 5 and 6 nurse applicants partly due to inadequacy in numeracy.

But it hasn’t always been this way. In 1858, Florence Nightingale became the first woman to become a member of the Royal Statistical Society thanks to her pioneering work looking at mortality rates among British soldiers in Crimea. Nightingale arrived at the hospital to find absolute chaos. Hospital data were either not available, or not up to date, and the hospital itself was dirty, crowded and infested with rats. She set about gathering data on morbidity and mortality and used a Coxcomb diagram (essentially a fancy pie chart) to show that more soldiers were dying from preventable diseases such cholera and dysentery, that were contracted in the hospital, than battle wounds. After her reforms were introduced, including hand washing, this trend was reversed and within a year, almost no soldiers were dying from preventable illness. Nightingale became the first statistician to use graphics as a way of presenting data to an uninitiated and mathematically illiterate audience. Most importantly, she got her point across and after a few hurdles, widespread reform was introduced to hospitals at home and abroad that still form the basis of our infection control policies today. Nightingale’s statistics saved thousands of lives.

Today, the average student nurse will graduate with £52,000 of debt. On top of placement hours, they will need to work an average of 54 hours a week in order to make enough money to live on in London. When inflation and interest is taken into account, they will pay approximately £175,750 of their loan back and will still not have paid off the whole lot. But according to a study by Universities UK, less than half of prospective students know this or understand the maths that goes into working this out.

Numbers and statistics underpin so much of our lives and can make the difference between best practice and dangerous practice for our patients as well as ensuring there is enough money to pay wages and keep hospitals afloat. Having a better grasp of the implications for scrapping the student nurse bursary may have led to stronger protests against the idea which is already having a huge impact on workforce planning. Luckily, the government anticipated this and are already moving toward a nurse apprenticeship scheme so that would-be nurses can be trained in hospital, by-passing the hefty tuition fees charged by universities. How convenient.

The simple fact is, understanding numbers saves lives as well as money and ironically, you can’t put a price on that.


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