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Abstract. Objectives: Drug dosing errors commonly cause morbidity and mortality. This prospective controlled study was performed to determine: 1) residents' understanding of drug dose calculations and ordering; and 2) the short-term effect of a brief educational intervention on the skills required to properly calculate dosages and order medications. Methods: The study was conducted at an urban public hospital with a four-year emergency medicine (EM) residency program. The EM residents served as the study group and were unaware of the study design. A written, eight-question test (T1) with clinical situations and factual questions was administered. Immediately following the test, correct answers were discussed for 30 minutes. Key concepts were emphasized. Six weeks later, a repeat test (T2a) with a similar format was administered to the study group. The same test (T2b) was simultaneously administered to a control group, residents of similar training who did not take T1, in order to determine test equivalency (T1 vs T2). Tests were graded using explicit criteria by a single investigator blinded to the order of administration. Results: Twenty residents completed both tests T1 and T2a. Their mean scores were 48% and 70%, respectively (p < 0.001, paired t-test). The control group of ten residents had a mean score of 49% (T2b), similar to the study group's scores on T1 (T1 vs T2b, p = 0.40, unpaired t-test). Conclusion: Emergency medicine residents require specific training in calculating and executing drug ordering. A brief educational intervention significantly improved short-term performance when retested six weeks later. Long-term retention is unknown. Key words: medical errors; medication errors; prescriptions, drug; education, medical; internship and residency. ACADEMIC EMERGENCY MEDICINE 2000; 7: 1311-1316 T HE INSTITUTE of Medicine (IOM) report, 1 released in 1999, implicates medication errors as the direct cause of at least 7,000 patient deaths annually. These numbers are supported by the Harvard Medical Practice Study, published in 1991, which identified that nearly 4% of all patients admitted to hospitals in New York State suffered a consequential iatrogenic injury.2 The apparently simple act of administering a medication is actually the culmination of numerous sequential steps, each with its own potential for error. Thus the causes of medication errors are diverse and span the spectrum from incorrect drug ordering to However, one of the leading causes of iatrogenic medical injury is incorrect drug calculations and ordering.3 This type of error is implicated in up to 15% of all errors in medication ordering. 4 The problem is particularly prevalent in the practice of pediatrics, where weight-based calculations are needed for virtually every prescription.5 Moreover, since children account for approximately 15% of emergency department (ED) visits, the impact of drug dosing errors in emergency medical practice is obvious.Little formal education in dose calculations and order writing is typically offered in medi...