Reporting medication errors and near misses should be taught to prelicensure nursing students but is not always included in nursing programs. This quality improvement project focused on the near-miss medication error reporting by student nurses. The authors found that dosing errors were 81% of the incidents, but there were multiple contributing factors including communication, competency and education, environmental and human limitations, and policies and procedures. The findings can be helpful to other nursing programs to refocus education on medication errors to areas were students have problems.