Influencing nursing student attitudes toward older adults: a pre/post interventional study

The older adult population in the US is burgeoning and nurses will be at the forefront of providing the skilled, compassionate care needed for them. Undergraduate nursing students do not commonly desire to work with older adults after graduation, likely related to negative attitudes, which can adversely impact the care provided.

To determine the effect of a course using a suite of teaching techniques designed to positively shift nursing students' attitudes toward older adults.

A one group pre and post-test design was used to test the effect of completion of the Nursing Care of the Older Adult course on baccalaureate undergraduate junior level nursing students' attitudes toward older people at a large University in the Midwest for two consecutive years (2019 and 2020).

A quality assurance evaluation using a voluntary anonymous survey (Kogan's Attitude Toward Older People Instrument) on paper (2019) or online (2020) took place on the first and last day of class. Normality was assessed and the central limit theorem was applicable, therefore, independent samples t-tests were performed on the primary outcome, total score, with the primary predictor as pre vs post. This process was repeated on a 2020 cohort in the same course with a paired samples t-test, as paired subject ID's were recorded in 2020 but not in 2019. Due to the impact of the COVID-19 pandemic on all parts of academic life, no direct comparisons were made between the 2019 and 2020 samples. Course content included lectures, videos, MaskEd™ simulation, group work, case studies and clinical experiences.

Both cohorts had significant improvement in the total Kogan instrument score, indicating a positive change in attitudes toward older adults [2019 pre M 167.2, SD 20.3 to post M 176.9, SD 22.4, t (292.43) = 3.96, p < 0.001 and 2020 pre M 179.4, SD 21.3 to post M 188.1, SD 22.2, t (70) = -5.61, p < 0.001].

The innovative, intentional teaching strategies incorporated into this gerontology course were effective in promoting positive attitudes toward older adults.