Differences in teaching modalities and the effect on undergraduate nursing students' knowledge about, attitudes...

As the older adult population in the United States grows, demand for nurses prepared in gerontological care is rising. Yet many nursing students are reluctant to pursue this specialty, often owing to limited exposure and persistent age-related stereotypes.

To compare knowledge about, attitudes toward, and intent to work with older adults among students in two accelerated BSN programs: one with a stand-alone gerontology course and one in which gerontological content is integrated throughout the curriculum.

A two-group, longitudinal quasi-experimental study surveyed undergraduate nursing students at program entry, six months into their program, at program completion, and six months post-graduation. Validated instruments measured students' knowledge, attitude, and intent. Multiple multivariate linear mixed models examined curriculum and time effects.

Students in the stand-alone course achieved significantly higher knowledge scores and more positive attitudes toward older adults across all time points compared to those in the integrated curriculum. While both groups showed improvements in knowledge and attitude over time, attitude consistently predicted stronger intent to work with older adults. Conversely, higher knowledge scores were associated with lower intent in one model. Most intent questions remained stable across time points, with some showing slight declines six months after graduation.

Focused gerontological coursework enhances nursing students' knowledge and attitudes, yet sustaining intent to enter geriatric practice may require additional post-graduate support. Findings underscore the value of explicit gerontology content in undergraduate curricula and highlight the need for transition-to-practice strategies that reinforce positive attitudes toward older adult care.