The effect of an experiential learning strategy on nursing students' knowledge and attitudes toward older people in Taiwan

The aim of the research was to improve Taiwanese undergraduate nursing students' attitudes toward and knowledge about older people in order to encourage them to work with older people. People aged 65 and over currently make up 9.7% of the Taiwanese population (Department of Statistics 2006). With the increasing population of older people, health care professionals will have more experiences of caring for older people. However, an increasingly large body of literature suggests that most health care professionals have negative attitudes toward older people and little knowledge about older people. Studies from Western countries have indicated that attitudes toward and knowledge about older people can be improved through a variety of educational efforts. Two studies were conducted to examine these issues. Study 1 involved a cross sectional survey of 302 nursing students from four-year and two-year programs in a university in southern Taiwan. Overall, the results showed that nursing students held positive attitudes toward older people but had poor knowledge about older people. Moreover, the findings suggested that nursing students' intention to work with older people and gender were important factors influencing their attitudes toward older people. Age, nursing program, and living with older people were the variables which made independent contributions to knowledge about older people. Study 2 was a quasi-experimental design using pre-post tests with an intervention (experiental based learning) and control group (usual lecture based learning) (n = 60) to test the impact of a gerontological educational subject. Focus group data were also collected to examine students' reactions to the gerontological nursing subject and the experiential learning strategies used in an experiential-based learning group. The sample was students in the second semester of their second year from the same university used for Study 1. All 60 students were randomly assigned into either experiential-based learning or lecture-based learning groups for their gerontological nursing subject. The data were collected across three time points (pre-test, week 16 and week 20) using 2 validated instruments from Study 1. Qualitative data were also collected from the experimental group after students' clinical practice at week 20. In order to test for the effect of the intervention over time, repeated measures analysis of variance was used to determine the effectiveness of the experiential learning approach and clinical practice on each of the dependent variables of attitudes and knowledge. The results of Study 2 indicated that students' attitudes toward and knowledge about older people did not differ between the two groups In addition, there was no change in attitudes following the completion of the gerontological nursing subject. Students in both groups had improved their level of knowledge at the end of the gerontological subject. Therefore, the study hypotheses were not supported. Several factors such as lack of linkage between theoretical concepts and experience, the dominant 'exam culture', students' usual learning style and the structure of the program may explain the results. This was the first study which had introduced experiential learning into the selected university. It was necessary to conduct this initial study to understand the students' reaction to it. Therefore, based on the research findings from both the quantitative and qualitative results, the study indicates that additional studies are needed to continue exploring how experiential learning strategies may be used to improve students' attitudes toward and knowledge about older people