Developing dementia knowledge, attitudes, and confidence through nursing education: A quasi-experimental one-sample panel evaluation of a 3-year sequential dementia education programme

Background
Dementia is a significant global health challenge, with a rapidly increasing prevalence. Despite the need for high-quality dementia care, many nursing students report feeling underprepared to care for individuals with dementia. The lack of evaluation of structured, sequential, and curriculum-aligned dementia education has been identified as a gap in the current literature.
Aim
This study aimed to evaluate the impact of the Dementia Education Programme (DEP) a multi-modal, sequential approach to dementia education integrated into the pre-registration nursing curriculum.
Methods
This study used a quasi-experimental one sample panel design to evaluate the impact of the DEP on nursing students' dementia related knowledge, confidence, and attitudes. Validated instruments were used to assess outcomes. Data were imported into SPSS, merged by unique participant ID for consistency across time points, and missing data were addressed. RM-ANOVAs were conducted for each outcome. To further explore when significant changes occurred, post hoc pairwise comparisons were conducted using the Bonferroni correction. Pearson's correlation coefficients were then calculated to examine the relationships between dementia knowledge, attitudes and confidence across the sample. Finally, independent sample t-tests and one-way ANOVAs were conducted to explore differences in outcome measures scores based on demographic or experiential variables.
Results
Significant improvements were observed across all three outcomes over time, with large effect sizes, demonstrating sustained impact across the programme. Attitudes showed a temporary plateau between Years 1 and 2 before increasing in the final year. Moderation analyses indicated that knowledge increased at a similar rate across student groups, whereas greater gains in attitudes and confidence were observed among students with prior caregiving experience and prior dementia education, with the largest increases in confidence seen in people aged 45+. Knowledge was weakly associated with confidence, while attitudes showed a moderate association and emerged as the strongest predictor, explaining 38.1% of the variance. Baseline scores did not differ by demographic or experiential characteristics.
Conclusions
This study provides the first longitudinal insights into sequential dementia education programmes across all three years of a nursing degree. These results highlight the importance of structured, sustained approaches to dementia education in nursing curricula. Future research should explore whether gains in knowledge, attitudes, and confidence are sustained and translate into clinical practice. Mixed-methods studies are recommended to capture students' experiences of the programme and identify its most impactful components.