Yifen Cheng, Shuqin Sun, Yu‐Feng Hu, Jing Wang, Wenzhen Chen, Yukuan Miao, Hui Wang
6 min
As the global population ages, the demand for qualified geriatric nursing professionals is rapidly increasing. Nursing students often lack sufficient knowledge and hold negative or discriminatory attitudes toward older adults, which can negatively impact the quality of care. Although various novel teaching strategies have been introduced to replace or supplement traditional lectures, educators lack comparative evidence regarding which methods are most effective. This study aims to evaluate and compare the impacts of six different geriatric nursing teaching methods on nursing students' knowledge acquisition and their attitudes toward the elderly using a network meta-analysis.
The researchers conducted a systematic review and network meta-analysis following PRISMA-NMA guidelines. They searched eight electronic databases from inception through January 2024 for randomized controlled trials (RCTs) and quasi-experimental studies evaluating teaching methods in geriatric nursing education. A total of 39 studies involving 5,310 nursing students were included. The analysis evaluated six distinct instructional approaches: traditional teaching methods (TTM), problem-based learning (PBL), simulation-based learning (SBL), placebo simulation-based learning, service learning combined with traditional teaching (SL+TTM), and the learning with older people programme (LOPP). Surface under the cumulative ranking (SUCRA) probabilities were calculated to rank the interventions.
Network meta-analysis revealed that active and experiential teaching interventions significantly outperformed traditional teaching methods in improving student outcomes. According to SUCRA rankings, problem-based learning (PBL) achieved the highest effectiveness for enhancing theoretical knowledge mastery of geriatric nursing. Conversely, simulation-based learning (SBL) demonstrated the best application effect for improving nursing students' attitudes toward older adults. When evaluating both knowledge acquisition and attitude improvement simultaneously through a comprehensive scatter plot, service learning combined with traditional teaching (SL+TTM) emerged as the most optimal overall strategy.
Geriatric nursing education directly shapes vocational preferences and the quality of care provided to aging populations. By providing a rigorous comparative ranking of teaching methods, this study gives nursing educators evidence-based guidance to select appropriate instructional designs based on specific educational goals, ultimately helping to reduce ageism and improve workforce readiness.
OBJECTIVE: The purpose of this study was to evaluate the effect of different teaching methods of geriatric nursing on the mastery of geriatric knowledge among nursing students and their attitude toward the elderly. METHODS: Relevant randomized controlled trials (RCTs) and quasi-experimental studies on teaching methods to improve nursing students' knowledge and attitude were systematically retrieved in electronic databases. The time scale of retrieval spans from the database establishment to January 2024, and the database consists of PubMed, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure Database (CNKI), China Biological literature database (CBM), Wanfang Database and VIP Database. Network meta-analysis was performed by Stata 16.0 software. RESULTS: Thirty-nine studies involving 5310 nursing students met our inclusion criteria, and a total of 6 teaching methods were analyzed. According to the surface under the cumulative ranking (SUCRA) ranking, problem-based learning (PBL) was most effective in enhancing the knowledge mastery of geriatric nursing, while simulation-based learning (SBL) demonstrated the best application effect in improving nursing students' attitude toward the elderly. When considering both knowledge acquisition and attitude improvement simultaneously, service learning combined with traditional teaching method (SL+TTM) was found to exhibit the most optimal effectiveness. CONCLUSION: Educators in geriatric nursing education should prioritize the adoption of PBL, SBL and SL + TTM to enhance nursing students' knowledge and attitude. PROTOCOL REGISTRY: PROSPERO (CRD42023442001).
Sam: Precisely. They gathered thirty-nine studies involving more than five thousand nursing students to run that comparison.
Alex: And what did the combined data actually show?
Sam: The results pointed to two different winners depending on what you're trying to teach. For mastering medical facts and clinical knowledge, the method where students work through open-ended real-world problems in groups came out on top. Educators call this problem-based learning.
Alex: Why does that beat a traditional lecture for actually retaining information?
Sam: Because students aren't passive. Instead of writing down what a professor says, they're actively wrestling with clinical puzzles—figuring out diagnoses, debating options, building the knowledge themselves. That kind of active engagement tends to produce deeper understanding.
Alex: They construct the knowledge rather than just receive it.
Sam: Exactly. But when the goal shifted from knowledge to attitudes—how students actually feel about older patients—simulation-based learning performed best.
Alex: Because wearing that equipment and feeling joint stiffness or blurred vision changes how you see a patient as a person, not just a case.
Sam: The immersive nature forces students to reflect on what those physical limitations actually mean day to day. That reflection appears to reduce negative or dismissive perceptions of older adults.
Alex: But nursing requires both things at once—the medical knowledge and the right attitude. Did any single method handle both?
Sam: Yes. A hybrid approach that combines community service with structured classroom instruction showed the strongest overall performance across both measures. Students work directly with older adults in community settings—nursing homes, community centers—under clear learning objectives, while also receiving formal instruction.
Alex: So they get the theory and the human contact at the same time.
Sam: That combination lets students integrate factual knowledge with genuine empathy. It scored well across both metrics in the analysis.
Alex: How did the researchers actually quantify which method ranked higher overall?
Sam: They used a probability-based scoring system that ranks each teaching method from best to worst based on how consistently it performed across all the data. The technical name is the surface under the cumulative ranking curve—SUCRA for short. Think of it as a leaderboard that accounts for uncertainty, not just raw scores.
Alex: And where did things land on that leaderboard?
Sam: Problem-based learning ranked highest for knowledge outcomes. Simulation-based learning led for attitude improvement. And the community service hybrid scored well across both, which is why the authors highlight it as the most comprehensively effective option.
Alex: Are there any significant catches in how this evidence was assembled?
Sam: There are, and the authors are upfront about them. A notable portion of the included studies used weaker research designs—they weren't strict randomized controlled trials, which are the gold standard for this kind of comparison. That introduces some uncertainty into the rankings.
Alex: So the evidence has some rough edges.
Sam: It does. And some of the specific teaching methods had fewer studies behind them, which means those particular rankings should be treated as a guide rather than a definitive verdict. The overall trend is clear, but curriculum designers should apply some judgment rather than following the numbers mechanically.
Alex: So the practical takeaway for nursing educators is that there's no single perfect method—it depends on what you're trying to achieve at a given moment in the curriculum.
Sam: That's a fair reading. The findings suggest that problem-driven group work is well-suited for building clinical knowledge, immersive simulation is well-suited for shifting attitudes, and combining community service with structured instruction may offer the most balanced approach overall. The most effective curricula are probably the ones that move deliberately between these tools as the learning goals change.
Alex: It's a more demanding ask of educators—but it also sounds like a more honest response to how complicated it actually is to train a good nurse.
Sam: And that complexity is worth taking seriously. Caring for an aging population is one of the central challenges facing healthcare systems globally. Getting the training right matters.
Alex: Thanks for walking us through it. And thanks to everyone listening to ResearchPod.