RT journal article T1 Effectiveness of a multimodal intervention and the simulation flow to improve empathy and attitudes towards older adults in nursing students: A crossover randomised controlled trial A1 Fernández Gutiérrez, Martina A1 Bas Sarmiento, María del Pilar A1 Del Pino Chinchilla, H A1 Poza Méndez, Miriam A1 Marín Paz, Antonio Jesús A2 Enfermería y Fisioterapia K1 Age simulation suit K1 Aged K1 Attitude K1 Empathy K1 Intervention K1 Multimodal simulation K1 Nursing AB Aim: The aims of this study were (1) to develop a multimodal intervention according to the NLN Jeffries Simulation Theory planned to improve attitudes and empathy towards older adults in undergraduate nursing students using theoretical contents, age simulation suits, and storytelling of old participants, and (2) to evaluate the influence of the simulation flow on the effectiveness of this intervention in improving attitudes and empathy towards older adults.Background: The increase in longevity in recent decades has led to an increase in the demand for professionals linked to the care of the older adults. Some studies indicate that health care professionals lack empathy and understanding toward older adults. Therefore, it is essential to introduce innovative teaching strategies to improve attitudes and empathy toward older adults in future health professionals.Design: A crossover randomised controlled trial.Methods: A three-period crossover randomised controlled trial with an experimental group, a control group (that transitions to a delayed experimental group) was conducted on 70 nursing students after the initial 73 were allocated. A multimodal intervention was used that, in addition to geriatric nursing theory, incorporated complex age simulation suit and student-older adult interaction. Pre-test and post-test data were obtained through the Jefferson Scale of Empathy and Kogan's Attitudes towards Older People Scale. Thus, students in the experimental group 1 received the following simulation flow: Geriatric Nursing Theory + Seminar with age simulation suit + student-older adult interaction. The students in the delayed experimental group 2 received this order: Geriatric Nursing Theory +Seminar without Age simulation suit + student-older adult interaction + Age simulation suit.Results: Statistically significant differences were observed in both empathy (t = 3.155, p = 0.001, d = 0.782), and attitudes (t=3.256, p=0.001, d=0.803) when comparing control group scores (who only received the theoretical contents of the seminar) and experimental group 1 scores after receiving the full multimodal simulation (i.e. a seminar wearing an age simulation suit + volunteer interaction with an older adult). Regarding the order of educational strategies in the simulation flow, there were significant differences in the empathy scores found when both groups had received the full intervention. Accordingly, training with age simulation suits followed by storytelling provides better scores in empathy than in the opposite direction (t = 2.028, p = 0.048, d = 0.54).Conclusions: The use of a multimodal intervention, implementing an age simulation suit and the narration of an older adult's life experiences (in this order), improves attitudes and empathy. PB Elsevier SN 1471-5953 YR 2022 FD 2022 LK http://hdl.handle.net/10498/37219 UL http://hdl.handle.net/10498/37219 LA eng DS Repositorio Institucional de la Universidad de Cádiz RD 08-nov-2026