Effectiveness of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults: A systematic review and meta-analysis

Aim: This study aims to investigate the efficacy of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults. Background: A new approach to teaching to enhance nursing students' attitudes toward and empathy for older adults involves the use of an aging simulation suit. Design: This systematic review and meta-analysis seeks to determine the efficacy of the aged simulation suit on the attitudes and empathy of undergraduate nursing students toward older adults. This protocol for a systematic review and meta-analysis was registered as CRD 42023393879 on the PROSPERO database. Methods: In February-March 2023, a systematic review with meta-analysis of randomized controlled and quasiexperimental studies was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Population, Intervention, Control, Outcomes, Study Design (PICOS) structure was used for search strategy. Databases CINAHL, Cochrane Library, PubMed, PsycINFO, and Web of Science, as well as ULAKBIM, Turkish Medline, Turkiye Klinikleri, and YOK National Thesis Center, were searched for the articles. The Joanna Briggs Institute Critical Appraisal Tools were used to evaluate the methodological quality of a study and the extent to which its design, conduct, and analysis addressed the possibility of bias. Results: The meta-analyses of attitudes toward older adults included six studies (including 535 nursing students). The intervention group's attitudes toward older adults were found to be similar to those of the control group (SMD: 15.84, Z = 1.98, p = 0.05). The subgroup analyses revealed similarities between intervention group's and the control group's mean score on attitudes toward older adults (SMD: 4.85, Z =0.70, p =0.48, for RCT; SMD: 23.05, Z = 2.02, p =0.04, for quasi-experimental). Three studies (involving 207 nursing students) revealed significantly higher mean empathy score for the control group compared with the intervention group following the intervention (SMD: 7.08, Z =4.82, p =0.00001). The subgroup analyses revealed statistically significantly higher mean level of empathy for the control group compared with the intervention group was after the intervention (SMD: 7.49, Z =3.15, p =0.002, for RCT; SMD: 6.83, Z = 3.65, p =0.0003, for quasi-experimental). Conclusions: Nursing students should be aware of older adults' feelings and experiences aging-related changes and aged simulation interventions can be a useful intervention to allow students to empathize with an older adult.