Cognition and dementia with Raymond and Brain: Curriculum development and evaluation using interactive animated flipped-classroom modules to impact nursing students' attitude toward dementia care.

Aim: To design a modular, flipped-classroom curriculum using character animations to improve knowledge and attitudes regarding dementia care among pre-clinical nursing students.

Background: Demographic trends suggest an urgent, unmet need for nurses with interest and adequate training in caring for people with dementia and other disorders of cognition. While flipped classrooms using video show promise, little is known about specific animation techniques to impact knowledge and attitudes in preclinical nursing education.

Design: A curriculum was developed, implemented and assessed across three nursing schools in series, totaling 223 eligible students in the states of Connecticut and Hawaii, USA from 2019 to 2022. The evaluation included prospective pre-post assessment of knowledge, attitudes and module acceptability, as well as qualitative interpretations of needs assessment data.

Methods: The six-step curriculum development process was based on that described by Kern et al., including: 1) general needs assessment in the form of literature review; 2) targeted needs assessment, in the form of faculty stakeholder meetings, a student focus group and baseline surveys; 3) optimization of learning objectives based on needs; 4) development of a pedagogical approach, namely animated, interactive modules informed by previously described best practices in animation development; 5) implementation across three different nursing schools; and 6) assessment of the learners and evaluation of the curriculum, primarily via surveys and engagement metadata.

Results: Needs assessments confirmed the importance of prior experiences, sense of mission and other affective elements as key factors mitigating learners' baseline receptiveness to training and careers in cognition-related care. Students at all three institutions rated the modules' impact on their dementia-related attitudes highly, however these ratings were statistically significantly lower when both modules were delivered as a single assignment at one site. Knowledge quiz scores significantly increased from baseline at all three sites. Only 2.6% of respondents would have preferred a text-based reading assignment. Acceptability scores, including clarity, relevance, entertainment, attention and complexity, were generally rated highly, but attention and entertainment were rated significantly lower when both modules were administered as a single assignment.

Conclusion: Cognition and Dementia with Raymond and Brain demonstrates the successful blending of animation industry workflows with best practices of curriculum development to create a novel, animated module series that is acceptable and effective in priming nursing students with the attitudes and knowledge to continue learning about cognition and its disorders.