The Effect of a Comprehensive Dementia Education Program on Improving Attitudes Toward People Living With Dementia

This randomized controlled trial aims to evaluate a virtual reality (VR) dementia education program among nursing students in Indonesia. Participants will be nursing students enrolled in specific semesters and courses that have been selected for the implementation of this educational program. At Universitas Airlangga, the study will involve students in the fifth semester (third year). All prospective participants will be assigned new ID numbers to ensure confidentiality. This protocol has been reviewed and approved by the Ethics Committee of the Faculty of Nursing, Universitas Airlangga.

The VR dementia education program will be integrated into the Psychiatric Nursing course, which includes topics related to dementia care. Participants will be recruited during this course through in-class announcements. An overview of the study procedures will be provided, and detailed instructions will be given shortly before data collection begins. The research team will inform students about the study approximately one week in advance, and recruitment will take place via Google Forms. Students who agree to participate will receive their new ID numbers and details regarding the schedule and location of the program through class announcements three days before the intervention.

On the intervention day, participants will arrive at the designated location and sign the attendance list using their assigned IDs. The Principal Investigator (PI) will explain the study procedures and emphasize that participation is voluntary and that students may withdraw at any time without penalty. Students who choose not to participate will still receive standard dementia-related learning material through the university's e-learning platform, but they will not take part in the VR-based educational program. Students who agree to participate will provide informed consent and complete questionnaires before and after the intervention.

Eligible participants will be identified through the university's e-learning portal. Students registered in the selected courses for the 2025/2026 academic year will be screened at the beginning of the semester. All eligible students will receive comprehensive information about the study and an invitation to participate.

The research team will describe the study in person and distribute written information at the start of the course. The 2025/2026 course consists of four classes, each with approximately 50-60 students. All class will be randomly assigned to the intervention group. The intervention group will receive the comprehensive VR dementia education program, and the control group will receive standard dementia-related material via the e-learning platform. Both groups will complete pre- and post-intervention questionnaires. To evaluate long-term effects, follow-up data will be collected from both groups at the end of the course (expected February-March 2025).

The intervention group will participate in a single VR dementia education session, while the control group will receive a single standard lecture through the e-learning platform. Students who provide informed consent will complete the baseline survey (T1). In the intervention group, students will attend a classroom lecture and discussion on dementia (first class session) and then complete a post-lecture survey (T2). Both groups will then complete the final follow-up survey (T3) at the end of the semester. The control group will follow the same survey timeline (T1-T3).

• Knowledge of Dementia [Time frame: - Baseline (before the intervention, on the same day as the session) - Immediately after the intervention (within 0-60 minutes after the session ends) - Long-term follow-up at 3 months after the intervention]
• Intention to Help Persons Living with Dementia (PLWD) [Time frame: - Baseline (before the intervention, on the same day as the session) - Immediately after the intervention (within 0-60 minutes after the session ends) - Long-term follow-up at 3 months after the intervention]
• Ageist Attitudes Towards Older Adults [Time frame: - Baseline (before the intervention, on the same day as the session) - Immediately after the intervention (within 0-60 minutes after the session ends) - Long-term follow-up at 3 months after the intervention]