Beyond attitudes: Understanding geriatric career intentions among nursing students in traditional and accelerated programs

Background As global populations age, the demand for nurses prepared to care for older adults is increasing, yet interest in geriatric nursing remains low. Accelerated second-degree programs, a growing component of nursing education, often provide less exposure to gerontological content than traditional tracks. Understanding how educational pathways, along with students’ backgrounds and attitudes, shape career intentions can inform more targeted training strategies. Objectives This study examined whether nursing students in traditional undergraduate and accelerated second-degree programs differ in their attitudes, ageist beliefs, and intentions to work with older adults, and whether these attitudes mediate the relationship between program type and career intention. Methods A cross-sectional survey was conducted with 417 first-year nursing students from eight academic institutions in Israel. Data included demographics, prior experience with older adults, attitudes, ageism, and intention to work with older adults. Mediation models controlled for age, gender, experience, and prior gerontology education. Results Students in accelerated programs reported significantly higher intention to work with older adults compared to those in traditional programs, despite holding more ageist and less positive attitudes. Mediation analysis showed that positive attitudes (B = 0.428, p < 0.001) and ageist attitudes (B = -0.167, p = 0.004) significantly predicted intention. Age and prior experience also positively predicted intention. Conclusions Educational pathway shapes career intentions, but attitudes alone do not fully explain program differences. Findings highlight the need for track-specific strategies: fostering positive views and reducing ageism in accelerated programs and translating favorable attitudes into career motivation in traditional programs. Aligning curricula with students’ backgrounds and career goals can help build a skilled and motivated geriatric nursing workforce.