Integrating organ donation education into emergency nursing curriculum: impact on nursing students’ knowledge, beliefs, and behavioral intentions

Organ donation is pivotal for addressing the global shortage of transplantable organs, yet its progress is hampered by inadequate public awareness and suboptimal engagement of healthcare professionals. In China, particularly in Chongqing, where cultural perceptions and educational gaps uniquely influence organ donation acceptance, nursing students—future frontline advocates—play a critical role in bridging this gap. However, their knowledge, beliefs, and behavioral intentions (KBB) regarding organ donation remain poorly characterized, particularly in the context of emergency nursing education. This study aimed to (1) assess the current status of KBB toward organ donation among nursing students in Chongqing and (2) evaluate the effectiveness of integrating organ donation education into emergency nursing curricula in improving their KBB. A two-phase study was conducted from February to June 2024 in Chongqing. Phase 1: A cross-sectional survey using a validated KBB scale (Cronbach’s α = 0.82–0.89) was administered to 3013 nursing students in Chongqing to characterize baseline KBB. Phase 2: A quasi-experimental prospective intervention was performed on 1309 eligible students in Chongqing: 983 in the intervention group received 8-week emergency nursing curriculum integrated with organ donation modules (via case-based learning, scenario simulation, and digital tools), while 326 in the control group received standard emergency nursing curriculum. KBB was assessed at baseline and immediately post-intervention. Data were analyzed using independent t-tests, ANOVA, and multiple linear regression. Cross-sectional results showed moderate knowledge (44.14 ± 10.50, range 0–80) and beliefs (22.87 ± 4.90, range 0–40) but low behavioral intentions (12.57 ± 6.13, range 0–30) among participants in Chongqing. Key influencing factors included prior exposure to organ donation education (β = 0.21, P < 0.001), social welfare participation (β = 0.18, P < 0.001), and academic year (β = 0.15, P < 0.001). Post-intervention, the intervention group showed significant improvements in knowledge (Δ=+3.43, P < 0.001), beliefs (Δ=+5.20, P < 0.001), and behavioral intentions (Δ=+3.93, P < 0.001) compared to baseline, with all outcomes significantly higher than the control group (all P < 0.001; control group Δ: knowledge + 0.32, beliefs + 0.51, behavioral intentions + 0.29). Nursing students in Chongqing exhibit deficits in organ donation KBB, with behavioral intentions being the weakest. Integrating organ donation education into emergency nursing curricula—rather than delivering it as a standalone module—effectively enhances their KBB, supporting the inclusion of such integrated content in nursing education to cultivate competent advocates for organ donation in clinical practice.