A growing aging population will require nurses who prefer to work with older adults. Schools of nursing have used several strategies to improve students' attitudes, and encourage preferences for working with older adults. However, research on these strategies is inconsistent, with some programs improving students' attitudes whereas others have no effect. More recent studies have found that although attitudes have improved, working with older adults is generally the least preferred area of nursing. The purpose of this longitudinal mixed methods study is to describe and explain student nurse attitudes and preference changes over time. Eighty undergraduate nursing students were surveyed over 2 years. Students' attitudes and preference for working with older adults improved over time. However, their preference to work in nursing homes was consistently ranked last among the 10 choices for work preferences. In focus groups, students reported that the gerontological course dispelled myths about caring for older adults, and that clinical placement played a major role in influencing student work preferences.