A Poverty Simulation for Heath Care Professions Students

Purpose:  Research was conducted to evaluate whether a poverty simulation presented for health care professions students effected a change in attitudes toward those living in poverty.

Problem: Poverty is on the rise in the United States (National Center for Health Statistics, 2012).  Poverty is a significant social determinant of health, impacting mental illness, obesity, cardiovascular health and other acute and chronic illnesses. It is essential that nursing students and other health care professionals develop an empathic understanding for the complexity of poverty and related health outcomes, yet few undergraduate students may have real life experience or exposure with this vulnerable population (Patterson & Hulton, 2011; Yang, Woomer, Agbemenu, & Williams, 2014). It is also important to educators and clinicians to work in collaborative interprofessional groups to provide the most comprehensive and highest quality health care for clients. 

Methodology:  Undergraduate students (n=80) enrolled in nursing, social work, and child life specialist programs in a large midwestern University participated in a poverty simulation.  An interprofessional team organized and conducted the simulation.  The simulation lasted approximately 3 hours and required the students to role play being part of a low income family for a month. An effort was made to put students from different health care majors together in families and during debriefing to allow different perspectives to emerge.  Community volunteers who had real life experience living in poverty staffed resource agencies providing assistance. Students were asked to complete a pre and posttest that assessed attitudes toward those living in poverty (Short Form of the Attitude Toward Poverty Scale, Yun & Weaver, 2010). A section for general comments collected qualitative data.

Analysis: Paired sample t-tests were used to determine differences in attitude toward those living in poverty pre and post simulation. T-test analysis was completed on questionnaires that were fully completed (n=37), contained <10% missing data (n=58), and with mean replacement for missing data (n=58). Qualitative comments were insufficient to analyze beyond basic descriptive statistics (i.e. percentages of objectives met, etc).  Additional analysis of data from a scheduled simulation April 2015 will be included in the presentation.

Findings: There was no significant overall change in attitudes pre and post simulation; however, multiple items of the scale demonstrated significance (p<.05). Subjective comments about the experience were very positive.

Implications for Nursing: Although subjective data indicated effectiveness of the poverty simulation, more rigorous methodology is necessary to collect reliable empirical evidence.  Additional simulations emphasizing interprofessional collaboration will be offered to subsequent classes of students.  Simulations can also be adapted to incorporate more vulnerable populations such as more older adults and clients with chronic mental illness.