Impacting Practice: Using a Poverty Simulation to Develop Leadership Skills in Baccalaureate Nursing Students

Friday, 28 July 2017: 11:05 AM

Adelita G. Cantu, PhD
School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

Social determinants of health (SDH) combine in many ways to impact the health and health outcomes of individuals and communities. One of the most significant SDH is poverty. Based on a meta-analysis of nearly 50 studies, researchers found that many social factors, including poverty accounted for over a third of total deaths in the United States in a year. Thus it is mission critical that we prepare the future healthcare workforce with the attitude, knowledge and skills that prepare them to integrate SDH into their practices so as to have a positive impact on health outcomes.

Simulation is a technique for practice and learning that has been applied to nursing education. Simulation-based learning can be a way to develop health professionals’ knowledge, skills, and attitudes, providing a valuable tool in learning resolve practical dilemmas. This abstract will describe how a School of Nursing integrates a poverty simulation in an undergraduate nursing population health clinical course to build knowledge about SDH and inform practice relative to the pathways of SDH that determine health and health outcomes.

For the last four years at our institution, undergraduate baccalaureate-nursing students have participated in a poverty simulation during the first day of their clinical rotation for population health. The simulation requires that each student is a member of a family that lives a month within the confines of a low-income household. During the month, they are responsible for paying their bills, dealing with challenges that arise suddenly and work to not be evicted from their home by the end of the month. The critical component is the debriefing after the simulation, which allows for discussion about SDH and their impacts on health.

After the simulation, the reminder of Population Health clinical has numerous clinical activities that are designed to reinforce the knowledge that students gained from the poverty simulation. The activities include a doing a community assessment, a public transportation day, working with a homeless transition center, understanding how food deserts impact health and how community gardens and a food bank can positivity change health outcomes. After each activity, students reflect on their experiences and one of the questions is Describe any nursing strategies (communication, health education, etc) that you used this week that were influenced by the awareness and knowledge gained from the poverty simulation.”

Approximately 500 answers to that question have been reviewed for common themes Three themes emerged: 1) the importance of communication and active listening; 2) the influence SDH has on how community residents prioritize behaviors, particularly health behaviors, and 3) the importance of nurses being aware of community resources and how residents can access resources. In this presentation, narratives will be shared that highlight how students engaged in nursing strategies that were influenced by these themes. Also and more importantly, students have expressed how they will use this knowledge to inform their practice as a nursing professional. Other implications for how this has social justice impact on nursing practice will be discussed.