Simulation Experience Spotlights Poverty’s Impact on Health

A student participates in the poverty simulation, where he goes to the "quick cash" station.OCTOBER 31, 2017 – Students in the Bachelor of Science in Nursing and Clinical Nurse Leader Programs took part in an immersion experience to explore the impact poverty has on their patients’ lives and health.

“We are trying to simulate the challenges that (patients and families) in poverty face day to day,” said instructor Lorraine Spencer, MSN, RN, who is a public health nurse.

She planned the three-hour-long immersion along with faculty and staff colleagues Susan Coleman, MPH, RN; Kelli Giffin, MSN, RN; Andrea Vargas (C’15); and Sarah Vittone, DBe, RN. Several faculty, staff, and community collaborators helped run the event.

The planning team purchased the Missouri Community Action Network’s “Community Action Poverty Simulation” for the immersion experience, which was held October 27 in the Healey Family Student Center.

Advocating for Patients

A student participates in the poverty simulation, attending a station focused on employment.The experience simulated one month in the life of a family. Students were assigned to different groups or “families,” and each student played a different role within their family. During four weeklong periods, which lasted 15 minutes apiece in the simulation, students confronted various realities – from daycare, groceries, and rent, to utility bills and health care. They also navigated a network of social services.

“A huge takeaway from this poverty simulation is the need for public health, especially in the hospital setting,” said BSN student Bridget Denzel (NHS’18). “It is critical for professionals to assess low socioeconomic status, a patient’s social determinants of health, and how the social determinants of health effects are impacting their health in the hospital setting.”

Denzel underlined the way health care providers can help their patients connect with “social services and health care community centers,” as well as address “the underlying problem of poverty and health inequalities.” Rachel Farnsworth (NHS’18), who is earning her master’s degree through the CNL Program, echoed Denzel’s sentiments.Stations at the poverty simulation included homelessness services and interfaith services.

“I learned that it is our responsibility as members of the health care team to advocate in favor of social justice for all patients and their families,” she said. During the poverty simulation, I was able to ‘walk a mile in the shoes’ of someone struggling to make ends meet. I understood why feeding a family can take priority over making health decisions. It allowed me to empathize with patients in similar situations, and use critical-thinking skills involving how I can approach these issues with patients with whom I will work.”

Ethical Reflection

The poverty simulation included a station dedicated to social services.Giffin, who manages the school’s O’Neill Family Foundation Clinical Simulation Center, added that the immersion complements the clinical simulation activities the students experience during their studies.

“Students are immersing themselves in a situation that we are trying to make as realistic as possible,” said Giffin at the outset of the simulation. “I hold they will get a great deal from this experience.”

Vittone, a clinical bioethicist and assistant professor of professional nursing practice, noted she thought the simulation was a good opportunity to help students engage in ethical inquiry about how assumptions about patients can affect the care provided.

“The powerful learning is the reflection,” Vittone said.

Health Equity

Patricia Cloonan, PhD, RN, dean of the School of Nursing & Health Studies, attended the immersion.

“Our school is deeply interested in health equity and the social determinants of health,” she said. “We also have a strong track record in clinical simulation. This experience allows us to engage our students in a new way about the non-clinical factors that affect a person’s health and well-being.”

The immersion was held as a part of Spencer’s course on public health nursing.