In Their Shoes - a Poverty Simulation

Background: Poverty is the most influential social determinant of health. Because nurses care for people from all socioeconomic groups, they will encounter people who live in poverty who often feel that health care providers are frequently insensitive to their needs and concerns. Therefore it is incumbent upon nursing faculty to address poverty-related-to-health issues with their students.

Purpose: The goal of this educational experience was to use and evaluate a poverty simulation that explores undergraduate public health nursing (PHN) students’ attitudes about those living in poverty.

Description: A four hour poverty simulation was included as part of the students’ clinical experience. The simulation was conducted within a school of nursing’s conference rooms and classrooms, each of which offered an experience that a family in poverty likely has. These experiences included taking public transportation, paying bills, dealing with daily needs (groceries and school crises), filling out annual paperwork for various agencies, attending health care appointments, and interacting with the police. Prior to proceeding through these experiences, students completed attitudes toward poverty (ATP) scale and were preassigned to a “family” of three to four members. After completing the simulation the students again completed the ATP scale and participated in a debriefing session.

Findings: Debriefings with students illuminated themes, including: 1) Receiving government assistance is harder than people think; 2) Poverty isn’t about being lazy; 3) Poverty creates a snowball effect in the family. Based on student feedback, the simulation was successful in sensitizing PHN students to the experiences of living in poverty.