Title : Innovative poverty simulation activity to teach about health equity
Abstract:
Aim: The aim of the study was twofold. Our goal was to determine how poverty is perceived by Nurse Practitioners (NP) and other health provider students and if a poverty simulation would change students’ attitude and stigma toward poverty. Our second goal was to show how integration of health equity into nursing curricula could improve understanding of the upstream challenges and conditions of poverty.
Background: With NPs abating the shortage of primary care services, especially within rural, underserved, poorly resourced areas, it is imperative that they understand poverty and how health equity is related to care outcomes.
Method: We used a mixed method design that presented the Community Action Poverty Simulation to N=161 health provider students at two different universities. We measured poverty using the Attitude Towards Poverty Short Form (ATP) that included subscales of personal deficiency, stigma, and structural perspectives. We included open-ended questions of the experience on how the simulation made them feel, how learning was impacted, and how they would use this experience in practice. We used two-group t-tests to compare means pre- and post-simulation and simple content analysis for the narratives and written open-ended questions.
Results: We found significant differences with the ATP subscale means between the groups tested, although no significant differences were found in the pre-and post-simulation ATP scores. Significant differences were also found regarding individual items within the ATP scale concerning the personal deficiency and structural subscales. Qualitative narratives were rich and indicated that the simulation was valuable in understanding poverty and health equitable care. Overall, our results indicated greater understandings of poverty and its antecedents and how to improve health equity in care. Our results indicate that incorporating a poverty simulation into curricula would provide future providers with tools they need to meet the needs of a growing population of impoverished patients. We believe that exposing students to the enormous challenges that poverty creates can improve quality of care.
