How do you cash your paycheck if the banks are closed when you get off work? What is your alternative to leaving your underage children home alone if you don’t have child care? And how can you get to work, meet with assistance providers or attend health care appointments when you don’t have transportation?
Health care providers, community leaders and faculty and students from Vanderbilt University School of Nursing (VUSN) and other area universities battled those challenges and more during a poverty simulation pilot project facilitated by two VUSN faculty members and staffed by volunteers from Nashville’s Edgehill community.
Faculty members Tamika Hudson, MSN, APRN, and Jannyse Starks, DNP, FNP-BC, brought the simulation to Vanderbilt after attending a conference on the impact of poverty. They began planning to initiate a training program in December 2016 and completed facilitator training with the simulation program’s creators, the Missouri Community Action Network, in March.
“We recognize the need to expose our students to the realities of poverty as we prepare them for their roles as advanced practice nurses,” Starks said, noting that nurse practitioners work with diverse client groups, including many from disadvantaged backgrounds.
“We believe it is important to provide them with a firsthand view of what it is like to live in poverty. Our hope is that it will provide a sense of acknowledgement, awareness and empathy that will better prepare students to be competent and compassionate providers.”
The Community Action Poverty Simulation asked participants to take on the role of a low-income family member living on a limited budget and dealing with various true-life scenarios. During the three-hour exercise, the participants had to provide for their families, maintain their residences and interact with various agencies and businesses for the equivalent of a month.
To make interactions more realistic, the roles of employers, pawnbrokers, payday loan lenders, health care professionals, police officers and other resource providers were played by local Edgehill community residents who have experienced poverty and could respond as real-life providers do.
The simulation wrapped up with a feedback session with all participants. Students, faculty and community leaders related how difficult they’d found their roles, concurring that the exercise had given them a new perspective on the challenges facing many of their patients and neighbors.
Edgehill community residents reported how the exercise gave them feelings of empowerment. Many mentioned the benefit of being able to tell their stories and thanked the group for wanting to educate people about the complexities of poverty.
The simulation was co-sponsored by VUSN and the Vanderbilt University Office for Equity, Diversity and Inclusion. In addition to students and faculty from the School of Nursing, participants included representatives from the College of Pharmacy at Lipscomb University, Fisk University, Meharry-Vanderbilt Alliance, Mercury Court Clinic, Metro Nashville Public Schools, Middle Tennessee State University, Peabody College and Vanderbilt University School of Medicine.
Starks and Hudson will use lessons learned from the pilot event to organize future poverty simulations for Nursing School students, the Vanderbilt community and health profession students across Middle Tennessee.
“The patients we serve are representations of the evolving country we live in,” Hudson said. “It is imperative that students develop sound knowledge regarding social determinants of health and key predictors of health outcomes. Sensitization to patient scenarios that differ from students’ culture and customs is essential to providing culturally competent care.”