A Worthy Faux
Newer simulation activities allow students to confront discomfort in a low-stakes, but powerful, learning environment On a Friday morning in July, a pawn shop opened in a corner of Evarts Lounge was doing good business. So, too, was the nearby storefront offering paycheck advance loans. Meanwhile, staff providing health care and social services in the neighborhood had comparatively little to do. The “neighborhood” in this case was the ground floor of Helen Wood Hall, which had been converted into a small city for several hours for a role-playing exercise to help Accelerated Bachelor’s Program for Non-Nurses (ABPNN) students gain a deeper awareness and better understanding of the daily challenges and barriers facing some of society’s most vulnerable members. Conducted for the first time this past summer as part of the ABPNN’s Population Health course, the poverty simulation allowed future nurses to experience what it is like to live as part of a low-income family. Faculty and staff volunteers served as bankers, social workers, retail clerks, policemen, teachers, and other community members during the exercise, following a carefully crafted script to help guide the students’ experience. In character as fathers, mothers, grandparents, and children, ABPNN students were tasked with juggling a number of responsibilities, such as getting themselves to work and their child to school without reliable transportation, despite having very limited resources. As they navigated a month’s worth of activities in a compressed two-hour timeframe, they often encountered other challenges, such as language barriers, unhelpful authority figures, and unexpected financial burdens. Hence, the flurry of activity at the simulated pawn shop and paycheck advance store. It’s also no wonder that many of the students couldn’t
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or didn’t make health care a priority. With so many other difficult factors in their lives, they either didn’t have the time or couldn’t afford to visit their health care provider. That’s an important lesson the event’s organizers hope will resonate with students for years to come. “It will help them to know how they can advocate for their patients, how they can empower vulnerable members of our community and help to allocate resources that will allow them to survive and meet the basic needs that these families have,” said Erin Baylor, DNP, RN, PNP-BC, ONP, director of simulation and experiential learning at the UR School of Nursing. “I think it also provides our students a little more empathy for the challenges that our patients are facing.” “When we have patients struggling with compliance or with showing up on time, it’s really remembering the intersectionality that poverty plays in our everyday lives, not just in health care, but in terms of discrimination, racism, and other barriers that people face,” said ABPNN student Casey Weaver. “When you take into account all of those challenges that people face, it’s almost remarkable that people show up at all.” Poverty remains a huge issue in the U.S., and in Rochester, one of the poorest cities in the country with more than 30 percent of residents below the poverty line. Before the simulation, students drove around the city for a “windshield survey,” taking note of the resources available in different neighborhoods. They also took part in a group debriefing session with all the participants after the simulation. “Many of us probably experienced a form of poverty or at least some of that poverty culture,” student Rabia Cav said.
