Letter to the Editor
In Response to the Published Article “Enhancing Nursing Students' Understanding of Poverty Through Simulation”
Article first published online: 7 JAN 2013
© 2013 Wiley Periodicals, Inc.
Public Health Nursing
Volume 30, Issue 1, pages 5–6, January/February
How to Cite
Drevdahl, D. J. (2013), In Response to the Published Article “Enhancing Nursing Students' Understanding of Poverty Through Simulation”. Public Health Nursing, 30: 5–6. doi: 10.1111/j.1525-1446.2013.01052.x
- Issue published online: 7 JAN 2013
- Article first published online: 7 JAN 2013
I read with interest Patterson and Hulton's (2012) article on using poverty simulation in the March/April 2012 issue and applaud the authors’ pursuit of innovative methods to assist nursing students in “understand[ing] complex issues of poverty and the multifaceted health challenges that face those who are poor” (p. 143). In the 2012 Association of Community Health Educators (ACHNE) annual meeting, using poverty simulation in community/public health nursing undergraduate courses was of great interest to many conference participants as there were several individual presentations as well as a symposium dedicated to the topic. As someone who has maintained the importance of nurses understanding the influence of social context, including poverty (Drevdahl, 1999; Drevdahl, Kneipp, Canales, & Shannon Dorcy, 2001), I agree with the authors’ general intent. I believe, however, before public/community health nurse educators implement this approach, additional factors should be taken into consideration. First, the simulation used by Patterson and Hulton (and endorsed by many of the ACHNE presenters) makes assumptions about those in poverty, including that the poor need drug and alcohol counseling. In addition, the simulation kit has the option of including an “illegal activities” person in the scenario (representing someone who engages in various criminal activities). These aspects of the scenario underscore the stereotype that criminal activities and/or addiction problems are the sole “property” of the poor, rather than issues that can be found at any class level.
Second, and more worrisome, is the unacknowledged assumption that students in the classroom have no understanding of the “reality” of poverty. From my personal experience and from what other nursing faculty have shared with me, this is very rarely true. Although seldom revealed, it is the unusual instance when at least one student in the classroom has not encountered poverty—either by living through it while a student or having experienced it in his/her past. This is particularly relevant in the current economy and the concomitant increase in university tuition rates. Our campus has had more than one student who has lived out of his/her car while attending classes. A colleague recounted a story of a student, who when asked as part of a class assignment to go to the local welfare office and “pretend” to apply for assistance, was left not knowing how to act when this was a very real experience she had lived through many times. What are we asking of these students who know poverty much more intimately than can be conveyed in any simulation? Even if students can “opt out” of the exercise, do they then need to answer other students’ queries about their reasons for not participating? Are they left with no option but to reveal personal information about which they should have the right to hold private?
The goal of poverty simulation is an admirable one; however, as much as educators use simulation to “positively impact [students’] attitudes toward those individuals and families who are poor” (p. 143), we are obligated to be sensitive to all students in the classroom, including those for whom the poverty simulation is a reflection of their own life experiences. “Students” do not constitute a homogenous category of people and treating them as if they are all, in fact, the same is pedagogically biased and unjust. The work of creating curricula that can assist students in meeting the needs of real people is important, but we should not presume that students have little understanding of what it means to be poor.
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