Effectiveness of a Poverty Simulation in Second Life®: Changing Nursing Student Attitudes toward Poor People

Abstract

<jats:title>Abstract</jats:title><jats:p>Social justice is a fundamental value of the nursing profession, challenging educators to instill this professional value when caring for the poor. This randomized controlled trial examined whether an interactive virtual poverty simulation created in Second Life<jats:sup>®</jats:sup> would improve nursing students’ empathy with and attributions for people living in poverty, compared to a self-study module. We created a multi-user virtual environment populated with families and individual avatars that represented the demographics contributing to poverty and vulnerability. Participants (<jats:italic>N</jats:italic> = 51 baccalaureate nursing students) were randomly assigned to either Intervention or Control groups and completed the modified Attitudes toward Poverty Scale pre- and post-intervention. The 2.5-hour simulation was delivered three times over a 1-year period to students in successive community health nursing classes. The investigators conducted post-simulation debriefings following a script. While participants in the virtual poverty simulation developed significantly more favorable attitudes on five questions than the Control group, the total scores did not differ significantly. Whereas students readily learned how to navigate inside Second Life<jats:sup>®</jats:sup>, faculty facilitators required periodic coaching and guidance to be competent. While poverty simulations, whether virtual or face-to-face, have some ability to transform nursing student attitudes, faculty must incorporate social justice concepts throughout the curriculum to produce lasting change.</jats:p>

Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty

“…[12][13][14][15] Patterson and Hulton's methodology was used including the same poverty simulation, assessment tool, and data analysis strategy. 12 This study in pharmacy students showed positive improvements in attitude in 15 of 21 ATP Short Form items compared to four items in Patterson and Hulton's nursing student group.…”

“…12 Other nursing student studies cannot be directly compared to this study because of the variety of reporting strategies used for the ATP Short Form, which include individual items, domains, and total scores. [13][14][15] These studies used the Missouri Association for Community Action Poverty Simulation with the exception of Menzel et al, who used a virtual poverty simulation experience with a family and community resource structure similar to the Missouri Association's simulation model. [12][13][14][15] The ATP Short Form was used to measure changes in attitude toward poverty.…”

“…[13][14][15] These studies used the Missouri Association for Community Action Poverty Simulation with the exception of Menzel et al, who used a virtual poverty simulation experience with a family and community resource structure similar to the Missouri Association's simulation model. [12][13][14][15] The ATP Short Form was used to measure changes in attitude toward poverty. 16 This validated instrument is also used in the published research in nursing students as well as in studies with students in nonhealth majors.…”

“…Poverty simulation has the potential to improve student attitudes toward poverty. [11][12][13][14][15] Vandsburger reported improved student attitudes toward poverty following the use of a poverty simulation in a mix of undergraduate health and human services students. 11 Four evaluations of poverty simulations in nursing students documented improved attitudes toward poverty using the validated Attitude Toward Poverty (ATP) Short Form assessment tool.…”

“…11 Four evaluations of poverty simulations in nursing students documented improved attitudes toward poverty using the validated Attitude Toward Poverty (ATP) Short Form assessment tool. [12][13][14][15][16] The ATP Short Form contains 21 items covering 3 domains: personal deficiency measured by seven items, stigma measured by eight items, and structural perspective measured by six items. 16 Three of the nursing student studies used the Missouri Association for Community Action Poverty Simulation.…”