Title: Better Preparing Nursing Students to Empathize with Patients in Poverty

Location: USF College of Nursing

Client Population: USF Nursing Students. Currently Bachelors level students,
however this could be expanded to various Masters level programs as well (i.e.,
Nurse Practitioners).
Identified health need: How to appropriately apply discharge planning (teaching,
medications, etc.) to patients who are living in poverty.
Duration: The simulation would last approximately four hours.
Lesson Description: We would be developing a plan to create a simulation unique
to the application of nursing discharge planning to patients in poverty. The students
would play the part of the patients. Either faculty or advanced semester nursing
students will play the part of the practitioners and nurses. The patients/students
would all be in a poverty scenario where they need medical attention and receive
orders/prescriptions that they cannot possibly accomplish due to living/financial
conditions. These scenarios would include the need to eat healthy, exercise, get
expensive tests, get expensive medication prescriptions filled.
Goals: Develop a plan to create a simulation unique to the application of nursing
discharge planning to patients in poverty. Future classes will further develop this
plan into an actual simulation. We are simply laying the foundation.
Objectives:
1. Lay the foundation to create a simulation of the application of nursing
discharge planning to patients in poverty.
Blooms Taxonomy level: Synthesis
2. The future nursing students who go through the simulation will
demonstrate an understanding of and empathize with the current life
situations of patients living in poverty.
Blooms Taxonomy level: Comprehension
3. The future nursing students who go through the simulation will be able to
use their understanding of the life situations of patients living in poverty
and apply them to the discharge planning of the patients.
Blooms Taxonomy level: Application
4. During the debriefing after the simulation, the nursing students will be
able to discuss and judge what the implications are from the nursing
discharge planning they applied during the simulation.

Blooms Taxonomy level: Evaluation

Materials:

Several nursing scenarios of patients living in poverty.

A venue, such as an auditorium or gym, to hold the simulation.
Play money.
Name badges.
Signs.

Lesson Procedure/Activities:

1. Gain attention:
o We would present student nurses with a pre-questionnaire that would both gauge
how they perceive patients who live in poverty and what they would do if they
were in that situation.
2. Describe the goal:
o For nursing students to be able to apply their knowledge and empathy of living in
poverty to discharge planning to help patients who are living in poverty to achieve
their health goals or at least improve their health statuses.
3. Stimulate recall of prior knowledge
o This would be done during the debriefing after the simulation is over. The
nursing students would be asked to recall their knowledge and come up with
better ways to incorporate into discharge planning that would allow the patients a
chance to achieve their positive health outcomes. We would present them with
the same questionnaire they had in the beginning to see if their opinions have
changed and how they would handle the situations after walking in their patients
shoes.
4. Present the material to be learned
o A guided simulation where the nursing students are transformed into patients
living in poverty who are unable to follow providers recommendations or get their
required prescriptions.
5. Provide guidance for learning
o The nursing students will receive random profiles of patients living in poverty
with health challenges.
6. Elicit performance "practice"

o It will be the students challenge to improve the health of themselves over the
course of the simulation while feeding themselves/family, working and staying
within their budget.
7. Provide informative feedback ,
o At the end of the simulation there will be a debriefing where the students will
come up with ways that could have been implemented in their discharge planning
that could have allowed them to achieve their positive health outcomes. We will
have discussions about this so all participants will go home with new tools in their
toolkits for appropriately developing discharge planning for their patients living in
poverty. The nursing students will also learn to be a patient advocate for generic
or discounted medications and how to appropriately suggest that to the provider.
8. Assess performance test, if the lesson has been learned.
o Same questionnaire that was presented at the beginning will be presented at the
end to see if our simulation training was effective.
9. Enhance retention and transfer :
o There should be an in class assignment associated with this simulation that has
them either write a 2-3 page paper or a reflections journal. This would force the
participants to think about the simulation metaphysically so it would reinforce
what was learned.
Assessment/Evaluation: Will be evaluated by a pre and post questionnaire to
discover if the simulation/debriefing has changed the way nursing students would
perceive patients living in poverty and how they would adjust discharge planning for
said patients.

References:
Nine events of instruction. Retrieved from
http://edutechwiki.unige.ch/en/Nine_events_of_instruction. Retrieved on February
22, 2015.