Caring for the poor: Lessons learned from a simulation on social determinants of health

Elsevier

Available online 4 August 2022, 151623

Applied Nursing ResearchHighlights•

Simulations, depicting real life situations, can facilitate an understanding of poverty and other social determinants of health

Experiential inter-professional learning enhances collaborative problem solving and critical review

Focus groups are distinct in eliciting common meaning through multiple perspective sharing of experiences, reflections, and actions.

Structural and systemic indiscretions in the healthcare system were suggested from the findings

Abstract

Poverty is a dominant social determinant of health (SDOH). One in 10 people in the United States lives in poverty. During the pandemic unemployment increased exponentially, swelling the number of individuals and families with limited resources. Adverse health outcomes and challenges in accessing healthcare for the poor are well documented. This paper describes a simulation comprised of case study enactments to increase collaboration among future healthcare providers as they mitigate the negative impact of SDOH, with particular focus on poverty. University students from schools of nursing, public health, and medicine, joined by health care and social service providers from the community, engaged in problem solving through role playing enactments of case studies. Focus groups were conducted to explicate the process and capture challenges, triumphs, and problem solving strategies associated with SDOH, particularly poverty. Directed content analysis and thematic analysis were used to analyze the focus groups. Six themes emerged from simulation debriefings that provide critical lessons related to SDOH and caring for the poor: “When it Rains, it Pours,” “Coming of Age Too Soon,” Delay and Deny, “Time is Money,” “When You Don't Know Your Options, You Don't Have Any,” and “Walking in the Shoes of Others.” Recommendations included using simulations, with focus groups as a primary methodological approach, for preparing and updating the skills of the present and future healthcare workforce in addressing SDOH especially as recovery from the pandemic takes place.

Keywords

Social determinants of health

Poverty

Simulation

Focus groups

Inter-professional collaboration

COVID-19 pandemic

© 2022 Published by Elsevier Inc.

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