Students and faculty experience what life is like when you’re poor

Brenda Morrow, Edgehill Family Resource Center Director

How do you cash your paycheck if the banks are closed when you get off work? What is your alternative to leaving your underage children home alone if you don’t have childcare? And how can you get to work, meet with assistance providers or attend health care appointments when you don’t have transportation?

Jannyse Sparks, Tamika HudsonHealth care providers, community leaders and faculty and students from Vanderbilt University School of Nursing and other area universities battled those challenges and more during a poverty simulation pilot project facilitated by two VUSN faculty members and staffed by volunteers from Nashville’s Edgehill community.

VUSN faculty members Tamika Hudson, MSN, APRN, FNP-C, CLC, and Jannyse Starks, DNP, FNP-BC, brought the simulation to Vanderbilt after attending a conference on the impact of poverty. They began planning to initiate a training program in December 2016 and completed facilitator training with the simulation program’s creators, the Missouri Community Action Network, in March.

“We recognize the need to expose our students to the realities of poverty as we prepare them for their roles as advanced practice nurses,” Starks said, noting that nurse practitioners work with diverse client groups, including many from disadvantaged backgrounds. “We believe it is important to provide them with a firsthand view of what it is like to live in poverty. Our hope is that it will provide a sense of acknowledgement, awareness and empathy that will better prepare students to be competent and compassionate providers.”

Octavia Covington, Jana LauderdaleThe Community Action Poverty Simulation asked participants to take on the role of a low-income family member living on a limited budget and dealing with various true-life scenarios. During the three-hour exercise, the participants had to provide for their families, maintain their residences and interact with various agencies and businesses for the equivalent of a month.

To make interactions more realistic, the roles of employers, pawnbrokers, payday loan lenders, health care professionals, police officers and other resource providers were played by local Edgehill community residents who have experienced poverty and could respond as real-life providers do.

Shannon Davies, Wisdom OnyegbuleThe simulation wrapped up with a feedback session with all participants. Students, faculty and community leaders related how difficult they’d found their roles, concurring that the exercise had given them a new perspective on the challenges facing many of their patients and neighbors. Edgehill community residents reported how the exercise gave them feelings of empowerment. Many mentioned the benefit of being able to tell their stories and thanked the group for wanting to educate people about the complexity of poverty.

“Living in poverty is so hard to imagine for us who’ve never struggled in the same way,” one student wrote on a feedback form. “The perspective I gained is truly invaluable and has certainly changed my understanding of daily life for many people. I especially appreciated having the Edgehill community members there to run the stations and share their reflections—while heartbreaking to see the struggles they face, hearing their perspectives was definitely a highlight of the afternoon.”

The simulation was co-sponsored by the School of Nursing and the Vanderbilt University Office for Equity, Diversity and Inclusion. In addition to students and faculty from the School of Nursing, participants included representatives from the College of Pharmacy at Lipscomb University, Fisk University, Meharry-Vanderbilt Alliance, Mercury Court Clinic, Metro Nashville Public Schools, Middle Tennessee State University, Peabody College and Vanderbilt School of Medicine.

Miss Adrie, Miss Cheryl, Miss Karen, Miss Gwen Starks and Hudson will use lessons learned from the pilot event to organize future poverty simulations for nursing school students, the Vanderbilt community and health profession students across Middle Tennessee.

“The patients we serve are representations of the evolving country we live in,” Hudson said. “It is imperative that students develop sound knowledge regarding social determinants of health and key predictors of health outcomes. Sensitization to patient scenarios that differ from students’ culture and customs is essential to providing culturally competent care.”


Brenda Morrow, director of the Edgehill Family Resource Center, speaks about lessons learned after the poverty simulation exercise.

Inset photos from top:

VUSN faculty members Jannyse Starks (left) and Tamika Hudson explain the rules for a poverty simulation exercise to students, faculty and community leaders.

Edgehill community resident Miss Octavia (left) role-plays being a police officer investigating why a teenager (VUSN Assistant Dean of Diversity Jana Lauderdale) is truant from school.

Vanderbilt School of Nursing student Shannon Davies (left) and Lipscomb University School of Pharmacy student Wisdom C. Onyegbule are thrown a curveball when their role-play characters are evicted unexpectedly.

Edgehill volunteers represent businesses and organizations with whom residents interact.

NOTE: At the residents’ request, we are identifying them only by an honorific and first names.

Photos by Anne Rayner