Effectiveness of a poverty simulation in Second Life®: changing nursing student attitudes toward poor people

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® 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 (N = 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®, 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.