Journal Article

Teaching health disparities on the road: An experiential educational intervention for doctor of nursing practice students

Vandermause, Roxanne K., Lavin, Roberta P., Fish, Anne F., Bender, Annah, Kuensting, Laura, Murphy, Natalie L.

2024

Overview

This analysis was conducted to understand the nuanced and underlying benefits and challenges of an experiential educational intervention for DNP students learning how neighborhoods and health disparities may be related. Poor social and environmental conditions in many low-income urban neighborhoods are linked to deleterious health outcomes. Many of the structural and political influences are unknown to health providers, which can inhibit their understanding of the social effects on health. One aspect of a new DNP social determinants of health curriculum is a guided community bus tour in economically disadvantaged neighborhoods to enhance understanding of health disparities. A concurrent mixed methods design, including comparison surveys and thematic analysis, was used to analyze student responses to the experiential educational intervention. A community-based bus tour implemented in socially disadvantaged neighborhoods in an urban environment was the study focus. New DNP students (n=91) in a midwestern university introductory course agreed to provide feedback following an experiential learning activity. The analysis of responses to the educational intervention was completed using a systematic thematic analysis alongside descriptive statistics and paired t-tests in a convergent mixed methods analytical approach to answer the research aim. Students expressed confidence in naming and addressing health disparities after the bus tour activity. Analysis showed: (a) A visual tour can impact new learning, (b) Policy can explain inequity and is new to students, (c) Students do not well articulate racial disparities and (d) Understanding racial history requires attention and conversation. A community bus tour met our expectations for teaching DNP students concepts related to health disparities as it illustrated real-life situations in actual neighborhoods. However, there were unusual student responses that prompted us to reflect on the activity and consider improvements. More emphasis needs to be placed on cultural wealth and on discussion planning for such experiences. Our results lay the groundwork for curriculum development. Setting goals and targets in line with the 2022 CDC’s Core Health Equity Science and Implementation Strategy is essential. •An experiential bus tour provided a stark recognition of poverty for some but a daily reality for others.•Teaching about health disparities requires attention to cultural challenges as well as cultural wealth.•Implicit bias is a common risk in educational design that can be mitigated.•Reflective and experiential educational practices like bus tours, should lead to actionable community intervention strategies.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Adult / Analysis / Bus tour / College students / Community / Community Change / Concepts / Cultural competency / Curricula / Curriculum / Curriculum development / Design / Disadvantaged / DNP / Education, Nursing, Graduate / Educational activities / Educational Methods / Educational Needs / Educational programs / Educational Strategies / Environmental conditions / Experiential learning / Feedback / Female / Foundation Programs / Goal setting / Graduate studies / Health disparities / Health education / Health promotion / Health status / Health Status Disparities / Humans / Intervention / Introductory Courses / Learning / Learning Activities / Learning Experience / Low income groups / Low Income Students / Male / Mixed methods research / Naming / Neighborhoods / Nursing / Nursing education / Outcomes of Treatment / Outdoor air quality / Physical Environment / Physicians / Poverty / Poverty Areas / Predatory lending / Problem-Based Learning / Professional practice / Public health / Qualitative descriptive / Racial Differences / Racial inequality / Redlining / Research methodology / Responses / Social Determinants of Health / Social Environment / Social factors / State Aid / Statistics / Student Surveys / Students / Students, Nursing - psychology / Students, Nursing - statistics & numerical data / Surveys and Questionnaires / Teaching / Teaching Methods / Thematic analysis / Underserved / Understanding / Urban areas / Urban poverty / Wealth