2025 Theses Doctoral

Effect of a Social Determinants of Health Video Case Study on Attitudes Toward Poverty and Empathy in Nursing Students: A Quasi-experimental Study

Swope, Clarissa Marie

There is a need to integrate social determinants of health (SDOH) education throughout the undergraduate nursing curriculum. However, it is most often emphasized in community and public health courses of junior and senior-level nursing students. As a SDOH, poverty is a significant barrier to achieving optimal health and wellness. Nurse educators must be equipped with accessible and effective SDOH teaching strategies that can be implemented earlier in the nursing curriculum. These strategies can be used to help undergraduate nursing students begin to recognize their attitudes and empathy toward individuals living in poverty.

The main purpose of this study was to examine the effect of a SDOH classroom activity on attitudes toward poverty in prelicensure nursing students. The second purpose was to examine the effects of a SDOH classroom activity on empathy in prelicensure nursing students. The differences in empathy and attitudes toward poverty before and after participating in the activity were also explored. The final purpose was to examine the difference in the effect of a SDOH classroom activity on empathy and gender identity in prelicensure nursing students.

A quasi-experimental, multi-site, two-group, pretest-posttest design was conducted with a nonequivalent comparison group. A convenience sample of 98 prelicensure nursing students from three undergraduate nursing programs located in the Midwest and Northeastern parts of the U.S. participated in a SDOH classroom activity and completed pretest and posttest surveys. The study intervention consisted of a SDOH video versus paper case study followed by faculty-led, structured debriefing. The intervention group watched the video case study, while the comparison group read a paper case study. The Attitude Toward Poverty-Short Form (ATP-SF) and Jefferson Scale of Empathy for Health Professions Students (JSE-HPS) were administered to participants before and after the SDOH classroom activity.

A statistically significant difference was found between total pretest and posttest ATP-SF scores. No statistically significant effect on posttest ATP-SF scores based on the type of case study was found. A statistically significant effect on JSE-HPS scores based on case study type was identified; however, the size of this effect was small. No statistically significant differences were found in the effect of the type of case study on empathy and attitudes toward poverty. Unequal sample sizes between gender identities of participants prevented a valid analysis of the data.

The findings from this study provide support that a SDOH classroom activity may be an effective teaching strategy to improve attitudes toward poverty in prelicensure nursing students. Although the type of case study was not effective, both groups received identical faculty-led debriefing and attitudes toward poverty were improved for both groups. Future research is needed to explore the effect of debriefing on attitudes toward poverty. Additionally, experiential SDOH teaching strategies should be employed in researching empathy as an acquired skill in prelicensure nursing students.