Inclusive Simulation for Weight Bias Reduction to Prepare Students for Equity-Driven Nursing Practice

Abstract : Key Words: simulation, education, nursing, obesity, equity

Introduction: Obesity and weight discrimination impact not only physical health but also the quality of overweight and obese patient care. However, there is a lack of diversity in the physical/hands-on aspects of healthcare simulation training. The purpose of this project was to improve nursing student’s cultural humility, decrease obesity bias, and improve skill levels in caring for overweight/obese patients.

Methods: Kolb’s Experiential Learning Theory guided new content and skills sessions that addressed weight discrimination using obesity suits to provide simulated patient care activities, including:
1) Weighing, 2) Linen change in an occupied bed, 3) Wheelchair/bed transfer, 4) Wearing the obesity suit while experiencing potential challenges from the patient perspective, 5) Discussion of using people-first language, and 6) Student reflection, discussion, and debriefing. Students were invited to complete an online Qualtrics survey before and after their skills session.

Results: Paired t-tests were completed for 130 sophomore nursing students on three scales. For the Attitudes Toward Obese Persons scale, 15/20 questions significantly changed from pre to post-testing. For the Cultural Humility scale, only 2/19 scores were significant, but pre-test means were high. There were no statistically significant changes in the Beliefs About Obese Persons scale.

Conclusion: This effort was successful in using inclusive simulation strategies to educate nursing students in the care of overweight/obese patients. This project has the potential to positively influence the readiness of graduating and registered nurses to engage in inclusive practices and reduce weight biases, ultimately leading to better patient outcomes.