University of North Carolina, Chapil Hill

University of North Carolina, Chapil Hill

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Overview of the Curriculum Innovation

Nursing students at all levels need to understand the magnitude and impact of obesity in the United States. In June 2013 the American Medical Association designated obesity as a “disease”, a designation which could have a profound effect on treatment and reimbursement at both the individual and the community level.  A simulation has been developed that involves both undergraduate public health nursing students and graduate advanced practice nursing students in assessing an obese patient in an ambulatory care setting.  Prior to the simulation undergraduate public health nursing students watch “The Weight of the Nation” a four-part series developed by HBO, Inc. .  They also review the social epidemiologic, economic and population health data on obesity and conducted a community focused assessment to determine the impact of this health condition on their practice community.  The simulation experience was created through a team of interested graduate nurse practitioner faculty and an undergraduate public health nursing faculty member.  Faculty incorporated not only a public health focus but also a primary care component that mirrored the challenge posed in the Institute of Medicine report on public health and primary care to more closely integrate community and primary care to support improvement in population health outcomes.  In preparation for the simulation experience students also viewed the videos developed by the Rudd Center at Yale University on weight bias and stigma as well as read Cohen, L., Perales, D., Steadman, C. (2005) The O Word: Why the Focus on Obesity is Harmful to Community Health as well as other evidence based practice literature.  Faculty noted that scheduling the two levels of nursing students, the lack of information on proper assessment techniques and measurement tools for the obese patient, and the limitations of the obesity simulator were challenges that had to be overcome.  Students evaluated the experience positively noting that this was one of the few times that obesity had been highlighted during their clinical education.  Suggestions for future development of the experience include the incorporation of cross-disciplinary teams in the simulation and more interaction between the NP students and the undergraduate students before and after the simulation. 


Beth F. Lamanna, WHNP, MPH, RN
Clinical Assistant Professor
The University of North Carolina at Chapel Hill
School of Nursing