An Authentic Poverty Simulation for Health Care Profession Students Using Community Volunteers Experiencing Poverty

Preparing students to address the social determinants of health in integrated care settings

BACKGROUND

Health professionals are increasingly being called to address the social determinants of health (SDOH) and, to do so effectively, often requires an integrated approach to care. As a result, accreditation standards across multiple professions have emphasised the importance of interprofessional education (IPE).

APPROACH

This paper describes large-scale, community-engaged learning that is required annually of students from nursing, pharmacy, public health, and social work. Through a series of asynchronous and synchronous activities that are informed by the Interprofessional Education Collaborative core competencies, students are trained to be SDOH change makers who can readily adopt integrated care service delivery frameworks into their future practice.

EVALUATION

Approximately 1000 students have participated in this event since the University launched its IPE curriculum in 2017. Student consistently report achievement of the course learning objectives, with 91% of students reporting that the learning activities enhanced their understanding of their professional roles/responsibilities in regards to addressing poverty and food insecurity.

IMPLICATIONS

Two key lessons learned from these efforts are described, including the benefits of a trauma-informed pedagogical approach and special considerations for large-scale learning.

Impact of a Co-curricular Poverty Simulation on Pharmacy Students' Socioeconomic and Patient Advocacy Attitudes and Beliefs

Background: Pharmacists are well-positioned to assist patients facing poverty with financial and well-being resource navigation. Pharmacy educators must find avenues for students that foster awareness of applicable challenges encountered by economically disadvantaged patients. Objective: This study examines the impact of a poverty simulation on pharmacy students' socioeconomic and patient advocacy attitudes and beliefs. Methods: Third year professional pharmacy students participated in the Community Action Poverty Simulation (CAPS). Students were asked to voluntarily complete a survey prior to and following their participation. The survey was based upon a combination of 3 previously validated survey tools: Attitudes Toward Poverty (ATP) scale, Medical Student Attitudes Toward the Underserved (MSATU), and the Locus of Control Scale (LCS). Students also responded to open-ended questions postsimulation. Results: Forty of the 74 students completed both the presimulation and postsimulation surveys. Significant changes were seen in a matched sample analysis for 17 of 49 survey questions. Prominent differences (decreasing agreement) came from the statements: "An able-bodied person collecting welfare is ripping off the system" and "Welfare makes people lazy"; and increasing agreement that "I feel personally responsible for providing medical care to the needy." Open-ended survey responses reflected a greater understanding of time and effort needed to locate and navigate available resources, and challenges such as adhering to medication regimens due to inability to pay. Conclusion: A poverty simulation, such as CAPS, is an effective method to encourage pharmacy students to reflect on their future impact toward patients facing the challenges of poverty. The shift in students' attitudes and beliefs on various measures revealed that the simulation had an impact on altering perceptions for those with low socioeconomic status.

Using a Simulation to Increase Awareness of the Impact of Poverty on Health Care

A poverty simulation can increase participants' knowledge of the impact of poverty on patients' health care choices. Professional development specialists can develop poverty simulations for their health care organizations. Planning and delivering a successful simulation requires preparation beforehand to logistically implement a simulation that has a positive, meaningful impact. [J Contin Educ Nurs. 2022;53(2):57-58.].

Developing Global Health Diplomacy-related Skills Using a COVID-19-like Epidemic Simulation as a Learning Strategy

Public health and global health practitioners need to develop global health diplomacy (GHD) skills to efficiently work within complex global health scenarios, such as the current coronavirus disease (COVID-19) pandemic. Problem-based learning was used as a framework to create a scenario-based activity designed to develop GHD-related skills. The application and effectiveness of this scenario-based activity to develop GHD-related skills were assessed. A mixed-methods approach involving a self-administered survey and one focus group discussion was used. The survey collected baseline participant characteristics as well as understanding and improvements in GHD-related skills using a 5-point Likert scale. The focus group was audio-recorded and thematically analyzed using both inductive and deductive codes. Data integration was achieved by connecting and weaving. Method and investigator triangulation techniques were used. Participants self-reported significantly better postscenario-based activity responses when asked about their understanding of diplomacy, negotiation, communication, and how to address public health emergencies (P < 0.01, Wilcoxon signed rank test). Most participants either agreed or strongly agreed that their GHD-related skills improved with participation in the scenario-based activity (diplomacy = 55.6%; negotiation = 66.5%; communication = 72.2%; addressing public health emergencies = 72.1%). Overall, qualitative data were consistent with results obtained using quantitative methods. The scenario-based activity was effective for improving the self-reported understanding of GHD-related skills. The scenario-based activity was also effective for developing the selected GHD-related skills (as self-reported). This scenario-based activity is likely to reduce cognitive load and avoid participant overload, thereby facilitating learning. Further research is required to elucidate its long-term impact on skills development.