Poverty simulation for students highlights everyday hardships

Before you judge someone, walk a mile in their shoes. That is what dozens of students from UTHealth Houston School of Dentistry and Cizik School of Nursing did during a poverty simulation in September.

Held across three Tuesdays during the month (Sept. 13, 20, 27) inside the Denton A. Cooley, MD and Ralph C. Cooley, DDS University Life Center, roughly 80 students per session took part in the Community Action Poverty Simulation (CAPS), which immersed participants into an interactive experience with each assuming the role of a family member living in an impoverished state.

“The purpose was for participating students to develop empathy for those who are less fortunate and to improve health care equity when they go out into practice,” said Deborah R. Franklin, DDS, MA, who directed the CAPS program. “As they go through the simulation, they may not do everything perfectly, and that’s ok. As in life, you may run out of time or not have enough money to do everything you need to do.”

The educational objective of the simulation was for students to gain a better understanding of the daily difficulties faced by those living in poverty, from mounting bills to line waiting with social services to lack of access to transportation—all things that could influence a patient’s access to care.

The CAPS program is part of UTHealth Houston’s new Quality Enhancement Plan (QEP) focused on Health Care Policy for Health Professionals. Known as HP², the QEP promotes student engagement, critical thinking, and career preparedness, and reflects UTHealth Houston’s commitment to institutional quality and effectiveness.

“Our aim at the School of Dentistry is to produce a well-rounded practitioner or health care provider,” said Dean John A. Valenza, DDS. “We don’t want to simply graduate tooth technicians. We want people who are engaged with the human beings that they’re treated. They need to understand all potential things going on in a patient’s life and not just their dental needs.”

During the simulation, the task of the individuals or families was to provide basic necessities and maintain shelter during the course of four, 15-minute weeks separated by five-minute weekends. All participants received a packet with details outlining their simulated character profile as well as money and transportation vouchers.

Students took on the roles of single parents, being homeless, teenage pregnancies, incarcerated heads of households where a young adult is forced to raise their siblings, and other characters based on real people served by social service agencies.

The challenge for students was to make it through a month paying all basic expenses and juggling family responsibilities while dealing with unique life circumstances.

On the other side of the simulation, volunteers sat behind tables with signs that represented the various agencies, businesses, or social service resources for students to interact with. Volunteer jobs included banker, childcare worker, community action agency staff, community health center doctor, employer, illegal activities person, Interfaith Center pastor, law enforcement officer, mortgage/rent collector, pawnbroker, public health caseworker, Quick Cash staff, school teacher, Social Service Office employees, supercenter clerk, and utility collector.

By the end of the simulated month, several students reported losing their jobs and facing evictions or utility shut-offs, and many families faced being homeless and having hungry children. Most students were unable to complete a routine day of getting to work on time, paying bills, and maintaining their household due to a variety of obstacles.

Following the simulation, students underwent a debriefing process to discuss their experiences. Overall, students who participated in the simulation reported greater empathy toward people in poverty.

The CAPS program marked the School of Dentistry’s first poverty simulation. Student participants were second-year dental students and students from the Pacesetter BSN program at Cizik School of Nursing at UTHealth Houston.

Franklin hopes the format of an interprofessional collaboration among various schools at UTHealth Houston will continue with the next poverty simulation.