Longitudinal impact of a poverty simulation on healthcare practitioners' attitudes towards poverty

Abstract

Background: Many clinicians have limited knowledge about the challenges of living in poverty, leading to stigma and differential treatment in healthcare settings. A poverty simulation event may help clinicians gain empathy and knowledge about the ways that poverty impacts health and well-being.

Purpose: This study evaluated the impact of a poverty simulation and the effect of personal characteristics on clinicians' attitudes towards poverty.

Methods: Using a prospective longitudinal mixed-methods study design, a convenience sampling of clinicians from a freestanding children's hospital was recruited to participate in a poverty simulation event. The 21-item Attitudes Towards Poverty (ATP) tool was administered pre- and post-simulation and at 3 follow-up time points. Multiple linear regression analysis and linear mixed effects models were used to analyze ATP data. Qualitative data were analyzed to identify broad themes.

Results: Mean scores in the ATP domains of stigma and structural perspective increased post-simulation, but only stigma scores demonstrated sustained improvement. Scores in the personal deficiency domain remained unchanged. Being male, White, and having Liberal political views were associated with lower ATP scores in our data. Qualitative data show participants felt the simulation generated feelings of compassion and empathy.

Discussion: Simulation participation improved ATP scores in two domains immediately post-event, suggesting the simulation positively impacted clinicians' attitudes towards poverty. Follow-up data suggest the impact of the simulation may be temporary.

Translation to health education practice: Experiential learning activities, like poverty simulations, help foster awareness and empathy among clinicians but may not have long-term impact. Ongoing education is needed to create a workforce sensitized and equipped to care for families from all backgrounds.

Keywords: Cultural competence; Experiential learning; Poverty; Simulation; Social determinants of health.