Impact of a poverty simulation program on the unconscious biases – A multi-site study

Abstract

Background and objective: University-based, pre-licensure programs can expose healthcare students to the realities of poverty and its relationship to healthcare using an interprofessional Poverty Simulation. The aim of the study was to evaluate the effectiveness of a Poverty Simulation on the unconscious bias among health professions students.

Methods: A pre-test/post-test online survey design was implemented (N = 181) at two institutions. Paired-sample t-tests compared pre-and post-simulation scores for the Poverty Attributions Survey (PAS) and Interprofessional Attitudes (IPAS) subscales.

Results: Significant differences were found for the PAS subscales assessing Individual (pre-simulation M = 4.09, SD = 1.15; post-simulation M = 4.71, SD = 1.13) and Cultural attributions of poverty (pre-simulation M = 3.74, SD = 1.16; post-simulation M = 4.20, SD = 1.25); t(168) = -7.814, p < .001 and t(175) = -5.242, p < .001, respectively. A significant difference between pre- (M = 1.83, SD = .57) and post-simulation scores (M = 1.68, SD = .69) for the IPAS Teamwork, Roles, and Responsibility subscale was found, t(170) = 2.511, p = .013, Cohen’s d = 0.23.

Conclusions: Results support engaging healthcare students in the realities of poverty to positively influence understanding and empathy, reducing unconscious bias.