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Published in CenterView on April 01, 2013
Training for the upcoming simulation are, from left, Partricia Rucker of Entergy Mississippi, Amani Bailey, Dr. Ralph Didlake, Millie Didlake, Mary Davis of Entergy Mississippi, Caroline Compretta and Pam Wardlaw.
Training for the upcoming simulation are, from left, Partricia Rucker of Entergy Mississippi, Amani Bailey, Dr. Ralph Didlake, Millie Didlake, Mary Davis of Entergy Mississippi, Caroline Compretta and Pam Wardlaw.

Simulation helps UMMC students gain empathy for disadvantaged patients

By Bruce Coleman

This spring, students at the University of Mississippi Medical Center will be forced to make some difficult life-altering decisions.

Should they purchase the medicine required to maintain their health, or should they pay the electric bill that is past due? Should they attend a counseling session with a health professional or the job interview they’ve been working on for weeks?

Should they use grocery money on fuel to take their parent to a scheduled appointment with a specialist? 

These choices aren’t reflective of a sudden spike in tuition rate. Instead, they are part of a role-playing exercise to help future health-care professionals better understand the complexities and frustrations of living with deficient resources.

Funded by a grant from Entergy Mississippi, the Missouri Community Action Poverty Simulation will allow students to experience poverty firsthand, according to Dr. Ralph Didlake, professor of surgery and director of the Center for Bioethics and Medical Humanities. Part of the institution’s Quality Enhancement Plan (QEP) initiative, the poverty simulation is scheduled to take place once each semester. 

“In order for our providers to be engaged with their patients in the communities they serve, they have to deeply understand these communities,” Didlake said. “In Mississippi, that means understanding poverty.

“It is important as health-care instructors that we are able to help students in all of our schools understand poverty and its impact on health care.”

To that end, Didlake and others at the center hosted a “train-the-trainer” workshop last Wednesday to instruct staff and faculty volunteers how to properly facilitate the simulation.

During the simulation, 80 students will be divided into “families,” each with a specific “life scenario,” including their social status, economic circumstances, monetary and travel resources, and set of “life challenges” they must navigate throughout the four-hour simulation.

“For example, they might find themselves bankrupt, they may have to give up a child to a child protection services group, or they may have a major illness,” Didlake said. “These scenarios will present challenge after challenge that they’ll have to use their resources to overcome.”

Facilitators will be stationed at various tables representing important services to the community, from banks and lenders to health-care providers to law enforcement, among many others. Participants will have to expend their resources to “travel” from one table to the next.

“The intent is for the students to understand how poverty complicates the challenges of daily living,” Didlake said. “We want to increase caregiver empathy, to deepen the provider’s engagement with the people they serve and to understand that sometimes care has to be altered to fit a patient’s circumstances.”

Amani Bailey, education administrator for the Center for Bioethics and Medical Humanities, participated in the simulation at the Missouri Association for Community Action, Jefferson County, the organization that developed the exercise. She called the experience “very emotional.”

“They emphasized the fact that this is not a game – it’s a simulation to give you an idea what individuals with limited resources experience,” Bailey said. “I was given the role of a child. I’d never stopped to think of what poverty meant to a child, what it meant seeing what their parents go through in making these tough decisions.

“In our exercise, my baby brother was taken away to a foster home. It made me think, a lot of times we don’t give enough credit to children for the things they’re dealing with when we see the stresses on their parents.”

Bailey hopes UMMC students will share in that feeling of empathy when they encounter the simulation.

“My hope is for the students on this campus to understand this before prescribing medicines or a course of treatment that may be very expensive, or sending patients to a clinic they might not can get to,” she said. “They should understand that when a patient is noncompliant, it doesn’t always mean they’re being defiant – it can be a matter of several other things going on with them.

“Even though it’s very important, health care may be just a small piece of what is going on in their lives – just one more thing on their “to do” list.”

As a result of this awareness, Bailey said some community resources have responded to the needs of those they serve by expanding their hours of operation and integrating services into one locale, modifications that often have proven beneficial to employees as well.

“Addressing poverty doesn’t have to be a negative,” she said. “It could be a ‘win-win’ for providers and patients alike.”

The poverty simulation could become a similar “win-win” for UMMC students and staff, according to Didlake.

“We think it’s a valuable activity and a really significant communication element for faculty and students – and for the community,” he said. “Our students may not have encountered some of these situations.

“It’s our obligation as educators to put these issues before out students. If we do that properly, they have an almost endless capacity to respond. I think they will respond well to this experience.”

For more information on participating in future poverty simulations, email Bailey at azbailey@umc.edu

Poverty in Mississippi

According to the United States Census Bureau, Mississippi led the nation with a poverty rate of 22.6 percent in 2011, while its median household income was $36,919. Both figures approximately matched the previous year’s marks.

Source: CNN Money (money.cnn.com)