Workshop Trains Facilitators for Poverty Simulation and Effects on Health

By Spencer Watson

Students, faculty and staff from across UAMS, including the main campus and regional campuses, participated in the Community Action Poverty Simulation Nov. 21, then learned how to facilitate that simulation to help others in the health care field gain insight. Researchers hope the exercise will help providers better relate to patients in difficult financial circumstances.

“We’re transferring this learning into an actionable outcome,” said Leanne Lefler, Ph.D., RN, APRN, an associate professor in the College of Nursing. She was awarded grant funds from the Office of Interprofessional Education and the Office of Educational Development to purchase the CAPS kit and organized the training workshop for those interested in facilitating it.

Evan Melkersman, at left, leads the training to facilitate the poverty simulation.

Evan Melkersman, at left, leads the training to facilitate the poverty simulation.

“We want those who experience this simulation as participants or facilitators to act on what they’ve learned in whatever position they’re in. It can be supervisors who retrain their staff to pay attention to certain subtle things they notice or teachers who might want to integrate more of this type of learning into a class.”

CAPS is owned by the Missouri Community Action Network, a statewide association of Missouri’s 19 Community Action Agencies. Evan Melkersman, CAPS project manager with the network, was on hand to teach facilitators their role in organizing and running the simulation.

“We never require anyone to go through the training to become a facilitator for the poverty simulation because the kit is so all encompassing. It contains a director’s manual, which tells you everything you need to know from A to Z about how to do it,” he said. “But we’ve had a fair amount of people who have deep backgrounds in education and facilitation who end up going through this training and appreciate the nuances of it and see it as very important.”

The two-day training first involved running the simulation, which provides identities and life circumstances for all participants, who then must navigate social services and community organizations as they “live out” a month in poverty in 15-minute blocks that each represent a week, dealing with issues such as losing a job, being evicted, applying for government assistance, feeding their children, securing transportation, etc. Afterward, there’s a debriefing to discuss the experience and what was learned.

“Nobody is born with empathy. It’s a learned behavior. What the poverty simulation does so well is it gives participants a dose of empathy. And it also creates a foundation for understanding some of the causes of poverty,” said Melkersman. “Does it outline everything? No, you just can’t do that in three hours. But it provides a glimpse. It’s just the tip of the iceberg.”

The second day of the workshop involved teaching participants how to effectively run the simulation for others.

“What I always emphasize with facilitators is to focus on what impact they want this simulation to have,” Melkersman said. “I tell them to be very intentional with who your participants are, what your objectives for the simulation are, what your intended outcomes are. Be very forward thinking. Because the impact of the simulation really happens after the simulation itself.”

In May, participants took on the role of family members struggling with financial hardship during a pilot run of the poverty simulation.

In May, participants took on the role of family members struggling with financial hardship during a pilot run of the poverty simulation.

Lefler said having well-trained facilitators to run the simulation will benefit both students and practitioners at UAMS and, ultimately, will improve patient care.

“What we’re trying to do is consider social determinants of health, the environment a patient comes from and goes back home to. It may be the whole reason they’re not responding to treatment,” she said. “And in this value-based care world we’re going into, it’s even more important. We definitely  need to focus more on social circumstances.

“We’re very forward thinking at UAMS to do this and spread it throughout our health services system to our regional campuses and everywhere we might do this. This group is stepping forward to help facilitate this simulation being done over and over, and now we have a cadre of people professionally trained to do this in all these different settings.”