Poverty Simulations: Are the Learning Outcomes Consistently and Uniformly Positive?

Research indicates significant improvement in average attitudes toward those in poverty following poverty simulations, but little research addresses whether students benefit uniformly. This study measured variability in poverty attitude change following poverty simulations and tested whether poverty attitudes are associated with simulation evaluations.

Third-year dental students were surveyed at baseline (T₁), post-simulation (T₂), and 2-month follow-up (T₃). Poverty attitudes reflect Likert-scale agreement with 20 statements addressing personal responsibility and public policies. Simulation evaluations were measured at T₂ and T₃ by agreement with eight statements addressing the simulation's value and impact on patient care. Data analysis relied on descriptive statistics, paired-samples t-tests, and Pearson correlations.

Students' (N = 169) average poverty attitudes were 9.4 points higher at T₂ than T₁ (p < 0.001) and 7.9 points higher at T₃ than T₁ (p < 0.001). However, 21.7% reported lower attitude scores at T₂, and 34.6% reported lower attitude scores at T₃, with a 4-point median decline from T₁ in each group. Baseline poverty attitudes did not predict simulation evaluations, but T₂ poverty attitudes correlated with T₂ (r = 0.33) and T₃ (r = 0.45) evaluations. Also, T₃ poverty attitudes were correlated with T₂ simulation evaluations (r = 0.35) and T₃ (r = 0.44) evaluations (all p < 0.001).

Poverty simulations enhance poverty attitudes on average, but potentially worsen attitudes among a substantial percentage of students. Those with negative post-simulation attitudes toward poverty also are likely to value the simulation less and may require different teaching strategies.