For the second year in a row, Southern Illinois University School of Medicine resident physicians and medical students spent a few hours experiencing some of the nonclinical challenges associated with being a patient in poverty. Roughly 14,000 people live below the federal poverty line in Springfield, according to the most recent census data.
Almost 60 SIU residents and medical students participated in the poverty simulation on Aug. 27, where participants were given unique scenarios, sets of tasks and a randomized allotment of fake money to complete said tasks, such as filling prescriptions or getting their child registered for school. The simulation, aptly held at the Memorial Learning Center, had a number of community health workers playing various institutional roles the participants had to interact with – such as a bank, community shelter, the Department of Human Services, Springfield Police Department and others.
Josh Sabo, executive director of Heartland Housed, told Illinois Times his organization reviewed some of the scenarios drawn up by SIU’s Office of Community Health Work. He emphasized that such a simulation could benefit many kinds of health care providers.
“I’m just super impressed by the level of detail that’s gone into this as an exercise, especially for health care providers,” he said. “There’s so much about that job that’s very complex, but I think it’s exciting to see the work that’s going on to see health care as one important component of the whole person.”
It’s a stark contrast to the hundreds of hours of clinical work completed in medical school, where future doctors study case examinations and medical procedures. Sabo said the simulation could be something he tries out with his own staff.
“One of the things I’m thinking about as I look across this room is how beneficial this, or something like this, could be for the folks that work in our system day in and day out. I think anything we can do to elevate the level of empathy is so, so important,” he said.
Some participants had to wear headphones that played near constant voices or sounds made out to simulate auditory hallucinations that are most commonly associated with schizophrenia or PTSD.
An Illinois Times reporter wore a pair of headphones for about 20 minutes and noticed the audio would sometimes add in bits of real music, including “Soul Man” by Sam & Dave.
All participants had unique circumstances for the simulation that were inspired by real situations observed by SIU community health workers.
“They all have different situations and scenarios that they start off with, so some might be single, some might have a family. If you look around, someone might be in a wheelchair or with kids,” said Haley Klein, a community health worker who was playing the role of a pharmacist for the simulation.
The entire process was simulated through four 20-minute “weeks” with varied errands that could be difficult without a car and money for gas or transportation.
“They’ll also get a new scenario for the week – they will still be the same person but something might have happened: they might have been evicted, especially if they haven’t paid their rent, they might have to get groceries that week,” Klein said.
Sarah Knowlton, a doula and community health worker, said she was impressed by the scale of the simulation.
She said it was important to “not have the residents and students see their patients as just their medical problems but the whole of what they go through.”
Knowlton, who was playing the role of administrators for the school and day care, noted how it may not be an option for every medical school, but all should consider more holistic elements of learning.
“This takes a lot of time to put together, so I understand not every school may have the resources or the time to do it, but I do think there needs to be education about what actual people in the community go through and talk about these issues with the residents and the students,” Knowlton said.
Resident doctors seemed to appreciate the programming. Dr. Taiwo Akinsoji, a resident family physician, said she benefited from last year’s poverty simulation and decided to attend this year’s as well.
“I’m more proactive with referring (patients) to social workers, providing them resources like calling the pharmacy for discount programs,” Akinsoji said. “I’m more involved when it comes to my patients.”
Erin Jones, SIU’s director of community health, reminded participants that real patients who can’t afford to pay for their prescriptions could be referred to Kumler Outreach Ministries.
Dr. Martin De Venecia, a resident family physician, was given a scenario where he was a single parent with two babies. He said it was “pretty difficult.”
“This has helped us put into perspective how many tasks our patient population has to go through to manage everything,” De Venecia said.
Dr. Vincent Tran, also a resident physician practicing family medicine, said the simulation provides valuable insight for doctors but is still far from the real struggle some patients experience.
“In real life, it’s probably a lot harder than what’s actually being placed into the simulation,” Tran said. “Like this aspect of getting a Social Security card takes a lot longer and such.”
This article appears in September 4-10, 2025.
