Dwell, poverty simulation

Dwell tabletop simulation game set with board open and game components spread around and on the board.
Dwell tabletop simulation game on poverty implications on health and health care access

Project Description

Dwell™ is a tabletop simulation game to teach about situational poverty and its impact on one’s choices, health, livelihood, communities, and families. Players perspective-take as a provided character who must support and care for themselves and possibly an entire household. Dwell™ is primarily intended to be a facilitated game, particularly when played by multiple sets of players concurrently, as a curriculum module or part of a workshop.

Project Team

Lien Tran1 3Jill Sanko 2, and Deborah Salani 2 make up our interdisciplinary design team bringing together experience in simulation, game design, social impact games, poverty, and nursing education.

Thank you to Yui Matsuda 2 for her support and assistance in researching the impacts of Dwell and to Casey Lue 1 and Pablo Obando 1,2 for their graphic design contributions. Special thanks to Susana Barroso-Fernandez 2, Jacqueline Lopez 2, and Laura Albuja 2  for their contributions in the early phases of developing Dwell. This project also received pilot funding from University of Miami’s Center for Communication, Culture, and Change to prototype and test Dwell.

1 University of Miami, School of Communication
2 University of Miami, School of Nursing and Health Studies
3 DePaul University, Jarvis College of Computing and Digital Media

Project Objectives

By the end of the game, players should be able to:

  • Discuss how poverty impacts health, healthcare choices, and healthcare access
  • List new facts and statistics about how poverty impacts people
  • Apply greater empathy when caring for others who are economically disadvantaged
  • Begin developing new strategies to help educate and connect economically disadvantaged people with community resources

Dwell™ accomplishes these objectives as a roleplaying game in which players navigate Dwellville over the course of a simulated month, one week at a time, as one of 5 characters trying to meet their long- and short- term goals. In addition to living in Dwellville as one of its residents, players participate in regular “reflections” (at the end of each in-game week on “Saturday”) during which they are encouraged to talk as their game character (in the first person) with the other players at their table about their experiences during the simulated week of play: what were the successes and challenges, how are they planning to meet their goals in the next week, etc. In addition to reflections, players select a category and share a did-you-know statistic or fact on “Sunday” from an online fact library and then talk about how it pertains to their in-game experience. Finally at the end of the game, players participate in a larger debrief that allows them to talk about and compare their extended experiences as each character. Additionally, players are asked to reflect upon and share how this experience may change future interactions with people who are economically disadvantaged.

Background

Poverty is an issue that allied health and healthcare professionals face when practicing in any setting, including hospitals, clinics, and schools. Poverty is a ubiquitous condition that impacts half the world’s population indirectly and directly. Locally, the city of Miami is one of the poorest cities in the United States with 21.3 percent of residents living below the poverty level (Miami-Dade County Department of Regulatory and Economic Resources). In 2015, more than 43 million people were living in poverty nationally (World Hunger Education Service). Internationally, the World Bank estimated that 896 million people live on $1.90 day or less (World Hunger Education Service). Research has shown that poverty influences the five dimensions of family, including health, productivity, physical environment, emotional well-being, and family interaction (Park, Turnbull, & Turnbull).

Despite these facts, many individuals working with poverty stricken people require a much greater understanding of the global and often life-long impacts that being poor has particularly on health. By playing Dwell, participants roleplay as an individual or multi-person household and experience how poverty influences their ability to live a healthy life and access healthy resources. An emphasis on facilitated reflection and debrief are critical to the Dwell educational experience. While the initial focus was on educating students studying in health care related fields, there has been much broader interest in the game at the university and as a result we are planning to expand the game’s target audience to include more persons who will interact with poverty-stricken individuals in not only professional capacities but also personal contexts – such as teachers, as well as middle school, high school, and college students. This broader audiences’ participation in the game can promote the development of empathy and compassion towards those living with financial strain and understanding their unique challenges.

Given the importance of educating future professionals in the fields of healthcare and other education about the implications of poverty, the Dwell team’s goal was to create a game with an educational impact that does not require long setup time or a significant amount of human capital to run the event, especially in comparison to similar tools currently used for health education. On the market is another simulation product called Missouri Poverty Simulation with similar educational goals; however, this simulation activity requires a large number of resources – including several human facilitators – to run the activity, which may not be feasible for every situation. Additionally, the Missouri Poverty Simulation does not have the in-game points of reflection or “Did You Know?” poverty facts built in like Dwell does.

Facilitation Materials

When facilitating Dwell, you may wish to use these slide decks to introduce and explain the gameplay as well as on in-game Sunday “Did You Know” events.

Facilitation Deck

Did You Know Events Deck

Findings

Findings from a comparative evaluation of Missouri Poverty Simulation and Dwell show that “students’ perceptions
regarding their willingness to help those living in poverty also improved after both simulation activities. Dwell™ was found to significantly increased students’ empathy toward those living in poverty” (Sanko et al, 2021). The full paper is available here.

Publications

Sanko JS, Matsuda Y, Salani D, Tran L, Reaves R, Gerber K. (2021, January). A comparison of learning outcomes from two poverty simulation experiences. Public Health Nurs. 2021;00:1–12. https://doi.org/10.1111/phn.12853

Awards

Exhibitions

  • Tran, L., Sanko & J. Salani, D. (2019, January). Dwell. Game exhibited at International Meeting for Simulation in Healthcare conference in the SimVentor’s Games Arcade, San Antonio, TX. | PDF
  • Tran, L., Sanko & J. Salani, D. (2018, October). Dwell. Game exhibited at Meaningful Play, East Lansing, MI. | Link

Related Press + Resources

  • Roleplay and Simulations” writeup from University of Miami’s Academic Technologies (2018)
  • Gutierrez, B. (2018, October.) ‘Dwell’ tabletop game shows students daily struggles of poverty. Retrieved from https://news.miami.edu/stories/2018/10/dwell-shows-students-daily-struggle-of-poverty.html | Link
Nursing students playing Dwell as part of a pilot program