I Kept My Pregnant Teenager Home

A (Very) Low Fidelity Pharmacy
I had the incredible opportunity last week to participate in a poverty immersion. With so many uninsured and underinsured getting ready to enter the healthcare world in just a few years, the simulation was a chance for those providing healthcare to gain a better sense of their lives. It by no means could ever replicate it, but I was surprised at the choices I made and the feelings that emerged. The immersion started with me as a dad in a family of four. I was laid off for months without health insurance, with a full-time working wife, a seventeen year old pregnant daughter, and an eight year old son. The object was to get through four 15-minute periods each representing a week with as much of my family needs met as possible. Suffice to say, I chose to keep my 17 year old daughter home for one week to watch my suspended 8 year old, so that I could go to social services to get food stamps.

Everyone who participated shared similar thoughts…mostly amazement at the choices we were forced to make, and how complicated the safety net was. It built a whole lot of sympathy, and more importantly got the room thinking on how services might be more seamless, timely and precise. And that is what a good simulation should do.

Simulations can hard to pull off. This one provided three nuggets on how to make them better:

  • Don’t over simplify. We as designers and facilitators often try to make the experience as easy as possible. Why?!? Life is complex and we’re dealing with smart people. They’ll figured it out.
  • Allow sufficient time. I groaned at hearing the simulation was 2 hours long. TWO HOURS. Well, that turned out to be the right amount of time. Two hours, allowed the participants to not only get into role, but be the role….for a long time. About a third of the way through I stopped being me and was really worried about my simulated family. It also allowed me to start optimizing my life because I was in the simulation long enough.
  • Low fidelity works. This was a great reminder just how low we can go. For a pharmacy, there was only a piece a paper with “pharmacy” written on it. For a bank, “bank”. Simple, but such powerful associations that nothing more was needed. Why waste on time on tasks that our brains are so powerful at doing for us.

What are your nuggets?

One thought on “I Kept My Pregnant Teenager Home”

  1. Chris,

    Thanks for the feedback. It was great to have a fellow ILN-er participating in our immersion exercise!

    Ethnoworks was asked to redesign the MACA Poverty Simulation for the Kaiser Community Benefit Summit to reflect the health realities facing the uninsured/underinsured populations and their service providers. Adapting an existing simulation proved to be quite a challenge. So many moving parts. To do this effectively, we drew upon our ethnographic healthcare research to create family scenarios inspired by individuals and families we encountered in the field. For us, it’s very gratifying to hear that you found it to be an impactful and positive learning experience.

    An immersion experience can pack a powerful punch. It’s a great way to move people, shift perspectives and inspire insights in a contained time and space.

    — ethnoworks (Soo-Young Chin, Jay Hasbrouck, Yoon Cho)


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