Gamified innovation to teach patient disadvantage.

BACKGROUND
Disadvantages such as social distress, safety, economic status and educational levels can significantly impact health risk factors, health care access and health outcomes. Teaching of disadvantage is critical for medical students to understand impact of disadvantages on patient health and facilitate patient-centred care. Disadvantage was initially taught through one tutorial to third year medical students. Students often narrowly focused on financial disadvantage and failed to consider other disadvantages. In 2019, an innovation to teach disadvantage to first year students was developed and evaluated.


APPROACH
A 'trio of learning activities' was designed that combined gamification and experiential learning. The first activity was the gamified Treasure Hunt where students overcame multiple disadvantages to collect 'treasure'. The workshop introduced the topic and potential impacts of disadvantages on health. The second activity included placements at general practices where students observed patient disadvantages. The third activity was the end-of-semester tutorial during which students debriefed their learning on disadvantage throughout the semester.


EVALUATION
Students completed the sentence 'Disadvantage is …' after the Treasure Hunt workshop and after the tutorial. Seventy-six percent of the 146 students participated in the evaluation. Responses were thematically analysed. Post-workshop data indicated improvement in students' understanding of disadvantage including its different types, invisible nature of some disadvantages and people's lack of control over disadvantages. Post-tutorial data indicated additional learning about intersectionality, clinical impacts and doctors' ability to address patient disadvantage.


IMPLICATIONS
Combining gamification and experiential learning provided an effective and engaging way to teach about disadvantage in a limited time. Positive evaluation of the innovation indicates this approach can be utilised to teach social determinants of health.