{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:46:48Z","timestamp":1792036008686,"version":"4.4.0"},"reference-count":61,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Dental Education"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Poverty simulations are frequently embedded in the curriculum of health professions training programs to enhance student attitudes toward poverty or to enhance student empathy. These outcomes are often not clearly distinguished, and empathy is rarely measured in a rigorous way. The purpose of this exploratory study was to measure changes in empathy following a poverty simulation, to compare them to changes in attitudes, and to explore whether personal experience of financial insecurity was associated with either.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Third year dental students (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009169) participated in a poverty simulation and completed anonymous surveys at three points: baseline, post\u2010simulation, and at 2\u2010month follow\u2010up. At baseline, students reported personal experience with financial insecurity. At all three points, students completed a 20\u2010item poverty attitudes measure and the Interpersonal Reactivity Index, measuring empathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to baseline, empathy was lower immediately after the poverty simulation (\n                      <jats:italic>M<\/jats:italic>\n                      \u2009=\u2009\u22121.78;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and 2\u2009months later (\n                      <jats:italic>M<\/jats:italic>\n                      \u2009=\u2009\u22122.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Poverty attitude scores were higher immediately after the simulation (\n                      <jats:italic>M<\/jats:italic>\n                      \u2009=\u20099.40;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 2\u2009months later (\n                      <jats:italic>M<\/jats:italic>\n                      \u2009=\u20097.93;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Personal financial insecurity was not associated with empathy and was modestly associated only with baseline poverty attitudes (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Although empathy and poverty attitudes were not associated at baseline, baseline empathy predicted poverty attitudes at post\u2010simulation (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and follow\u2010up (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.39;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Poverty simulations may result in a decline in participant empathy, even if these simulations improve attitudes toward poverty. Empathy and attitudes are distinct constructs, and if enhancing empathy is the goal, then alternatives to poverty simulations may be more effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eje.70326","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:10:06Z","timestamp":1792033806000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Influence of Poverty Simulations on Dental Students' Empathy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-4863","authenticated-orcid":false,"given":"Lance Brendan","family":"Young","sequence":"first","affiliation":[{"name":"Department of Preventive and Community Dentistry The University of Iowa College of Dentistry and Dental Clinics  Iowa Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4995-9795","authenticated-orcid":false,"given":"Michelle R.","family":"McQuistan","sequence":"additional","affiliation":[{"name":"Department of Preventive and Community Dentistry The University of Iowa College of Dentistry and Dental Clinics  Iowa Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6051-9711","authenticated-orcid":false,"given":"Chandler","family":"Pendleton","sequence":"additional","affiliation":[{"name":"Iowa Institute for Oral Health Research University of Iowa College of Dentistry and Dental Clinics  Iowa City Iowa USA"},{"name":"Now at Florida State University College of Medicine  Tallahassee Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1988.0162"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp13X660814"},{"issue":"6","key":"e_1_2_10_4_1","first-page":"412","article-title":"A Brief Instrument to Measure Patients' Overall Satisfaction With Primary Care Physicians","volume":"43","author":"Hojat M.","year":"2011","journal-title":"Family Medicine"},{"issue":"3","key":"e_1_2_10_5_1","first-page":"98","article-title":"Empathy in the Dentist\u2010Patient Relationship: Review and Application","volume":"110","author":"Jones L. 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