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Dental students should develop an understanding of the barriers to and frustrations with accessing dental care and maintaining optimal oral health experienced by persons with limited resources rather than blaming the patient or caregiver. Developing this understanding may be aided by helping students learn about the lives of underserved and vulnerable patients they will encounter not only in extramural rotations, but throughout their careers. The aim of this study was to determine if dental students' understanding of daily challenges faced by families with low income changed as a result of a poverty simulation. In 2015 and 2016, an experiential poverty simulation was used to prepare third-year dental students at one U.S. dental school for their upcoming required community-based rotations. In 2015, United Way staff conducted the simulation using the Missouri Community Action Poverty Simulation (CAPS); in 2016, faculty members trained in CAPS conducted the simulation using a modified version of the tool. In the simulation, students were assigned to family units experiencing various types of hardship and were given specific identities for role-playing. A retrospective pretest and a posttest were used to assess change in levels of student understanding after the simulation. Students assessed their level of understanding in five domains: financial pressures, difficult choices, difficulties in improving one's situation, emotional stressors, and impact of community resources for those living in poverty. The survey response rates in 2015 and 2016 were 86% and 74%, respectively. For each of the five domains, students' understanding increased from 58% to 74% per domain. The majority reported that the exercise was very valuable or somewhat valuable (74% in 2015, 88% in 2016). This study found that a poverty simulation was effective in raising dental students' understanding of the challenges faced by low-income families. It also discovered that framing the issues in the context of accessing dental care was important.

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The aim of this study was to conduct a needs assessment of Medicaid and health care reform education in the current dental curriculum of one U.S. dental school. A mixed‐methods approach was employed using focus groups and surveys. Three focus groups with dental students (nine first‐and second‐year students, eight third‐year students, and seven fourth‐year students) and one focus group with six external oral health stakeholders were conducted in 2018 to explore participants' attitudes and beliefs about Medicaid and health care reform. The focus groups used a semi‐structured guide, and transcripts were analyzed using thematic content analysis. Following the focus groups, all first‐and fourth‐year dental students were invited to participate in a survey assessing their general and dental‐specific Medicaid knowledge and attitudes about Medicaid. In both methods, participants made suggestions for future curricular experiences involving Medicaid. Surveys were returned from 81 first‐year students (96% response rate) and 72 fourth‐year students (86% response rate), for an overall response rate of 93%. Participating students and stakeholders agreed that Medicaid is confusing and challenging to incorporate into private practice. All participants viewed programs sponsored by organized dentistry as venues to learn about oral health policy. Nearly all participants agreed that private practice mentorship, improved practice management, and more experiential opportunities in the predoctoral curriculum would be effective strategies to increase knowledge about Medicaid and health reform. According to the survey responses, Medicaid and health reform knowledge is poor and scarcely covered in the current curriculum, and only 39% of participating students planned to participate in Medicaid after graduation. These findings suggest that curricular improvements are needed to incorporate more engaging and experiential learning using external resources.