Down to the Last Dollar: Utilizing a Virtual Budgeting Exercise to Recognize Implicit Bias

Date of Review: May, 2022

The resource introduces a two-hour session on how a low-income immigrant family needs to budget their monthly income to cover their expenses (and time). It was delivered to third-year medical students during their pediatric clerkship. The exercise is built around a budgeting exercise, where small groups of students use an Excel template to create a monthly budget for food and other monthly expenses. After working together to create a monthly budget, small groups then reflect and debrief on the exercise. The resource includes all materials needed to conduct the exercise, including a facilitator guide, Excel template, and introductory lecture slides. The exercise was delivered virtually, but could also feasibly be delivered in person. In evaluations, most students reported that the exercise allowed them to recognize the effects of poverty and food insecurities on health, and potential biases towards low-income patients. Overall, I think it would very feasible for other institutions to deliver this curriculum, and the student-reported outcomes indicate it could be effective. However, the evaluations were subject to bias and somewhat superficial, and the exercise was not clearly linked to clinical scenarios or opportunities for interventions that would result in more effective clinical and/or social care. This lack of depth likely makes this resource more appropriate for use as introductory material. –Dave Liss, PhD, NCEAS

Corresponding Author’s Email:


Rutgers New Jersey Medical School

Where was the Curriculum Implemented:

Newark, NJ

Outcomes that Have Been Reported for the Curriculum:

Learner Satisfaction or reaction

Self-reported learner attitude

Outcome and Study Design:

Post only

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