Exercise #37
Table of Power
Authors: Dr hab. Małgorzata Szkup
25–35 minutes
Description
A reflective group exercise exploring how social structures — background, education, economics, language, legal status — distribute access to resources, decision-making, and power. You build a two-column “table of power,” then apply the lens to your own position, to patients from other cultural backgrounds, and to your future clinical practice.
Methodological Guide
Objectives
Understand that different social groups have unequal access to resources, power, and decision-making.
Analyse factors that influence social position — background, economics, language, race, ethnicity, gender, sexual orientation, legal status, profession.
Reflect on how your own social position shapes the way you perceive the world.
Strengthen skills in recognising biases and structural inequalities.
Prepare to work with patients who may have limited access to resources in the healthcare system.
Analyse factors that influence social position — background, economics, language, race, ethnicity, gender, sexual orientation, legal status, profession.
Reflect on how your own social position shapes the way you perceive the world.
Strengthen skills in recognising biases and structural inequalities.
Prepare to work with patients who may have limited access to resources in the healthcare system.
Expected Outcomes
The student recognises structural inequalities, can analyse factors influencing social position, understands the consequences of marginalisation in healthcare, applies anti-discriminatory principles in practice, and can justify decisions in a substantive, data-driven manner.
Exercise Procedure
Introduction (2–3 min): discuss the three columns of the table; emphasise that the topic may be sensitive and respect is required.
Stage 1 group work (10–12 min): each student drags 18 social-group cards into More Power, Less Power, or Contextual. The teacher freezes the screen and leads a whole-group debrief, surfacing disagreements — especially for contextual cases (nurses, police officers, LGBTQ+ people).
Stage 2 reflection (10–15 min): each student writes their self-position reflection privately.
Final discussion (5 min): how does our own position in the power table influence how we perceive patients, and how can we consciously reduce inequalities in our future professional practice?
Stage 1 group work (10–12 min): each student drags 18 social-group cards into More Power, Less Power, or Contextual. The teacher freezes the screen and leads a whole-group debrief, surfacing disagreements — especially for contextual cases (nurses, police officers, LGBTQ+ people).
Stage 2 reflection (10–15 min): each student writes their self-position reflection privately.
Final discussion (5 min): how does our own position in the power table influence how we perceive patients, and how can we consciously reduce inequalities in our future professional practice?
Mode of Implementation
In class, this is a facilitator-led group activity with shared card sorting and guided discussion. The MultiCultiMed solo flow presents the drag-to-category stage and the self-position reflection as a private written exercise.
Role of the Teacher
Moderates the discussion and maintains a respectful atmosphere; supports students in recognising power dynamics; explains the difference between privilege and marginalisation; ensures the conversation stays structural rather than personal; connects conclusions to medical and social practice.
Theoretical Basis
Based on power dynamics (social structures distribute access to decision-making, resources, and influence), intersectionality (overlapping identity factors create new forms of privilege or marginalisation), and unconscious bias. Aligned with the EMPOWER model — Effectiveness, Multiculturalism, Professionalism, Well-being, Educational resources.
Practical Application
Helps students understand which patient groups face barriers to healthcare, analyse how language, economic, cultural, and legal obstacles shape communication, recognise inequalities in the patient–system relationship, respond when marginalisation affects treatment, and design a more inclusive approach to patient care.
Knowledge Transfer
Students learn to recognise their own social position and the factors that shape it, apply power-structure analysis to real clinical situations, analyse patient profiles in the context of privilege or marginalisation, and transform knowledge into conscious anti-discriminatory actions.
Reinforcement & Reflection
Debrief tracks: placement disagreements (which cards sparked debate?), contextual cases (nurses, police officers, LGBTQ+ people — what context flips their position?), self-position (where am I? what does that mean for how I see patients?), and professional practice (what can I do to reduce inequalities?).
Required Resources
Internet-connected device with access to the MultiCultiMed platform.
Assessment / Evaluation
Self-reflection; active participation in discussion; ability to justify card placements; ability to connect theory to clinical practice.
Practical Tips
Emphasise structural, not personal, analysis. Refer back to the group agreement if the conversation becomes tense. Use the contextual column to surface that power is relational and situational, not fixed. Use voting to resolve impasses.
Discussion Topics
How do social structures influence health and healthcare? What can a healthcare professional do to reduce inequalities? Which card placements surprised you most, and why?
Self-position reflection
- Where do YOU sit on this table in your working life — and how might that shape how you relate to patients who sit elsewhere?
Self-position reflection
- Where do YOU sit on this table in your working life — and how might that shape how you relate to patients who sit elsewhere?
Further Resources
Case studies on inequalities in healthcare; analysis of policies regarding migrants and refugees; exercises that deepen the topic of intersectionality.
Additional Remarks
Discussions of power can be emotionally challenging — exercise empathy and encourage quieter students to contribute, since the topic concerns everyone.