WGU D393: History of Healthcare in America

Why D393 Shows Up in Your Health Program

History of Healthcare in America (D393) is a three-competency-unit course housed in WGU's Leavitt School of Health, and it appears in health-focused undergraduate programs such as the B.S. Health and Human Services, where WGU's published standard path places it in the fourth term. There are no prerequisites. If you enrolled bracing for a dry march through dates, the real course is closer to a story: how the United States ended up with the healthcare system it has, told through the people who pushed it forward, the crises that forced change, and the laws that followed.

Direct answer: You pass D393 by learning the story rather than the trivia. For every major figure, institution, and law in the course material, be able to say what problem it responded to and what changed because of it, then use the pre-assessment to find the sections where that cause-and-effect chain is still fuzzy and re-study only those before you schedule the proctored objective assessment.

WGU's official course description tells you a lot about the exam's angle. The course examines individuals such as Henrietta Lacks, Ryan White, Clara Barton, and Katie Beckett who influenced healthcare in the United States from its inception to the present, and it looks at how their contributions shaped healthcare delivery from a systems and value-based care perspective. It also examines how healthcare interacted with culture, politics, and society across U.S. history, and it connects that history to the challenges the system faces today. WGU lists three learner competencies for the course: examining the historical evolution of access to quality healthcare, examining how individuals and historical events influenced advancements in healthcare, and examining historical challenges in healthcare and their impact on quality healthcare today.

One practical note before you start searching for study material: this course was previously numbered D050 under the same title. Plenty of older student notes and flashcard sets still carry the D050 label. The content overlaps heavily, but always verify anything you find against the material actually loaded in your current course of study, because course versions get refreshed and old sets go stale.

What the D393 Assessment Is Built Around

D393 is assessed by an objective assessment, meaning a proctored, computer-based exam rather than a written performance task. WGU does not publish item counts or cut scores for individual assessments, so treat any site quoting a specific number of questions or a specific passing percentage with suspicion. What you can plan around is the shape of the content, which follows the three competencies above.

Expect the exam to draw from territory like this:

• Early American care institutions — almshouses, pesthouses, and charity-based care, and why isolation and poverty relief preceded anything resembling modern hospitals.
• The professionalization of medicine — the shift from apprenticeship to university-based training, the arrival of scientific method and admission standards in medical education, and the reform era that closed weak proprietary schools.
• Nursing and humanitarian care — Clara Barton and the founding of the American Red Cross, and the broader rise of nursing as a trained profession.
• Public health and infectious disease — sanitation reform, vaccination campaigns, epidemics, and the growth of federal and local public health authority.
• Research ethics — Henrietta Lacks and the HeLa cell line, the Tuskegee syphilis study, and the consent, oversight, and human-subjects protections that grew out of those abuses.
• Access, coverage, and financing — the growth of employer-based insurance, Medicare and Medicaid, and later coverage expansions and reforms.
• Advocacy that changed policy — Ryan White and the HIV/AIDS response, and Katie Beckett and home- and community-based care for children with complex needs.
• Today's inherited problems — cost, disparities in access, and the move toward value-based rather than volume-based care.

If policy language is new to you, the same era-by-era framing carries over into D546 Healthcare Policy and Governance, and the equity themes here overlap with D621 Social and Behavioral Determinants of Health. Studying D393 well makes both of those noticeably easier later.

How Hard Is D393, Really?

Many students report that D393 is one of the lighter courses in a health program's early terms, especially compared with anatomy, statistics, or pharmacology. There is no math, no lab, and no written task to be evaluated and returned. The difficulty is volume: a lot of names, dates, acts, and institutions arriving in sequence, and a proctored exam that asks you to keep them straight without notes.

A realistic plan is one focused week if you already have healthcare work experience or a history background, and two to three weeks of steady evenings if the material is entirely new. Rather than counting days, count coverage: you are ready when you can move through every section of the course material and explain each major turning point out loud without looking. Students who struggle usually are not slow learners, they simply read passively and never tested themselves before test day.

A Study Plan Built for a Timeline Course

Phase one: take the pre-assessment early, not late. Take it before you have studied much. A low score at that stage is diagnostic information, not a verdict. Write down which competency areas dragged your score down, because those are the only sections that deserve heavy time later.

Phase two: build one master timeline. Open a single document or a long sheet of paper and lay out the eras the course uses, from colonial care through the present. As you work through each section, add entries in a fixed three-part format: what happened, what problem it responded to, and what changed afterward. That third column is what the assessment actually rewards. A date alone is a fact; a date plus consequence is understanding.

Phase three: use active recall, not rereading. Close the material and try to reconstruct the timeline from memory, then check what you missed. Make your own flashcards with the person or law on one side and its significance on the other, and deliberately shuffle them so you are not leaning on the order. Space your reviews across days rather than cramming a single long session, because interleaved review is what makes similar-sounding acts stop blurring together.

Phase four: rehearse the reasoning, then retest. Practice explaining, in two or three sentences each, why medical education reform mattered, why the Lacks and Tuskegee cases reshaped research consent, and how advocacy by individual families changed federal coverage rules. Then retake the pre-assessment or the course's practice items under quiet, timed, notes-closed conditions. When your practice performance is comfortably strong and stable across two attempts, schedule the proctored exam.

Where D393 Students Lose Points

• Memorizing dates without consequences. Knowing a year but not what it changed leaves you helpless on any question phrased as a scenario or an impact statement.
• Confusing similar figures and programs. Several advocates and several coverage programs sound alike at speed. Pair each name with one unmistakable detail you will never mix up.
• Skipping the ethics material. The research-ethics thread is central to the course's purpose, not a side story, and it is easy to underprepare because it feels like a different subject.
• Leaning on old D050 material as if it were current. Outdated sets can be wrong on recent policy and can miss sections your version of the course now includes.
• Treating the pre-assessment as the finish line. Passing it once, immediately after reading the same section, mostly measures short-term recall. Space it out and repeat it.
• Ignoring the "today" framing. The course explicitly ties history to current system challenges, so expect to reason forward from a historical development to a present-day consequence.

D393 Readiness Checklist

• Can you sketch the arc of American healthcare from charity-based care to today's value-based care without notes?
• Can you explain what almshouses and pesthouses were for, and why they came before modern hospitals?
• Can you describe how medical education changed once scientific training and admission standards took hold?
• Can you say who Clara Barton, Henrietta Lacks, Ryan White, and Katie Beckett were and name one concrete change connected to each?
• Can you explain how research-ethics abuses led to modern consent and human-subjects protections?
• Can you distinguish the major coverage and financing programs by who they serve and what gap they filled?
• Can you connect a specific historical decision to a present-day access, cost, or disparity problem?
• Have you scored well on practice material twice, on separate days, with everything closed?
• Have you confirmed your proctoring setup, ID, and quiet room before booking the exam?

D393 FAQ

Is D393 an objective assessment or a performance assessment?

It is an objective assessment, a proctored exam you take remotely or at a testing center. There is no paper or project to submit. WGU does not publish the number of items or the passing standard, so plan around mastering the competencies rather than around a target score you saw quoted somewhere.

How many competency units is D393 worth?

Three competency units. WGU's published Health and Human Services standard path lists it in the fourth term alongside other three- and four-CU courses, so it is a normal-weight course rather than a heavy one.

Is D393 the same course as D050?

The title is the same and the subject matter overlaps heavily, since D393 is the current code for History of Healthcare in America. Older notes labeled D050 can still be useful for orientation, but verify everything against the current course material, because sections and emphasis change between course versions.

Do I need a history background to pass?

No. There are no prerequisites, and the course teaches what you need. If general U.S. history context feels shaky, a light pass through D267 U.S. History: Stories of American Democracy material can help you place events on a timeline, but it is optional rather than required.

How much time should I set aside?

Many students treat this as a shorter course than the science-heavy ones in the same term. Plan roughly one focused week if the material is familiar and two to three weeks of consistent evenings if it is not, and let your practice performance rather than the calendar decide when you schedule.

What should I do if I do not pass on the first attempt?

Not passing is recoverable and common enough that WGU has a defined retake process. Meet with your course instructor, review the coaching report showing which competency areas fell short, and rebuild your timeline for just those areas rather than restudying everything. Targeted second attempts usually go much better than repeated broad rereading.

For related coursework in the same school, browse the Leavitt School of Health guides, or see every course we cover in the full WGU study guide index. You can also confirm program requirements directly on WGU's Health and Human Services program page.