Making simulation come to life

The goal of the Clinical Simulation Institute is to develop simulation experiences that are as as realistic as possible for our nursing students.  Part of the realism involves moulage, the art of creating mock injuries for the purpose of training. Moulages can mimic blood, urine, pus, vomit, wounds, among countless other fluids and injuries.

One of our staff, Debbie Sutter, talks about moulaging and her role in making the simulation experience come to life:

Hi, my name is Debbie Sutter, and I’ve been a nurse for 29 years.  I came to Goldfarb School of Nursing at Barnes-Jewish College in August of 2008 in the role of Clinical Simulation Facilitator.  Part of my job is to ensure the simulation labs have all of the supplies that they need for the scheduled labs, and assisting faculty with planning and implementing simulation scenarios.

Recently, I was asked to participate in a series of simulations that involved our senior synthesis students and third year medical students from Washington University School of Medicine. Unlike previous simulations, this one utilized standardized patients, or SP’s. SP’s are trained actors that work with all types of students in health care. My role was to get each of our “patients” ready so that they would look like they had recently undergone a surgical procedure. The art of making a wound appear to be real is called moulage.

I was charged with trying to moulage our 12 patients. My goal was for the wounds to act as a visual aid in the simulation and a rich learning experience for both students.  In order to learn how to do this well, our department sponsored a class that taught us how to make wounds using gel products that could later be applied to either manikins or to people.

After the class, my two colleagues, Tina Ahearn and Gale Bunt, assisted me in making the 12 wounds that were needed for this experience. The wounds are made using a product called Gel Effects. This is a solid material that when heated to 140 degrees Fahrenheit turns liquid. It is applied to a pallet and the pallet is tuned until it is in a circular shape. A piece of tulle is applied while the product is still tacky. This will enable an incision to be made in the wound without it tearing.

A second layer of flesh-toned gel is applied and then allowed to set up or harden. After it sets up, an incision is made and then  blood-colored gel is applied to mimic a fresh post-operative wound. Staples or steri-strips were applied to each wound depending on the type of surgery. The wounds were fabulous and enhanced the SP session. I will never again attend a movie or play and look at special effects the same way!

-Debbie Sutter

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