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Clubfoot Moulage for Infant Manikin (1090-004178)
CE Hours: 0.25 Session Type: SimVentors Session Sub Type: Prerecorded Video Demonstration Cost: $0.00
Description:
The curriculum at Samuel Merritt University mandates interprofessional education, based on the Institute of Medicine’s core competency of ‘work in interdisciplinary teams’ and the Interprofessional Education Collaborative core competency of ‘active implementation of interprofessional education programs at health science institutions’. In 2019, faculty identified an opportunity to develop an interprofessional simulation scenario involving students from three disciplines: podiatry, physician assistant, and pediatric nursing. Simulation educators worked with faculty from each discipline to create a pediatric simulation scenario requiring three members of an interprofessional team to work together to assess a newborn with a foot deformity. In order to present a high fidelity simulation experience, the simulation educators requested that simulation operations specialists create a clubfoot moulage. The clubfoot needed to be easy to add and remove from the manikin, low cost, and highly realistic. The presenter successfully altered a spare SimBaby Classic right leg to represent an internally rotated clubbed foot. Supplies: Laerdal SimBaby Classic Lower Leg Assembly Apoxie Sculpt Modeling Compound Metal pins Superglue Goop or E6000 Tools: Dremel Wire Cutters Needle Nose Pliers Hammer Safety Glasses N95 Mask Gloves Measuring Cups - 2 Spoons - 2 Drape Process: Remove skin and veins from SimBaby leg and set aside Use Dremel to cut through SimBaby leg just above the ankle Use Dremel to cut through standard SimBaby leg just below “toes” Remove additional material with Dremel so that leg pieces will sit at the desired new angles Insert 2 metal pins into the cut ends of each of the 2 smaller leg pieces Push the smaller leg pieces into their new locations using the pins Use a small amount of super glue to ensure the metal pins are secure Once the leg is pinned securely into its new position, prepare the Apoxie Sculpt Wear disposable gloves to measure equal parts of A & B Always retrieve parts A & B with different tools Mix together for 2 minutes until thoroughly combined Apoxie should be a uniform color Allow mixed product to rest 5 minutes before use Working Time Line Guide: 1/2 hour: Sticky & most adhesive 1 to 2 hours: Easy to work with 2 to 3 hours: Setting up, form-able detail 24 hours: Hard, cured & waterproof Once Apoxie Sculpt is prepped, sculpt the clubfoot Apoxie Sculpt can be used to fill in gaps A final thin layer covering the entire foot should be added once the foot is sculpted to increase stability. Allow to cure for 24hrs Once Apoxie Sculpt is fully cured, pull the SimBaby leg skin over the new foot. If the clubfoot has an extreme angle, heat the skin with a hairdryer to help it adjust to the new angle. If the skin no longer fits and looks accurate, you can use additional Apoxie Sculpt to fully sculpt the leg, toes, ankle, etc., then paint the sculpture to match your SimBaby’s skin tone. This method will result in a heavier than standard leg for SimBaby due to the weight of Apoxie Sculpt. I suggest choosing an angle that is dramatic enough to indicate to learners that the foot is clubbed, without being so dramatic that the original skin no longer fits onto the leg. It’s quite simple to quickly switch the legs on the SimBaby Classic. Just squeeze and pull gently to remove the pin at the knee joint. Samuel Merritt University ran multiple sessions of the IPE Pediatric Clubfoot Scenario in Fall 2019, utilizing the clubfoot moulage. Feedback from faculty and learners was positive regarding realism and the impact of the switch between a standard leg during orientation and a clubbed foot during simulation. SMU has plans to run this scenario regularly. Simulation educators have requested that simulation operations specialists expand the moulage to additional infant manikins.