Stories about: medical simulation

Moulage meets medicine: Making simulations feel real with special effects makeup

medical moulage - Maeve Geary at work
Photo: Katherine C. Cohen/Boston Children’s Hospital

Maeve Geary, BDes, to our knowledge, is the first PhD candidate to specialize in medical special effects simulation. A native of Belfast, Ireland, she completed a Bachelor of Design degree in Special Effects Development at the University of Bolton (Manchester, England). She has been with Boston Children’s Hospital’s Simulator Program, SIMPeds, since April 2016. At SIMPeds, she has contributed to a variety of custom “trainers” and is exploring whether increasing the realistic look and feel of mannequins impacts training and trainees’ ability to learn. Recently, she led the development of a trainer for urinary catheterization in infants — complete with visually and haptically accurate genitals, urethral opening and fat rolls.

It’s now apparent that treating medical mannequins with greater visual and haptic realism makes medical simulation training more effective for clinicians. Moulage, or special effects makeup, is an important part of making simulations feel real.

Here’s a quick tutorial in some very basic effects achieved with simple, readily available drugstore ingredients. Although much of my research is on complex fabrication techniques adapted from the film and television industry, these techniques are simple and accessible to all. (If you’re in Boston, attend our live demos this week!)

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GALLERY: Custom-built ‘trainers’ help clinicians master procedures

medical mannequins manikins trainers medical simulation
Andrew Hosmer (left) and Noah Schulz at the bench, building parts for medical trainers.

Walking into the SIMPeds Engineering Studio, a few blocks from Boston Children’s Hospital, the first thing you notice is body parts — high-fidelity replicas of human anatomy in various sizes. Some are in a glass display case, while others are laid out in various states of assembly, from a lone finger to the complete abdominal cavity of a newborn, packed with diminutive organs. Six newborn-sized, hollow duodenums, cast in rubber over a plastic mold, hang ready near a workbench.

These aren’t your usual medical mannequins.

In the adjoining InventorSpace, three 3D printers stand ready to fabricate additional custom parts. Some will be used by surgeons to rehearse an upcoming complex operation. Others are used for general training and preparedness purposes.

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Medicine meets theater: Pediatrics training, parent practice, device innovation ‘on location’

medical simulation

Pediatric medicine just took a step for the better in Boston’s Longwood Medical Area with a new, expanded pediatric Simulation (SIM) Center — a dedicated space where doctors, nurses and other staff can rehearse tough medical situations or practice tricky or rare procedures in a clinical setting that looks and feels real.

But clinicians aren’t the only ones who will be using the new 4,000-square-foot facility, which incorporates real medical equipment, set design and special effects.

Families can get hands-on practice with medical equipment they’ll be using at home. Inventors and “hackers” can develop and test new devices or software platforms and see how they perform in a life-like clinical environment. Planned hacks, for example, will explore different medical and surgical applications for voice-activated and gesture-controlled devices.

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Making rare operations common through special effects simulation

What if I told you that there was a new technology that improved outcomes for patients of all ages, reduced pain and suffering, reduced time in the operating room, reduced anesthetic times and, the more you did it, the better it benefited patients. And here’s the kicker — it has no side effects. And it’s available everywhere care is delivered.”

That’s what critical care physician Peter Weinstock, MD, PhD, described at his recent TEDx talk in the Boston suburb of Natick.

Weinstock is director of Boston Children’s Hospital’s Simulator Program, SIMPeds. The technology is ultra-high-fidelity medical simulation coupled with a simple concept: practicing before game time.

I mean really practicing.

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Hollywood SFX take medical training to a new level of realism

When critical care physicians at Boston Children’s Hospital practice cannulating an infant going on cardiopulmonary support, they’ll no longer have to cut through hard plastic mannequins with tubes for blood vessels. Instead, they’ll puncture a soft layer of realistic baby skin, dissect through subcutaneous fat and spread muscles that look and feel like the real thing.

They’ll insert the cannula into an internal jugular vein and carotid artery that are thin and flexible, after dissecting through their covering sheath. As they advance the cannula, the blood will have the right viscosity.

These mannequins are not your father’s Resusci-Anne. They’re the creation of the special make-up effects company Fractured FX, whose current credits include Cinemax’s The Knick, and Boston Children’s simulator program, SIMPeds.

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OPENPediatrics: A blueprint for big innovation

My father had a favorite bit of advice as we embarked on our adult lives: “Go big or go home.” Going big is exactly what OPENPediatrics is doing, empowering physicians and nurses to care for children across the globe.

The Web-based digital learning platform was conceived 10 years ago by Jeffrey Burns, MD, MPH, chief of critical care at Boston Children’s Hospital, and Traci Wolbrink, MD, MPH, an associate in critical care. It concluded a year-long beta test in April 2014, and version 1 has now been launched.

Developed to impart critical care skills, OPENPediatrics uses lectures, simulators and protocols to deliver training. In the process, it has helped save lives.

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“Dosing” medical knowledge: Beyond passive learning

Jeffrey P. Burns, MD, MPH, is Chief of the Division of Critical Care Medicine at Children’s Hospital Boston. He established and is Executive Director of the Children’s Hospital Simulator Program, one of the first hospital-based pediatric simulator programs in the U.S., and also co-chairs the hospital’s Ethics Committee. This post, second of three parts, is adapted from his recent talk at the IBM Impact 2011 Global Conference.


“Practice makes perfect” is an axiom that holds for most tasks, including providing health care to a critically ill patient.  And yet even if I’m in training for several years, the experiences I get and the experiences the person next to me gets are radically different – in fact, they’re very random.  I’m on one night, you’re on the next night, and what I saw last night, you won’t see tonight.

That’s no way to dose and sequence knowledge; in fact, no one would set up an educational program where you learned randomly.  There’s a troublesome paradox: Medical crises are relatively rare events in children, as compared with adults, and thus there are fewer physicians and nurses with the necessary experience in caring for critically ill children.

Every month, I get letters from all over the world – “Dr. Burns, can I observe in your ICU?” Last month, we’ve had somebody from Iran, Pakistan and Turkey. And yet we often must say “no,” because the walls are only so big. How can we best spread our knowledge and expertise?

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