Dark skinned manikin

M Simulation is Committed to Inclusive, Diverse Representation in Simulation-Based Learning

Jennifer Syltie Johnson

When Lou Clark, PhD, MFA, arrived at M Simulation as its executive director in March 2020, she quickly realized that its mannequins were not reflective of the community it served.

“Early on in my tenure, I really wanted to make it a priority to diversify our mannequin fleet,” said Clark. “I’ve looked for opportunities to do that whenever possible, and this involves strategic planning due to cost.”

Patient simulators or full-body mannequins provide critical opportunities for learners to practice technical and procedural skills that would otherwise be unsafe to practice on a real human being. The mannequins are used by students studying medicine, nursing, dentistry and other allied health professions in the M Simulation center in the University’s Health Sciences Education Center.

Simulation technology has evolved greatly in the past 50 years and today’s mannequins are significant capital investments for the University. The cost for a new, full-body, high fidelity adult mannequin is upwards of $80,000. M Simulation mannequins are used in rooms equipped with advanced digital technologies to support learning and assessment. Performance data from simulation education activities is captured in web-based software. This maximizes the educational experience for learners by allowing for immediate feedback and debriefing, assessment of skills, and continuous professional development.

M Simulation currently has 10 high fidelity full-body mannequins ranging from infants to adults. All of these mannequins have the technology to simulate physiology including breathing, pulse points, and heart rhythms. Additionally, the department has two dozen other lower fidelity partial-body mannequins, which offer learners specialized training for specific procedural training such as lumbar puncture.

Until recently, simulation equipment companies offered only light-skinned mannequins. Now manufacturers are producing light, medium and dark-skinned mannequin options. Today, M Simulation has two dark-skinned mannequins—one infant mannequin and one adult mannequin. The first was made possible, in part, through a donor gift to the University of Minnesota Foundation. The new adult mannequin was made possible through additional work the M Simulation team took on in the COVID response. As significant capital investments, the process of diversifying will take time and careful planning.

In addition to diversity in mannequin skin color, Clark is advocating for manufacturers to have better representation of women.

“The only full body female mannequin we currently have is one designed to deliver babies,” said Clark. Named Noelleâ, the maternal health patient simulator is designed to meet learning needs around birthing and neonatal health. “We look forward to the mannequin companies growing their options with more representation of women.”

As another way to make a more inclusive, diverse environment for learners, M Simulation has also focused on the synthetic skin it manufactures in-house for learners.

“We’ve made an effort to diversify the synthetic skin we use for suturing skills and other procedural skills,” said M Simulation Technical Simulation Coordinator Aaron Yeshe. “By using different mixtures of acrylic paint in our skin recipes, we can represent virtually any skin tone so that students can get a more realistic experience trying to find anatomic landmarks that might be more challenging or different on different skin tones.”

M Simulation staff also build anatomical models that feature the synthetic skin, which learners use for technical and procedural skills training. Assistant Director E.B. Floersch is one of the team members who designs and builds models to meet simulation training needs.

“We pride ourselves in developing innovative training tools for our faculty and stakeholders at a reduced cost,” said Floersch. Our M Sim Lumbar Puncture model—which is less than a quarter of the cost than that of a comparable industry model—features aspects that are not yet represented in currently available models such as varied skin tones, clear side panels that learners can ultrasound, and more.”

By developing a more inclusive mannequin and equipment inventory, Clark sees a great opportunity to reflect the diversity of M Simulation’s learners and the patients they will ultimately serve.

“If we don’t expand representation of our teaching equipment to reflect all patients, then the students aren’t getting the proper training to care for all communities,” said Clark. “That’s why it’s critical for us to do this.

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