Author: Jacqueline Semaan, MSN,/ BA, RNC-LRN
Moulage, the use of makeup to enhance clinical simulation can strike fear into the hearts of novice nurse educators. When we hear the word "moulage," we conjure up images of simulation specialists working frantically to create the realistic wound or patient condition using different makeup color wheels, latex, hairpieces, putty, and much more. Sometimes the decision is made to forgo the use of moulage on the manikin or standardized patient because creating effective, realistic moulage is too daunting of a task.
Moulage is an essential part of the simulation experience because it is a vehicle in which to tell a story. We know that the more realistic the situation, the more likely the participants will believe that the situation is real. The more realistic the experience, the more likely the participants will react as if they are truly experiencing the simulated situation. Simulated events provide participants with the opportunity to suspend belief and act in the manner they would if faced with the situation in the “real world”. It is then that we can evaluate whether the actions of the participants are appropriate or need further remediation. Moulage is a vehicle to suspending belief and enhancing fidelity as it activates the participants’ sense of smell, touch, and sight
Active learning activities are used to develop the critical thinking and clinical reasoning abilities of nursing students. Educators are bringing simulation into the classroom and implementing simulated clinical experiences that allow the students to feel they are in the clinical setting. They are actively engaged in the experience as they apply their newly acquired knowledge. Creating a clinical environment in the classroom provides the students with the opportunity to rehearse nursing care of a variety of different patient conditions, thus preparing them for future clinical experiences and closing the gap between theory and clinical practice. Therefore, moulage is a vital component in the creation of the classroom clinical experience. Imagine using moulage on a manikin or human actor in your classroom to bring the clinical experience of a hypoglycemic patient into the classroom. Envision students learning how to suction a tracheostomy or provide tracheostomy stoma care on manikins who have tenacious, yellow-green mucous secretions in their trachea and around the stoma and faceplate. Moulage provides the link between the physiology of the situation and how it is interpreted by the participants.
Does moulage have to be complex and time intensive? Of course not! Simple moulage techniques have the capability to elevate and enrich the fidelity of the learning experience. So how and where to begin? Luckily there is a vast amount of instructional information related to moulage use available to nurse educators.
Moulage is a wonderful vehicle to bring your in-class activities to life. It provides the realism we need to assist the students in treating the simulated situation as if it were real. By identifying your resources and what additional support you require, keeping it simple, identifying a starting point, and knowing your manikin or human actor, you can begin to utilize in-class simulations. These activities will engage the students in applying the concepts they have learned and further develop their critical thinking and clinical reasoning abilities.