Moulage in trauma education: a comparison study in undergraduate medical students

Intro
The use of moulage in medical education dates to 17th century Europe. The word moulage means “to mould”, describing the technical process of making a negative mould of a body part and then filling it with wax. The antique moulage now stored in musea around the world, today the word moulage encompasses the use of special effects makeup techniques and prosthetics to replicate illness and trauma. Despite its long history, there has been very little research to inform the theoretical and practical application of moulage. This abstract describes the methods utilised to explore how the authenticity of moulage influences medical student engagement in trauma simulations.
Methods
A randomised mixed-methods study was deployed to explore undergraduate medical students’ perceptions of engagement in simulation. Participants were randomised to one of three groups (Control, Experimental 1 and Experimental 2) to explore differences in engagement via measurement of the Immersion Scale Reporting Instrument (ISRI), self-reported engagement and eye tracking. Participants were interviewed using the Stimulated-Recall technique.
Results
33 undergraduate medical students participated in the study. There were no statistically significant differences between groups in the ISRI score. Statistically significant results were observed between the groups in the self-reported measure and eye tracking. Participants identified four primary themes that contributed to better engagement in simulation, including (1) the rules of simulation, (2), believability, (3) consistency of presentation and (4) personal knowledge. Limitations to the study include the low participant numbers and the single rater for ISRI scores.
Recommendations
Overall, the inclusion of moulage contributed positively to the simulation experience. Participants identified the use of moulage contributed to better suspension of disbelief in a hypothetical scenario, and provided more realistic portrayals of clinical care. The study highlights a need for further work to explore how moulage contributes to learning in health professions education more broadly.