Guest article from David Halliwell - Manikin Mentality: Please don't abuse your manikins...

David Halliwell gave me permission to re-post an article he wrote on LinkedIn. Check it out below - and follow him on LinkedIn to keep up with all his great articles.


Whilst showcasing our new manikin products at conferences around the world this year our team at Lifecast have become obsessed by trying to understand the mindset of the user - trying to get to grips with why they behave differently with x manikin vs manikin y.

Is it realism of the features? Is it weight or warmth or touch? What exactly is making the difference? What can we do to increase Realism?

Smell, colour and fine detail...

I understand the manikin is only one small part of the training event - and the skills of the educator, the environment, the props, the learning contract, the debrief are all key components.

I have always been a fan of the "magician and the wand" discussion - please see below... BECAUSE if your manikin is an expensive Wand - then your magician needs to look after it!

https://www.linkedin.com/pulse/simulation-theory-magician-wand-david-halliwell-msc-paramedic

I understand that there are different simulation tools for different jobs... and that with the right tools and people we can get the student to 'suspend their disbelief '.

Emotional Attachment / Buy in - are all concepts we have explored as we continue our journey to build tools that will transform simulation. Working with great brains to re-think the traditional simulation concepts.

As Educators / Trainers we need to try and explore the way tools are used - how and why they work - and long term to explore - how do they benefit student outcomes?

Recently I've noticed that there are a great deal of manikin abusers out there! 

Medical Manikin's are usually expensive tools - increasingly engineered to look and feel real - with new features being designed by companies around the world each week - yet as I watch people use them I sometimes feel concerned by the lack of care or attention they are given by participants.

In my previous NHS roles I would often spend £100,000+ a year (Every year) to replace broken manikins.

There are some common observations....

Rough intubation - a "I will get this tube down if it kills me!” mentality. Not every person is easy to intubate - not every manikin should be easy - maybe the educators are actually looking at how you cope when you can’t quite see the perfect view with ease.

If you continue to DIG around in the Away - rather than fall back, regroup and use plan B techniques - you are maybe not the right person to be playing with Airways.. 

Maybe its a positioning issue? Maybe its the tool you are using? Standard blade vs difficult airway blade - size of blade etc... Maybe the manikin is designed to be somewhat awkward.

Shoving OP airways in (without care…) Sufficient Attention is not given to OP Airway insertion - If you insert an airway with the little attention to detail that we see in manikins you really could be causing significant damage - to teeth and to soft tissues.

You may not know but the OP Airway causes more damage to teeth in Anaesthetised patients than the Metal Blade of the Laryngoscope -  http://www.frca.co.uk/article.aspx?articleid=101120

Shoving fingers in places where fingers shouldn’t go! - Recently I’ve seen many people "Shoving their fingers down the Lady manikins throat"... Why? I don’t get it.. Is it sexual? because ... it sure as hell isn’t clinical!

When I ask them what they are doing they say - "I was having a feel of the anatomy" - (Really? - Do you do that with your patients?) "

"I was seeing if I could digitally intubate" -  When did you last do that to a patient in your theatres? I understand that these skills exist - and maybe for 0.005% of patients and clinicians these may be skills you need, but maybe we could save hundreds of thousands of pounds to the NHS by just thinking differently...

Please try and 'Treat your manikins with the same care and respect with which you would like to be treated...'

Its a simple message - Please look after your manikin like you would expect to be looked after... Manual handling, Clinical skills, Skin care, the list goes on...

I feel we need a shift in mentality - TREAT YOUR MANIKIN LIKE YOU WOULD A PATIENT!