Abstract
BackgroundMoulage is a technique in which special effects makeup is used to create wounds and other effects in simulation to add context and create realism in an otherwise fabricated environment. The degree to which moulage is used in the simulated environment is varied; that is, there is no guide for how authentic it is required to be. To objectively assess whether a higher level of authenticity in moulage influences engagement and better outcomes, a common model to assess authenticity is required. The aim of this study was to explore expert opinions on moulage in simulation and develop an instrument for the classification of moulage in simulation.MethodsThe instrument was developed in 3 phases: expert panellist recruitment, domain identification, and consensus rounds. A Delphi technique was used to explore themes of authenticity using Dieckmann’s Theory of Realism as a frame of reference. An initial list of elements was raised by a panel of international experts. The experts participated in a further four rounds of questioning, identifying and then ranking and/or rating elements of authenticity in moulage. A priori consensus threshold was set at 80%.ResultsIn round 1, 18 of 31 invited panellists participated, and a total of 10 completed round 5 (attrition 44%). As a result of the Delphi, the Moulage Authenticity Rating Scale was developed. Under the three domains of realism, 60 elements were identified by experts. A total of 13 elements reached the consensus threshold, whilst tensions regarding the necessity for authentic moulage were identified throughout the rounds.ConclusionThis study demonstrates the complexity of moulage in simulation, with particular challenges surrounding the experts’ views on authenticity. A prototype instrument for measuring moulage authenticity is presented in the form of the Moulage Authenticity Rating Scale (MARS) to further aid progress in understanding the role of authentic moulage in simulation.
Highlights
Moulage is a technique in which special effects makeup is used to create wounds and other effects in simulation to add context and create realism in an otherwise fabricated environment
Initial elements generated In round one, a total of 60 elements were raised as contributing to the authenticity of moulage (Additional file 1)
How would a framework for moulage authenticity apply to our practice? Firstly, we suggest that understanding moulage with a theoretical lens would add weight to the importance of its application in simulation
Summary
Moulage is a technique in which special effects makeup is used to create wounds and other effects in simulation to add context and create realism in an otherwise fabricated environment. Simulation is used in a wide range of disciplines, including healthcare, education, and other industry sectors (such as defence, mining, and engineering) It serves as an opportunity for practice where particular situations are not common or unsuitable/unsafe for practice [1, 2]. Stokes-Parish et al Advances in Simulation (2019) 4:16 community places importance on creating a level of realism, as noted in various literature [8, 9]. Encompassed in these broad aspects of ‘realism’ in simulation, are cues and set-up—thought to be essential for participant engagement [10, 11]. One kind of cue that contributes to physical realism is moulage
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