Innovating Simulation: What the Pemberton Maneuver Teaches Us About the Trusted Power of Moulage in Training Exercises.

Bobbie Merica
Aug 25
3 min read

Updated: Aug 27

One of the greatest lessons from medical history is how simple, immediate physical signs have long guided clinicians and first responders to trust and effectively treat patients. Take the Pemberton maneuver, a humble arm-raising test to reveal vascular obstruction at the thoracic inlet. It was trusted because it was immediately accessible, highly informative, and grounded in deep clinical training, experience, and visual verification. This mirrors the challenge and opportunity we face in simulation-based education today.

The Clinical Power of a Trusted Physical Sign

The Pemberton maneuver’s legacy is rooted in how clinicians relied on a straightforward physical sign to diagnose complex pathology when imaging technologies were scarce or rudimentary. It provided an instantaneous, low-cost, and effective diagnostic tool that seamlessly fit into the clinical workflow, earning clinicians’ trust because of its reliability and immediacy. Similarly, in simulation, moulage, the application of makeup, prosthetics, and simulated injuries, when applied with science, plays an essential role in constructing realistic, immersive learning experiences that clinicians and first responders trust to build skills and rapid recognition response.

Intuitive Recognition and Early Adoption

We at Moulage Concepts recognized the power of moulage early on. Experience showed that the added realism, sensory detail, odors, and clinical cues that moulage provided transformed learner engagement and clinical skill development. We built it into our training approaches intuitively, and in 2009, we committed that accumulated knowledge and passion to our foundational book, which remains a go-to guide for simulation professionals worldwide.

Validation Through Research

Only later, as rigorous research caught up, was our empirical understanding formally validated. The 2024 systematic review “The impact of moulage on learners’ experience in simulation-based education and training” confirmed what moulage experts have long known: moulage dramatically enhances learner immersion, engagement, and educational outcomes. It is not just an artistic accompaniment, but a critical educational tool, bridging the gap between theory and realistic clinical decision-making, just as the Pemberton maneuver once bridged bedside exam and diagnosis.

Bridging Innovation with Tradition

Like the Pemberton maneuver, moulage succeeds because it is:

Immediately accessible: Quick to apply within training scenarios.
Informative: Provides essential visual, olfactory, and tactile clinical cues.
Grounded in clinical training: Enables experiential learning tied to trusted clinical signs.

The Path Forward: Beyond Realism

Our profession must continue to think outside the box to evolve moulage training, not only by creating visually immersive effects but by designing scenarios that seamlessly integrate physical signs and clinical cues, mirroring the real world where trust in the physical exam transformed medical practice.

By integrating years of practical experience and intuitive training with rigorous scientific research, moulage has proven itself to be an indispensable educational tool. This powerful blend of insight and evidence ensures that moulage will remain a trusted cornerstone of clinical training, just as the Pemberton maneuver once guided generations of clinicians in recognizing critical signs at the bedside. As we carry forward this tradition of bridging art and science in simulation education, we affirm what has always been true: Every Training Matters.

#MedicalEducation #SimulationTraining #Moulage #HealthcareInnovation #ClinicalSkills #MedicalSimulation #MedEd #HealthTech #PatientSafety #LearningAndDevelopment #MedicalTraining #HealthcareEducation #SimulationBasedLearning

Contact us today to learn more about our 360-sensitive approach to bridging the gap in clinical, first responder, and emergency preparedness training.

Moulage Concepts Inc. Training Leaders for Preparedness

For training you can see, feel, hear, and smell.