Hi,
What do skydivers, rock climbers, and spelunkers all do in common? They all prepare before getting into the thick of the activity. Indeed, having started our own adventure last week, the NIMBS design team began preparations and encountered our first challenge. However, let me recapitulate my team’s assignment to explain.
We want to make New Ballard Scoring, a method for systematically assessing gestational age (see table below), more frequently practiced in Malawi hospitals. The neuromuscular portion of New Ballard Scoring requires the practitioner to manipulate the extremities of a newborn, which is tough to learn with only words and images. NIMBS is trying to create a training manikin on which nursing students can practice New Ballard Scoring.
Our primary concern is whether more comprehensive training on New Ballard Scoring will make the assessment more widely practiced. In other words, we want to confirm that the cause of New Ballard Scoring’s lack of prevalence is rooted in insufficient training and not other constraints. Our doubts first surfaced when reading a previous team’s notes from interviews with Malawi nurses; the practitioners mentioned a lack of time and that experienced nurses often developed “instincts to identify prematurity by appearance”. I am grateful to our client, Prince, who has put us in contact with several nurses and nursing students from Malawi. Over the coming week, we plan on meeting them to understand their perspectives on the issue.
In the meantime, we continued preparing for our project through research. Since, to our best knowledge, there are no training manikins on the market with manipulatable extremities, we have been looking into proxies to try to help brainstorm a solution. Puppets, humanoid robots, various mechanical joints, and prostheses have all been in our investigations. Our design challenge is to create joints incorporating tension to stimulate muscle tone and mechanisms to adjust the range of motion to account for different flexibilities of infants of various gestational ages. We anticipate having to do a lot of CAD and 3D printing to achieve precise geometries; our team is currently learning Fusion 360.
Our team also created preliminary design criteria to help guide our decisions during prototyping. Our objectives include training efficacy, ease of use, comprehensiveness, appearance, low cost, and durability. We want our solution to be effective as a training model while looking like an infant and being sturdy.
Regarding the dilemma of whether a training manikin will help us achieve our goal, I feel that stopping to consider it is the right plan. An engineer’s work is not just to create a device but solve a problem. Our work this week has allowed us to identify the hurdles ahead rather than blindly jump, and I would rather fall and get up knowing what I had tripped over than not.
Until next week,
Andrew Sun