Creation of a Neonatal Skill Trainer for Pericardiocentesis, Thoracentesis, and Paracentesis; Gender and Racial Disparities in the Medical Field as a Result of Training With Medical Manikins

In neonatology, the absence of anatomically accurate, ultrasound-compatible manikins poses a challenge for training physicians in fluid removal procedures such as thoracentesis, abdominal paracentesis, and pericardiocentesis. Current manikins in the field simulate external anatomical accuracy and slight internal anatomical accuracy, but lack realistic internal compartments that replicate the structure and function of neonatal organs and cavities. Our technical project addresses this gap by designing and developing a reusable, 3D-printed neonatal manikin with lifelike organ compartments representing the pleural space, pericardium, and abdominal cavity. These compartments were housed within a realistic ribcage and encased in a fluid-retentive, ultrasound-compatible outer skin layer, enabling physicians to gain hands-on experience under conditions that closely mirror those of real-life neonatal patients. We focused especially on the refillability and durability aspects of the fluid chambers to ensure repeated use during procedural simulations. Our project aimed to significantly improve procedural preparedness, confidence, and technical skill for clinicians working in neonatal intensive care. While medical manikins like the one we created often advance the quality of clinical training, they also reflect a narrow demographic, typically portraying lean, white, adult male bodies. This lack of diversity in training models perpetuates systemic biases in clinical practice, as it limits medical trainees' exposure to the inherent physiological variations found across different races, genders, and body types. My STS research examines how the underrepresentation of diverse identities in medical manikins contributes to implicit bias in medical decision-making. My research investigates how manikins serve as both tools for training and symbols of normativity within medicine. This project uses case studies, literature reviews, and interviews with medical professionals to understand the impact of biased training tools on real-world patient outcomes. Exploring the links between training design and healthcare inequities allowed this research to investigate the need for inclusive simulation models in clinical education. Ultimately, this work contributes to broader discussions around equity in biomedical design and ethical healthcare. This research allows members of the medical field to take meaningful strides toward a future in which equitable healthcare is the standard rather than the exception. These two projects are connected in both their goals and outcomes. My technical project aims to develop a neonatal manikin that is anatomically realistic and functionally relevant for training in lifesaving neonatal procedures. However, even the choices that we had to make in our design, such as in skin tone, body structure, and anatomical detail, are not demographically neutral. Unfortunately, they continue to reflect values about which bodies are seen as standard and worth replicating in training. My STS research critically engages with these very assumptions, arguing that the current lack of diversity in medical simulation tools contributes to implicit racial and gender biases among healthcare professionals. These biases can then translate into unequal treatment, misdiagnoses, and poorer outcomes for marginalized patients. Together, these projects exemplify the power of integrating engineering practice with sociotechnical analysis to produce medical tools that are both functionally effective and socially responsible. While our technical project does not address the impacts of race, gender, and build bias, due to it being a neonate, this research informed our engineering approach to a more equitable device. This integrated approach is vital to the field of biomedical engineering, where the impact of design choices extends far beyond the lab or clinic and into the broader structures of healthcare delivery.