Dr MJ Rowland-Warmann debates the pros and cons of live model sharing in aesthetic injectable training
There is nothing more ‘real’ than working on live patients. Phantom heads are great for theory and a little bit of practical, but they are not the same as human tissue. The way needles go into a phantom head is very different from a living, breathing person. Experiences such as the depth of needle, whether touch is too firm or too light, or the way injection feels can be near impossible to gauge with phantom heads.
Live models are ideal – they allow delegates to experience not only the tissue that is to be injected but also the range of human responses they are likely to experience during their aesthetic treatments. But are delegates getting appropriate training with live models on UK courses? And are models having a suitable treatment experience?
It’s a common occurrence in beginner injectable training courses that one model is shared between several delegates, who may each treat half of a patient’s face.
Often models are shared because the training provider does not attract enough models, or, in many cases because the trainers don’t have a practice attached to the training school to draw models from, and therefore lack access to them. Sometimes, models may pull out on the day of the training, and maybe the training provider does not have enough space in their training facility to allow for one model per delegate. Although sharing models is undoubtedly better than training on phantom heads, model sharing also comes with its own disadvantages; both for the model and the practitioner.
Delegates pay an awful lot of money to come and learn on training days, and many feel like they are being short-changed when they are asked to share a model. Some training schools will argue that model sharing may improve peer learning – drawing on each other’s opinions and ideas to bring about the patient treatment. However, as discussed below, I would argue that using one model per practitioner is a much better approach.
From the model’s perspective, although they are usually getting free or reduced treatments, and expect novices to work on them in a training session with oversight from an experienced trainer, it’s important to remember that they are still patients. As clinicians we have a duty to keep them safe and also deliver the very best care to them. I believe that sharing them around like a game of pass the parcel is not delivering excellent medical care. Practitioners have different degrees of experience and skills, apply product to different injection depths, with different levels of pressure and this manifests in the results they achieve. One practitioner might be over cautious, whereas the next may be heavy handed. This combination on one single face inevitably gives the patient a result which is less desirable than expected. The face has two halves, and if delegates don’t want their patient’s face to end up completely different from one side to the other, model sharing is not advisable.
It is also important to consider aftercare in any treatment plan. Models, like any patient, should be afforded clear aftercare provision, with the opportunity for treatment reviews and treatment management in the unlikely event of a complication. For shared models, it can be very difficult to assign who is responsible for the post-treatment review process. What if something goes wrong? What if the patient wants to compliment the practitioner for the treatment? So many difficulties arise with multiple practitioners working on one patient.
Using one model per practitioner
I’ve found that many training providers don’t bother teaching consultation skills, treatment planning, patient discussion or aftercare – they just assume delegates are going to pick this up. As a result, there are a vast number of poorly prepared, inadequate communicators in aesthetics who can stick the needle in the skin but can neither consult nor properly care for the patient, because the most basic training hasn’t been covered on their courses.
With 1:1 model to delegate ratios, it is like private tuition in a group course. Delegates experience the whole consultation and treatment process, so they are more likely to integrate it seamlessly into their practice and start treating with their new skills competently and confidently from the beginning. By virtue of the fact that they have treated whole patient/more patients they will have gained more experience, which makes them more confident. I believe that simply doing more in the course will prepare them better for real-life patient treatment.
I also believe that peer learning is very much still possible when delegates each have their own models; if anything, it is more beneficial seeing a peer conduct the entire treatment from end to end to learn from, rather than the patchwork learning that many practitioners end up getting with a shared model experience.
Aesthetic medicine training is largely unregulated, but this does not mean delegates and patients don’t deserve a positive educational and treatment experience. Models are patients who deserve gold-standard care no matter what the treatment circumstance and even in training circumstances should be awarded personalised, dignified and appropriate care rather than conveyor-belt treatment. I believe that it is time educators and delegates hold themselves accountable to promote better training in aesthetics.
Upgrade to become a Full Member to read all of this article.