A 17-kilogram suit for empathy training

An occupational therapy student walks around the School of Medicine with the age
An occupational therapy student walks around the School of Medicine with the age simulator suit (Image: UCM).

How does a person with physical and sensory limitations feel? What are the restrictions for an elderly person who sees and hears poorly and whose joints are no longer what they used to be? Clinical researchers, especially those who deal with patients, have asked themselves that question and have tried to find the answer, and one of them has been the design of an aging and disability simulation suit. One of these researchers is María Luisa Delgado, coordinator of the Master’s Degree in Health, Integration and Disability at the Faculty of Medicine, who has launched the educational innovation project "Empathy training: Application of an age simulator suit as a teaching methodology for health science students" for both master’s degree students and fourth-year occupational therapy students.

In the occupational therapy skills classroom at the Faculty of Medicine, a group of students are experiencing firsthand what it is like to be in the shoes of the elderly, and for that they have put on a suit that limits all their physical and sensory activities.

The students work in pairs that rotate from session to session, so while one is evaluating his partner the other wears the suit that weighs a total of 17 kilos, divided into ten the vest, two kilos in each of the weights of the feet and a kilo and a half in each of the wrists. In addition, there is a neck brace, elbow and knee pads that limit movement, as well as gloves to reduce sensitivity and dark glasses and helmets that severely limit hearing. Throughout the educational innovation project, more devices will be included, such as a sensor that simulates Parkinson’s disease and glasses that simulate cataracts and macular degeneration.

The fifty-seven students of Clinical Practice II: Neurocognitive and Social Intervention will be assisted at all times by Maria Luisa Delgado herself, as well as by Cruz Rodríguez Rodríguez and Sergio Martínez Zujeros, professors of this subject. In the case of the Master students in Health, Integration and Disability, they will also be tutored by the teachers José Pulido Manzanero and Lucía Cea Soriano, from the subject Health, Illness and Quality of Life.

The activity has been divided into eight stations, each lasting six minutes. Most of them are based on the Tinetti Scale, which was designed to assess the mobility of the elderly and measures both balance and walking speed. In addition, there are dynamometry exercises to test hand strength; dressing and undressing in a hospital gown and pajamas to test the difficulty of doing so with limited movements; goniometric measurement to measure the degree of flexion, abduction and extension of joints such as the shoulder, elbow, wrist, knee, ankle and hip; a cognitive test that relates numbers and symbols, and one of transfers from a wheelchair to a toilet bowl or bathtub.

Leaving prejudices behind

Delgado reports that several studies suggest that "students, as young people, sometimes have a restricted understanding of the capabilities, limitations or needs, derived from the functional situation of the elderly, as well as people with disabilities". Hence, "teaching methodologies and tools designed to foster empathy are increasingly being introduced into the curricula of health science degrees. And among these initiatives, the most effective are immersive simulations and lived experiences such as this suit that allows you to "put yourself in the shoes of a patient" and "see the world through their eyes".

According to the master’s coordinator, this suit activity "is designed to foster empathy," especially among the fourth-year students, who are all already doing internships in different centers, including homes for the elderly. Delgado clarifies that, in any case, since they are young, the movement limitations of the suit do not affect them as they would an older person, although they do complain about the hearing and visual restrictions. As a result of the experience, part of this work, which will lead to research, wants to know if this suit really simulates aging and, if it does, what age it could be equated with.

The students, before putting on the suit, have filled out a questionnaire on stereotypical myths about old age in which they have to say what they think of older people, and after participating in the activity they are sent the same questionnaire to which they add questions about their experience with the suit. From the first answers it is already clear that the students learn that they cannot expect an elderly person to go fast because of the reduced range of mobility in the joints, and "they change a lot their prejudice about the elderly being clumsy".

So, beyond the research, those and those who will soon emerge from this experience, already in the early stages it can be seen that the objective of the project is being met, which is none other than "to improve the empathy of students and increase understanding of the limitations, not only from the theoretical point of view, but also from the first-person experience, and raise awareness towards a more humane, dignified and person-centered treatment".