Development of an Artificial Abscess Model: Its Functional Fidelity for Teaching Nursing Students

Abstract

Aim/Purpose: This study aimed to design, develop, and evaluate an artificial abscess model for nursing education. The objectives were to create a model that provides functional realism, measures satisfaction, and improves student competency in performing incision and drainage (I&D). It was hypothesized that students trained with the developed model would demonstrate a high level of satisfaction and improved clinical competency.

Introduction/Background: Skin abscesses are frequently encountered in clinical practice, with I&D serving as the standard treatment in both emergency departments and outpatient settings. I&D is new for nursing students. Because patient safety is paramount and precision when making small incisions is required, students must first undergo extensive practice with part-task trainer models (PTTs) in laboratory settings before practicing with real patients. PTTs are simplified simulation models designed to teach specific procedural skills by focusing on the essential components of a task rather than replicating the entire patient scenario. However, existing artificial abscess models are costly, single-use, and insufficiently realistic in skin texture and pus discharge, thereby limiting training effectiveness when resources are limited. These gaps highlight the need for an affordable, reusable, and clinically realistic simulation model to support safe skills acquisition before patient contact. To address these challenges, the researchers sought to develop an artificial abscess model that would provide the feeling of real skin, allow injections for local anesthesia, incision, pus drainage, and gauze packing for wound dressing–all at an affordable price. Students would benefit from repeated use of the model both in laboratories and in their free time to strengthen psychomotor learning and clinical confidence. This study bridges the gap between theoretical learning and safe clinical practice.

Methodology: Classroom action research was employed using 59 third-year nursing students as the sample. Participants were assigned to three groups based on grade point average (GPA) to ensure comparable baseline academic performance. The model was developed in two stages: (a) development of an artificial abscess model, and (b) trial and evaluation of the effectiveness of the artificial abscess model. Data was collected by using a satisfaction questionnaire (Cronbach’s α = .956) and an I&D competency checklist (inter-rater reliability = .869). Statistical analysis included descriptive statistics and one-sample t-tests that were greater than 3.51 out of 5.00 for satisfaction, and greater than 60% for I&D competency performance.

Findings: The first model prototype, containing 12 pustules, received mean scores below 3.51 for pustule spacing (x̄ = 3.00) and skin realism for anesthetic injection (x̄ = 3.33). Participants’ feedback consistently highlighted that the pustules were too closely positioned, causing difficulties in anesthetic administration and excessive stiffness and stickiness of the artificial skin.

The second version of the artificial abscess model was redesigned with eight pustules and a softer skin texture to facilitate local anesthesia administration. Evaluation scores demonstrated substantial improvements across multiple aspects, including scores of spacings between pustules from 3.00 to 4.59, realism of skin for anesthetic injections from 3.33 to 4.06, number of pustules from 3.67 to 4.76, and material realism from 3.67 to 4.53. Participants reported high satisfaction, increased confidence, and improved competence in performing I&D procedures, while recommending further refinements in skin softness, flexibility, and pustule spacing to better replicate human conditions.

The last version of the artificial abscess model featured a tan-colored surface with a sponge core between two silicone layers, and was odor-free, reusable, and suitable for local anesthesia administration. The artificial abscess model included six pustules and an improved formula that reduced stickiness and enhanced skin softness, leading to high participant satisfaction across all aspects (x̄ = 4.78). However, skin realism for anesthetic injections remained the lowest-rated item (x̄ = 4.48). Competency outcomes were strong, with a mean score of 77.37% (SD = 7.62), significantly greater than 60%. The results indicated that iterative refinement of the model substantially enhanced students’ psychomotor performance, confidence, and readiness for safe clinical practice.

Contribution/Impact on Society: The artificial abscess provides an effective and efficient abscess model for practical skills in nursing education, especially for institutions with limited resources. By allowing repeated practice procedures without risk to patients, the model enhances skill acquisition, boosts confidence, and contributes to safer patient care. It demonstrates how low-cost, reusable simulation models can strengthen nursing curricula.

Recommendations: It is recommended that nursing faculties integrate the artificial abscess model into simulation training as part of case scenarios. Similar models should be developed for other essential procedures to broaden the scope of hands-on training.

Research Limitations: The study was conducted in a single institution with a relatively small sample size, which may limit generalizability. Some aspects, such as skin’s realism for anesthetic injection, may require further refinement. Long-term transfer of skills into clinical practice was not assessed.

Future Research: Future studies should explore multi-institutional testing, evaluate skill retention in real clinical environments, and compare the artificial abscess model with other simulation modalities such as Virtual Reality or hybrid models. Expanding evaluation criteria with standardized rubrics would also strengthen assessment reliability.