Bowel care is one of the few nursing procedures that students rarely rehearse on a real patient before their first clinical shift. The BIX-H37 is a wearable artificial defecation simulator built for that gap: a soft, skin-like device with an adjustable elastic fit, designed for two students to practise enema administration and assisted defecation together.

Quick facts

Why the wearable format changes the drill

A benchtop buttock model teaches the hand motion. A wearable model teaches the procedure as it happens: positioning, draping, privacy, communication and cleanup, with a second student assisting. That is closer to the ward, where bowel care is a two-person task and dignity is part of the technique.

The adjustable elastic fit matters for realism and for access. The device sits at the correct anatomical position on the wearer, so the operator has to work around a body rather than a manikin on a table.

A 40-minute session plan

0–5 minutes: brief and consent. Explain the procedure, confirm privacy, and agree on a stop signal. The wearer is a participant, not a prop; this step is part of the skill being taught.

5–15 minutes: setup. Position the wearer in the left lateral position, place absorbent pads, prepare the enema set, check solution temperature and prime the tubing. The assistant manages supplies and documentation.

15–30 minutes: procedure. The operator administers the enema, monitors the wearer's verbal feedback, and manages the simulated output. The assistant records volume, time and any discomfort reported.

30–40 minutes: cleanup and debrief. Remove gloves, clean the device, document, and debrief on communication, privacy and technique. Cleanup is part of the competency, not an afterthought.

What the model teaches well

• Positioning and access. Left lateral with knees flexed, the standard position for enema administration.
• Two-person workflow. Operator and assistant roles, including who handles supplies and who documents.
• Dignity and communication. Draping, explanation and checking comfort throughout.
• Cleanup and infection control. The step most often skipped in benchtop practice.

Evidence on bowel care procedures is thinner than for CPR, but the principles are consistent: technique and patient comfort are linked, and enema administration can cause pain and cramping when performed poorly [1]. Simulation-based education improves procedure performance when it includes deliberate practice and feedback [2], which is exactly what a paired wearable drill provides.

What the model cannot teach

• No physiological response. There is no change in vital signs, no cramping feedback and no real bowel sound.
• No pathology. Constipation, impaction and obstruction scenarios need case discussion.
• Single anatomy. The device simulates defecation, not stoma care or catheterisation.
• Supervision required. Because the wearer is a person, the session needs a facilitator who can stop it.

Buying checklist

1. Order at least two units so pairs can rotate without waiting; the device is designed for two-student practice.
2. Ask about skin material and cleaning. Confirm the approved disinfectant and drying method.
3. Request a replacement cover or liner if available; repeated sessions wear the soft skin.
4. Plan privacy. Book a room with a screen or curtain; the drill fails if the setting is a open lab.
5. Include a documentation sheet in the kit so the assistant practises recording.

FAQ

Q1. Is the simulator worn by a student or a manikin? It is wearable. One student wears it while another performs the procedure, which is why it is designed for pair practice.

Q2. What procedures can be practised? Enema administration, assisted defecation and general bowel care. It is not a stoma or catheterisation trainer.

Q3. What is the price and minimum order? Price is quoted per order. Email chinoncpr@adaanatomy.com with quantity and destination for a current quotation.

Q4. How is the device cleaned? Follow the supplier's cleaning instructions for the soft skin; use the approved disinfectant and dry fully before storage.

Q5. What is the lead time? Lead time depends on quantity and destination port. Ask for it in writing with the quotation.

Q6. Are spare parts available? Ask for replacement covers or liners and confirm warranty terms in the same quotation.

References

1. Fihn J. Pain and cramping with enema administration. Gastroenterol Nurs. 2005;28(3):262. doi:10.1097/00001610-200505000-00014
2. McGaghie WC, Issenberg SB, Cohen ER, et al. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? Acad Med. 2011;86(6):706-711. doi:10.1097/ACM.0b013e318217e119
3. Greif R, Lockey A, Breckwoldt J, et al. European Resuscitation Council Guidelines 2021: Education for resuscitation. Resuscitation. 2021;161:388-407. doi:10.1016/j.resuscitation.2021.02.016

Contact

For a quotation, the cleaning protocol or a demonstration video: chinoncpr@adaanatomy.com. Production follows ISO 45001 management practice; CE documentation is available for EU procurement.