Craniofacial and Trauma Rehabilitation —
Training activity: 14

Details

Develop a treatment plan for a patient with a craniofacial deformity and assist with a facial impression procedure

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• Patient centred care and support
• Design requirements and options available for anatomical structures
• Patient safety, dignity and confidentiality
• Information required for the design and manufacture
• recommendations for the device
• Retention options
• Materials selection and options
• Impact of design on patient quality of life including patient sensitivities and body image
• Patients health, social circumstances
• Stages of treatment pathway
• Communication with the patient, family and carers in a professional manner
• Communication with the multidisciplinary team providing ongoing care
• Patient preparation
• Impression materials, technique and considerations
• Health and safety and infection control

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

What does success look like?

• Identify what is expected of you in developing a treatment plan and assisting with a facial impression procedure for a craniofacial deformity patient. Consider how the learning outcomes apply, including formulating treatment plans and using appropriate impression materials.
• Discuss with your training officer to gain clarity on the detail and justification required for the treatment plan, and your role during the impression procedure.

What is your prior experience of this activity?

• Think about what you already know about developing treatment plans for complex conditions or assisting with impression procedures.
• Consider possible challenges you might face in creating a comprehensive plan for a unique deformity or during the impression process, and think about how you might handle them.
• Recognise the scope of your own practice for treatment planning and impression assistance and know when you will need to seek advice or help and from whom.
• Acknowledge how you feel about undertaking this activity that combines planning and practical assistance.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop in critical thinking for treatment planning, material handling for impressions, or patient management during procedures, drawing upon previous observations or theoretical knowledge.
• Identify the materials you are likely to use and how they fit with the medical devices regulations.
• Identify the specific insights you hope to gain about the interplay between diagnosis, treatment planning, and practical steps like impression taking in craniofacial prosthetic rehabilitation.

What additional considerations do you need to make?

• Consult actions identified following previous experience with planning sessions or observations of impression procedures that could improve your approach.
• Identify important information you need to consider before embarking on the activity, such as the patient’s specific deformity, medical history, psychological state, and available impression techniques.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate while developing the treatment plan or assisting with the facial impression procedure?
• Are you encountering situations such as:
  • Impression material issues (e.g., setting too fast or too slow, or failing to capture critical detail)?
  • Patient distress (e.g., severe claustrophobia, gag reflex, or discomfort) during the procedure?
  • Unforeseen anatomical challenges (e.g., undercuts or fragile skin tissue) that complicate the safe removal of the impression?
• How is this particular impression procedure comparing to others you’ve assisted with?

How are you reacting to the unexpected development?

• How is this impacting your actions? Did you react and adapt your actions during the facial impression procedure when facing an unexpected development?
• Consider the steps you are taking in the moment, such as:
  • Immediately stopping the procedure or removing the impression material safely due to patient distress or airway concern?
  • Modifying the material mix or tray placement instantly based on immediate observation of material performance?
  • Seeking immediate advice on managing patient anxiety or ensuring airway safety during complex impressions?
• How are you feeling in this moment? Is the unexpected event affecting your ability to assist effectively and ensuring a good impression is taken?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice (e.g., prioritising patient safety and comfort over obtaining the perfect impression initially).
• What are you learning as a result of the unexpected development? For example, are you gaining crucial learning about managing real-time challenges during a facial impression for a craniofacial deformity, such as improving your speed and technique for patient comfort?

On action

What happened?

• Begin by summarising the key points of developing the treatment plan for the patient’s craniofacial deformity and your involvement in assisting with the facial impression procedure.
• Consider specific events, actions, or interactions which felt important, including your own feelings during the experience. E.g., Determining the optimal prosthetic retention mechanism during the planning stage; reacting quickly to impression material setting too rapidly/slowly; or comforting a patient experiencing claustrophobia during the impression procedure.
• Include any ‘reflect-in-action’ moments where you adapted to the situation e.g., adjusting the impression material mix or patient positioning, as it unfolded.

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding treatment planning and impression procedures.
• What strengths did you demonstrate in applying principles of treatment planning, problem-solving, or assisting with a precise clinical procedure? What skills and/or knowledge gaps were evident in linking the deformity to the treatment plan or in managing the impression process?
• Compare this experience against previous instances of treatment planning or assisting with impressions. Were any previous identified actions for development achieved? Has your practice improved in these areas?
• Identify any challenges you experienced e.g., complexities in treatment planning, patient anxiety during the impression, achieving an accurate impression, and how you reacted to these. Did this affect your ability to deal with the situation? Were you able to overcome the challenges?
• Identify anything significant about the activity. Did you need to seek advice or clarification on aspects of the treatment plan or the impression procedure? Did you need to escalate to ensure you were working within your scope of practice?
• Acknowledge any changes in your own feelings now that you are looking back on the experience

What will you take from this experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learned, including from any feedback you received.
• What will you do differently next time you develop a treatment plan or assist with an impression? Has anything changed in terms of your understanding of comprehensive patient care or procedural technique?
• Do you need to practise any aspect of this activity further? E.g., Practising safe and effective handling of impression materials to minimise patient anxiety, or developing comprehensive treatment narratives that systematically link clinical findings, prosthetic design, and long-term prognosis.

Beyond action

Have you revisited the experiences?

• Review your previous reflections on developing treatment plans and assisting with facial impressions. What improvements did you identify for plan formulation, material selection for impressions, or assisting effectively? Have these actions been completed, and are you ready to demonstrate this improved practice?
• Engage in professional storytelling with your training officer or assessor about cases where you developed a treatment plan or assisted with an impression procedure. Did discussing the situation from different angles provide new insights or validate your approach?

How have these experiences impacted upon current practice?

• How does this learning contribute to your readiness for observed assessments?
• How has your ability to formulate treatment plans, select appropriate materials, and work within a multidisciplinary team improved through these activities?

Relevant learning outcomes

#	Outcome
# 1	Outcome Deliver quality patient centred care with the best interests of patients in all elements of practice.
# 2	Outcome Practice in accordance with local and national health and safety policies, regulatory requirements and overall service governance.
# 3	Outcome Communicate effectively with patients, relatives, healthcare professionals and other stakeholders.
# 5	Outcome Practice in partnership with other clinical specialisms as part of a multidisciplinary team and understand their roles and their impact on patient care and pathway.
# 6	Outcome Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard.
# 7	Outcome Analyse and interpret patient investigations, multimodal imaging and information.
# 8	Outcome Select appropriate biomedical materials and components used in the treatment of patients and the manufacture of custom-made medical devices.
# 9	Outcome Assess and interpret patients’ needs to provide customised treatment dependent on medical, physical, social and psychological requirements.