Craniofacial and Trauma Rehabilitation —
Training activity: 14

Details

Develop a treatment plan for a patient with a congenital deformity requiring prosthetic facial rehabilitation and assist with the 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.

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?

• How will you define a successful outcome for developing a comprehensive treatment plan and assisting with a facial impression procedure specifically for a patient with a congenital deformity?
• In what ways will you ensure the treatment plan prioritises quality patient-centred care and the patient’s best interests?
• How will you demonstrate that your plan and the selected impression materials meet a safe clinical standard and comply with local and national health and safety policies?
• What level of detail and justification for the plan has your Training Officer identified as necessary to meet the requirements of this task?

What is your prior experience of this activity?

• What is your existing knowledge regarding developing treatment plans for complex congenital conditions and your technical proficiency in assisting with facial impression procedures?
• What challenges do you anticipate—such as unique anatomical variations, fragile skin tissue, or managing patient distress like claustrophobia —and how do you plan to handle them?
• How will you recognise the boundaries of your scope of practice for this activity, and from whom will you seek advice if a patient’s medical history or the complexity of the deformity requires senior intervention?
• How do you feel about embarking on a task that combines high-level clinical investigations and planning with direct, hands-on practical assistance?

What do you anticipate you will learn from the experience?

• What specific skills in critical thinking for treatment planning or material handling for impressions do you hope to refine, drawing upon your previous observations?
• What insights do you hope to gain about the interplay between diagnosis, multimodal imaging interpretation, and the practical steps of prosthetic rehabilitation?
• How do you anticipate this experience will improve your ability to assess and interpret a patient’s medical, physical, social, and psychological requirements?

What additional considerations do you need to make?

• Have you consulted the actions identified from previous experiences with planning sessions or impression procedures to ensure continuous improvement in your approach?
• What important patient-specific information do you need to consider before starting, such as the patient’s pathology, psychosocial history, and the most appropriate available impression techniques?
• How will you coordinate with other clinical specialisms within the MDT to ensure your treatment plan aligns with the broader patient care pathway?

In action

During the activity is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipated while analysing patient investigations or interpreting multimodal imaging to develop the treatment plan?
• During the facial impression procedure, are you encountering unexpected material issues, such as the impression setting too fast or failing to capture critical anatomical detail?
• Is the patient exhibiting unanticipated distress, such as severe claustrophobia, a gag reflex, or physical discomfort during the procedure?
• Have any unforeseen anatomical challenges, such as significant undercuts or fragile skin tissue, emerged that might complicate the safe removal of the impression material?
• How does the complexity of this specific congenital deformity compare with previous impressions you have assisted with?

How are you reacting to the unexpected development?

• How is the unexpected event impacting your actions? For instance, did you need to immediately modify the material mix or tray placement based on the immediate performance of the impression material?
• Did you react promptly to ensure patient safety and airway security by stopping the procedure or removing material in response to patient distress?
• How are you adapting your communication in the moment to comfort the patient or manage their anxiety during the clinical investigation?
• Are you seeking immediate advice from your Training Officer or MDT colleagues regarding the management of patient distress or technical planning difficulties?
• How is this development affecting your confidence in assisting with the procedure or your ability to undertake specific planning tasks independently?

What is the conclusion or outcome?

• How did you ensure you were working within your scope of practice, such as prioritising the patient’s immediate physical and psychological well-being over obtaining the impression?
• What vital learning are you acquiring about managing real-time challenges during a clinical procedure for a patient with a congenital deformity?
• As a result of this development, have you gained insight into improving your speed, technique, or patient management for future prosthetic facial rehabilitation cases?
• How will the outcome of this unexpected event be used to further refine the treatment plan and ensure it meets a safe clinical standard?

On action

What happened?

• How would you summarise the key stages of developing the treatment plan and your specific role in the facial impression procedure?
• What specific interactions or clinical investigations felt most significant—for example, how did you interpret multimodal imaging to define the prosthetic retention mechanism?
• How did you manage your own feelings when addressing the psychological impact of the congenital deformity on the patient during the assessment?
• Can you describe any ‘reflect-in-action’ moments where you had to adapt, such as modifying the biomedical material mix or adjusting the patient’s position to manage claustrophobia or distress?

How has this experience contributed to your developing practice?

• What specific learning have you gained regarding the formulation of treatment plans for complex congenital cases as opposed to acquired trauma?
• What strengths did you demonstrate in communicating effectively with the patient or working in partnership with the MDT, and what knowledge gaps were identified regarding regulatory requirements or service governance?
• When comparing this to previous engagements with simpler devices, in what ways has your practice improved in linking clinical findings to prosthetic design?
• What challenges did you experience during the impression—such as managing undercuts or fragile tissue—and how did your reaction influence your ability to maintain a safe clinical standard?
• Did you need to seek advice or escalation to ensure you were working within your scope of practice, particularly regarding the patient’s medical history or psychological requirements?
• How have your feelings changed now that you are looking back on the clinical outcome compared to how you felt before starting the task?

What will you take from the experience moving forward?

• What specific ‘next steps’ will you take to support the assimilation of this learning, such as refining your material handling techniques to minimise patient anxiety?
• What would you do differently next time to better integrate the patient’s physical, social, and psychological needs into the initial treatment plan?
• How will the feedback you received from the MDT or your Training Officer change your approach to documenting clinical investigations for congenital deformities?
• Which aspects of this activity do you need to practise further, such as developing treatment narratives that systematically link imaging analysis to long-term prosthetic prognosis?

Beyond action

Have you revisited the experiences?

• How have you reviewed your previous reflections regarding the formulation of treatment plans and the selection of materials for facial impressions to identify and action points for improvement?
• Are you now prepared to demonstrate this new learning in practice, specifically in how you link clinical investigations and multimodal imaging to the design of a prosthetic retention mechanism?
• In what ways has engaging in professional storytelling with your Training Officer or peers provided you with new insights or validated your approach to managing the unique anatomical challenges of congenital deformities?
• When revisiting your past reflections, have you noticed a transformation in your understanding of how to balance technical material handling with the psychological requirements of a patient undergoing rehabilitation?

How have these experiences impacted upon current practice?

• How has the cumulative learning from these planning and impression tasks supported your preparation for observed ‘in-person’ assessments, such as the Observed Clinical Event (OCE) where you must assess a patient for a facial prosthesis or discuss treatment options?
• How has your practice evolved in terms of multidisciplinary team (MDT) collaboration, particularly in understanding how your treatment plan impacts the broader care pathway for patients with congenital conditions?
• In what ways has your ability to recognise the boundaries of your scope of practice improved, specifically regarding when to seek senior advice for complex medical histories or severe patient distress?
• How effectively are you now integrating patient-centred care into your routine practice, ensuring that every element of the treatment plan prioritises the patient’s physical, social, and psychological requirements?
• To what extent has your technical proficiency in selecting biomedical materials and interpreting multimodal imaging matured, allowing you to formulate plans that meet a safe clinical standard more independently?
• Can you identify specific examples where these training experiences have shaped your development into a Clinical Scientist who can consistently deliver high-quality prosthetic facial rehabilitation?

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.