Craniofacial and Trauma Rehabilitation —
Training activity: 17

Details

Assist with the fitting of a range of auricular prostheses (adhesive, and implant-based) for patients with congenital deformity. Discuss prosthesis management and provide instruction to the patient, carers, or relative

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?

• Identify what is expected of you in assisting with fitting auricular prostheses and providing effective instruction on their management. Consider how the learning outcomes apply, such as patient-centred care, effective communication, and assessing patient needs.
• Discuss with your training officer and the senior clinician to gain clarity on your contribution to the fitting process and your communication with patients/carers.

What is your prior experience of this activity?

• Think about what you already know about auricular anatomy, different types of prostheses (adhesive vs. implant-based), or patient education.
• Consider possible challenges you might face during fitting or instruction, such as delicate anatomy or emotional sensitivity, and think about how you might handle them.
• Recognise the scope of your own practice for assisting with prosthetic fittings and patient education and know when you will need to seek advice or help and from whom.
• Acknowledge how you feel about undertaking this training activity involving both technical assistance and significant patient/carer interaction.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop in precise fitting techniques, adapting communication for patients/carers, and understanding long-term management of auricular prostheses.
• Identify the specific insights you hope to gain about the functional and psychological impact of auricular prostheses and the importance of thorough instruction for their care.

What additional considerations do you need to make?

• Consult actions identified following previous experience with prosthetic fittings or patient education sessions that could improve your approach.
• Identify important information you need to consider before assisting, such as the patient’s specific congenital deformity, lifestyle, and the type of prosthesis being fitted.
• Consider what an bacterial / fungal infection around a implant might look like and how this might be managed.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate during the fitting of the auricular prosthesis or the discussion of prosthesis management and instruction?
• Are you encountering situations such as:
  • Difficulty achieving adequate retention with the adhesive due to skin texture, contour, or moisture?
  • Pain or discomfort reported at the implant site during the initial fitting or connection?
  • The patient/carer expressing complex concerns about long-term maintenance, cleaning, or infection risk that you were not prepared to address?
  • The patient/carer struggling significantly with the manipulation of the adhesive or the implant-retained connection?
• Is the fitting process for this specific type of prosthesis differing from previous experiences?

How are you reacting to the unexpected development?

• How is this impacting your actions? Are you adapting your actions or communication in the moment as an unexpected development arises during the fitting or instruction phase?
• Consider the steps you are taking in the moment, such as:
  • Immediately pausing the fitting to check the implant connection or re-apply the adhesive?
  • Switching the instruction focus from the patient to the carer (or vice versa) based on observed difficulty?
  • Demonstrating a hands-on cleaning technique immediately after the question arose?
• How are you feeling in this moment? Are you finding it difficult to adjust your approach to ensure clear understanding and comfort for the patient/carer?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice (e.g., recognising when complications at the implant site requires urgent surgical / nursing advice rather than prosthetic adjustment).
• What are you learning as a result of the unexpected development? For example, are you gaining immediate learning about managing patient/carer anxiety regarding implant care, or realising the necessity of tailoring instructions specifically for the maintenance of an auricular prosthesis?

On action

What happened?

• Begin by summarising the key points of assisting with the fitting of the auricular prostheses, including the distinction between adhesive and implant-based types, and your role in discussing management and providing instructions.
• Consider specific events, actions, or interactions which felt important, including your own feelings during the experience. E.g., Demonstrating correct adhesive application technique to a carer; checking the passive fit and alignment of an implant-retained prosthesis; or clearly explaining the signs of local infection around an abutment.
• Include any ‘reflect-in-action’ moments where you adapted to the situation, e.g., modifying your explanation based on patient comprehension, adjusting fitting technique, as it unfolded.

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding fitting and instruction for auricular prostheses.
• What strengths did you demonstrate in your technical assistance during fitting, your ability to explain complex information clearly, or your empathy for patients with congenital deformities?
• What skills and/or knowledge gaps were evident in understanding the biomechanics of retention, aftercare protocols, or handling patient/carer questions?
• Compare this experience against previous patient education or assistance roles. Were any previous identified actions for development achieved? Has your practice improved in patient instruction and hands-on fitting assistance for various prosthesis types?
• Identify any challenges you experienced (e.g., patient dexterity issues with adhesive, explaining implant care, managing emotional responses) 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 specific fitting nuances or complex management instructions? Did you need to escalate to ensure patient understanding and safety within your scope of practice?
• Acknowledge any changes in your own feelings now that you are looking back on the experience, especially regarding patient interaction and empowering individuals with prosthesis management.

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 assist with fittings or provide patient instruction? Has anything changed in terms of your communication strategy or understanding of patient needs for long-term prosthesis care?
• Do you need to practise any aspect of this activity further, such as demonstrating care procedures or addressing common troubleshooting scenarios? E.g., Practising demonstrating complex care procedures for implant abutment hygiene, or developing scripted responses for common troubleshooting scenarios related to adhesive retention, or reviewing material selection for different retention methods?

Beyond action

Have you revisited the experiences?

• Reflect on past experiences assisting with fitting auricular prostheses and providing instructions. What actions did you identify to improve your assistance, communication, or ability to explain prosthesis management? Have these actions been completed, and are you ready to apply this new learning?
• Engage in professional storytelling with peers about patient interactions during prosthesis fitting or instruction. Has discussing different communication approaches or patient scenarios transformed your understanding of effective patient support?

How have these experiences impacted upon current practice?

• How will your learning from assisting with fittings and providing instruction support your preparation for observed assessments?
• How has your practice in communicating effectively with patients and carers, and your ability to assess and interpret patients’ needs, developed over time 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.
# 6	Outcome Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard.
# 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.