Craniofacial and Trauma Rehabilitation —
Training activity: 18

Details

Undertake a surgical plan for craniofacial osseointegrated implants. Discuss the plan with the patient and consultant surgeon as part of the consent process for the planned procedure.

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

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 are the intended outcomes of the training activity?

• How will you define a successful treatment plan that integrates the patient’s medical, physical, social, and psychological requirements?
• In what ways will your approach to the facial impression procedure ensure you deliver quality patient-centred care that keeps the best interests of the patient at the forefront of practice?
• How will you ensure that the planned clinical investigations and subsequent medical device manufacture meet safe clinical standards while adhering to your department’s Quality Management System (QMS)?
• What specific regulatory requirements and national health and safety policies must you consider to ensure this procedure is conducted within the bounds of overall service governance?
• How will you measure the effectiveness of your communication strategy with the patient and their relatives during the initial assessment and impression phase?

What do you anticipate you will learn from the experience?

• What specific insights do you hope to gain regarding the selection of biomedical materials and components specifically suited for capturing the anatomy of a congenital deformity?
• How do you expect this experience to improve your ability to analyse and interpret multimodal imaging (such as CT or 3D surface data) when formulating a prosthetic rehabilitation plan?
• What do you anticipate learning about the dynamics of multidisciplinary team (MDT) partnership, and how do the roles of other clinical specialisms impact this specific patient’s care pathway?
• Based on what you already know about facial rehabilitation, what new technical or clinical challenges do you expect to face during the impression procedure?
• How do you hope to develop your understanding of the psychological factors associated with altered body image in patients with congenital conditions?

What actions will you take in preparation for the experience?

• Have you discussed the specific anatomical landmarks and potential impression difficulties of this case with your Training Officer to gain clarity on the intended approach?
• What actions will you take to ensure you are working within your scope of practice, and have you identified which senior colleagues to consult if the complexity of the deformity exceeds your current training level?
• How have you prepared to manage potential patient anxieties or physical difficulties (such as claustrophobia) during the impression-taking process?
• How do you feel about embarking on this activity, and what steps have you taken to ensure your technical preparation matches the clinical requirements of a complex craniofacial reconstruction?
• Have you reviewed the relevant pre-surgical plans or patient history to ensure your proposed treatment plan is evidence-based and holistic?

In action

What are you doing?

• How are you approaching the analysis and interpretation of multimodal imaging and patient investigations as you formulate the treatment plan?
• What decisions are you making as the clinical assessment progresses regarding the selection of appropriate biomedical materials and components for the facial impression?
• In what ways are you ensuring that your actions in the clinic align with the principles of your Quality Management System (QMS) and overall service governance?
• Which aspects of performing the clinical investigations feel intuitive to you, and which parts require more conscious effort to ensure the device is planned to a safe clinical standard?

How are you progressing with the activity?

• How effective are your current actions in communicating complex information to the patient and their relatives during the impression procedure?
• What technical or clinical challenges are you facing when trying to capture the unique anatomical features of the congenital deformity?
• What are you learning about the patient’s medical, physical, and psychological requirements as the situation in the clinical environment unfolds?
• How does this activity connect to your existing knowledge and skills in delivering patient-centred care for less complex or non-congenital cases?
• Are you successfully practising in partnership with other clinical specialisms (i.e. Restorative dentist) within the multidisciplinary team (MDT) to ensure a holistic approach to the patient’s care pathway?

How are you adapting to the situation?

• Are there alternative impression techniques or materials you should consider in the moment if the patient exhibits distress or if the material does not perform as expected?
• What immediate support or guidance do you need from a senior colleague or the Consultant to ensure the treatment plan remains in the best interests of the patient?
• How are you ensuring that your involvement in the clinical procedure remains strictly within your scope of practice as a trainee?
• How are you adapting your communication style or the physical environment to better assess and interpret the patient’s social and psychological needs during the procedure?
• Are you maintaining adherence to local and national health and safety policies even when you have to adjust your actions to handle unexpected patient reactions?

On action

What did you notice?

• How would you summarise the key stages of this activity, from the initial analysis of patient investigations and multimodal imaging to the finalisation of the treatment plan and the execution of the facial impression?
• What were the most significant clinical features of the congenital deformity that you identified during the examination, and how did these findings dictate the complexity of the proposed treatment plan?
• What did you observe regarding the patient’s psychological or emotional state during the impression procedure, and how did this influence your bedside manner and communication style?
• Can you identify specific moments where your reflection-in-action—such as adjusting your approach to the impression material or modifying your communication to ease patient anxiety—directly impacted the success of the procedure?
• How did the multidisciplinary team (MDT) interact during this session, and what were the key takeaways regarding their various roles in the patient’s care pathway?

What did you learn from the activity?

• What specific knowledge have you gained regarding the selection and clinical performance of biomedical materials used for facial impressions, particularly in the context of fragile or unique congenital anatomy?
• How has this experience improved your ability to formulate a patient-centred treatment plan that balances technical requirements with the patient’s best interests and best clinical practice?
• In what ways did you apply the principles of a quality management system (QMS) to ensure the medical device was planned and the impression was recorded to a safe and reproducible clinical standard?
• What did you learn about the regulatory and health and safety requirements involved in clinical investigations and the subsequent handling of patient-contact materials?
• How does this experience relate to your future responsibilities as a Clinical Scientist, specifically in managing complex cases where both clinical and laboratory skills must be integrated?

What will you take from the experience moving forward?

• What areas for continued development have you identified, such as a need for further training in interpreting complex 3D surface data or refining your technique for managing patient claustrophobia during impressions?
• How will you apply the learning from this activity to your routine practice, particularly in how you document clinical investigations or communicate treatment risks and benefits to patients and relatives?
• What immediate steps will you take to support the assimilation of this learning, such as discussing the case outcome with your Training Officer or reviewing the finalised prosthetic design against the initial treatment goals?
• What resources or support—such as further academic study on the psychosocial disorders associated with congenital deformities or technical guidance on advanced impression materials—would be beneficial for your future development?
• How has this activity influenced your perspective on the legal and ethical requirements of patient consent and professional practice in reconstructive science?

Beyond action

Have you revisited the experiences?

• How has your understanding of the formulation of treatment plans for complex congenital/oncology cases changed since you initially reflected on this activity?
• When comparing this experience with previous Observed Training Activities (OTAs)—what observable clinical behaviours have you successfully assimilated into your routine practice?
• Have you engaged in professional storytelling with colleagues regarding the unique challenges of taking an impression of a congenital facial defect, and how did their perspectives transform your view?
• As part of a module review, have you re-evaluated how your initial plan addressed the psychological and social requirements of the patient compared to their long-term clinical outcome?
• How has revisiting this experience helped you better understand the link between multimodal imaging analysis and the physical reality of the patient’s anatomy during the impression procedure?

How have these experiences impacted upon your current practice?

• How has the learning from this task helped you prepare for your in-person assessments?
• In what ways are you now more effective at communicating treatment options and risks to patients and relatives, ensuring you deliver quality patient-centred care?
• How have you applied the knowledge of biomedical material properties gained during this activity to your current selection of materials for other types of custom-made medical devices?
• How has your routine practice in the laboratory or clinic evolved to more consistently reflect the principles of your department’s Quality Management System (QMS) and service governance?
• Can you identify how the experience of working within the Multidisciplinary Team (MDT) for this case has influenced your ability to coordinate complex care pathways for your current patients?

How might these experiences contribute towards your future practice?

• What transferable skills—such as the synthesis of clinical data or managing patient anxiety—have you developed through this activity that will be essential for your future role as a Clinical Scientist?
• How will your developed understanding of the psychosocial disorders associated with congenital facial deformities inform your long-term approach to patient rehabilitation?
• What clear actions for continued development have you identified, such as pursuing advanced training in CAD/CAM planning for complex reconstructions or mastering new emerging materials?
• How has this activity served as a building block in shaping your professional identity, specifically in maintaining safe clinical standards while managing high-complexity cases?
• In what ways will your experience with informed consent and clinical investigations for congenital deformities contribute to your future leadership in ethical and legal aspects of reconstructive science?

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.
# 4	Outcome Apply the principals of a quality management system to their professional practice.
# 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.