Craniofacial and Trauma Rehabilitation —
Training activity: 2

Details

Plan, design and manufacture a range of devices to support treatment of mandibular fractures

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 for planning, designing, and manufacturing a range of devices for mandibular fractures. Reflect on how the learning outcomes guide your approach, including collaborating with multidisciplinary teams and analysing patient information.
• Discuss with your training officer to clarify expectations for the versatility and effectiveness of the devices across different fracture types.

What is your prior experience of this activity?

• Think about what you already know concerning the complexities of mandibular fractures and the design/manufacture of associated medical devices.
• Consider possible challenges you might face with the variety and specific requirements of devices for mandibular fractures, and think about how you might handle them.
• Recognise the scope of your own practice for this range of activities, and know when you will need to seek advice or help and from whom.
• Acknowledge how you feel about undertaking this more complex training activity.

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop in adapting device design for various mandibular fracture types, drawing upon previous experiences with simpler devices.
• Identify the specific insights you hope to gain regarding the challenges and best practices in treating different types of mandibular fractures with custom devices.

What additional considerations do you need to make?

• Consult actions identified following previous experience with dentoalveolar or other fracture devices that might inform your approach for mandibular fractures.
• Identify important information you need to consider before embarking on the activity, such as the full range of mandibular fracture presentations or advanced manufacturing techniques.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate while planning, designing, or manufacturing the range of devices for mandibular fractures?
• Are you encountering situations such as:
  • A specific device geometry complexity requiring manufacturing steps beyond the routine expectation?
  • Difficulty integrating multiple components into a coherent and stable final device?
  • An objective quality check failing unexpectedly during the production phase?
• How is this experience comparing to previous engagements with similar device manufacturing?

How are you reacting to the unexpected development?

• How is this impacting your actions? Are you adapting or changing your approach to the procedure?
• Consider the steps you are taking in the moment, such as:
  • Immediately consulting Standard Operating Procedures (SOPs) for complex device assembly or quality control checks?
  • Changing the manufacturing sequence or tool selection on the fly due to component fit issues?
  • Seeking senior advice on managing variations in device design and ensuring structural integrity for a mandibular fracture device?
• How are you feeling in this moment? Did the unexpected challenge affect your confidence in managing the different device types?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice (e.g., identifying when a manufacturing issue required specialist technical support beyond your immediate repair capability).
• What are you learning as a result of the unexpected development? For example, are you gaining critical learning about managing variations in device design or improving efficiency in documenting mid-manufacture design changes?

On action

What happened?

• Begin by summarising the key steps you took to plan, design, and manufacture a range of devices to support treatment of mandibular fractures
• Consider specific events, actions, or interactions that felt important during the planning, design, or manufacture, such as setting up specific equipment, ensuring material safety, or managing unexpected interruptions. E.g., Calibrating a complex milling machine for accurate mandibular arch curvature; dealing with material failure during plate bending; or managing unexpected communication regarding fracture reduction tolerances.
• How did you feel during this experience?
• Include any ‘reflect-in-action’ moments, where you had to adapt to the situation as it unfolded, for instance, adjusting the design due to a material limitation or troubleshooting a minor issue during manufacturing.

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding planning, designing, and manufacturing devices to support the treatment of mandibular fractures
• What strengths did you demonstrate e.g., efficiency in design, technical precision in manufacturing, adherence to standards? What skills and/or knowledge gaps were evident e.g., unfamiliarity with specific material properties, optimal planning workflow for mandibular fractures?
• Compare this experience against previous engagements with similar activities. Were any previously identified actions for development achieved? Has your practice improved in creating mandibular devices?
• Identify any challenges you experienced during the activity e.g., achieving necessary precision, material curing issues, time constraints 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 this activity, such as needing to seek advice or clarification on material selection or design constraints.
• 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 regarding the device planning and manufacture.
• What will you do differently next time you plan, design, or manufacture a range of devices to support treatment of mandibular fractures?
• Has anything changed in terms of what you would do if you were faced with a similar situation again?
• Do you need to practise any aspect of this activity further? E.g., Practising CAD/CAM simulation for complex mandibular fracture alignment, or troubleshooting manufacturing issues unique to larger, load-bearing mandibular devices, or reviewing biomechanical standards for mandibular fixation.

Beyond action

Have you revisited the experiences?

• Have you reviewed your past reflections on planning, designing, and manufacturing devices for mandibular fractures? What specific actions did you identify for improvement, for example, regarding material selection or design principles? Have you completed these actions, and are you now prepared to apply this new learning?
• Discuss with mentors or peers the complexities of different mandibular fracture cases and how your device solutions evolved. Did their insights provide a new understanding of past challenges?

How have these experiences impacted upon current practice?

• Considering the various devices you’ve planned and manufactured, how will this accumulated learning contribute to your performance in assessments, especially those involving device design and patient care?
• How has your ability to assess and interpret patient needs for mandibular fracture devices, and your knowledge of appropriate biomedical materials, grown over time?

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.