Prosthetic Reconstruction, Rehabilitation & Surgical Planning —
Training activity: 2

Details

Undertake pre-surgical planning on a 3D printed model for a simple orbital floor repair. Plan design and manufacture a custom implant using either stock plate adaption or a custom design and evaluate against treatment goals

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

• How will using a 3D printed model aid in the planning process? What 3D materials are available for use and why selected for use?
• What are the differences between stock plate adaptation and custom design?
• What do you anticipate learning about pre-surgical planning using 3D models?
• What design and manufacturing considerations and techniques are specific to orbital floor implants?
• How will you evaluate the implant against the treatment goals?
• Have you reviewed the principles of orbital floor repair and relevant surgical approaches?
• Have you practiced planning on 3D models previously?
• Have you discussed the case and the planning process with the surgical team and your training officer?

In action

• While undertaking the pre-surgical planning on the 3D model and subsequently designing and manufacturing the implant, are you mindful of your actions and the reasons behind your choices? What immediate adjustments are you making to your plan or design based on the model or available materials? Are you relying more on established techniques or exploring new approaches during this process?
• Is the pre-surgical planning providing the necessary information for effective implant design and manufacture? Are you facing any challenges in adapting a stock plate or creating a custom design that meets the treatment goals? What immediate learning points are arising from the practical application of your planning and manufacturing skills? How does this activity reinforce your understanding of orbital floor repair and implant options?
• If the 3D model reveals unexpected anatomical features or if the initial implant design proves problematic, what alternative strategies are you considering during the planning and manufacturing stages? Do you need to consult with a supervisor for guidance on the best approach? Are you ensuring that your planning and manufacturing remain within established protocols and your skill level?

On action

• Describe the process of undertaking pre-surgical planning on the 3D printed model. What considerations influenced your decision to use stock plate adaption or a custom design? Describe the planning, design, and manufacturing process of the custom implant. How did the manufactured implant compare to the treatment goals and the 3D printed model?
• What specific skills or knowledge did you develop or improve in pre-surgical planning using 3D models and implant design/manufacture? What did you learn about simple orbital floor repair techniques? Were there any unexpected challenges or successes during the process? What did you learn from these? How effective was the evaluation of the implant against the treatment goals?
• What areas for continued development have you identified in pre-surgical planning and orbital implant creation? How can you apply the knowledge and skills gained to future orbital repair cases? What resources or support might you need to further develop in this area?

Beyond action

• Have you revisited experiences involving pre-surgical planning using 3D models and the creation of custom implants? How has your approach to these processes evolved since this training activity?
• How have these experiences impacted upon your current practice in surgical planning and implant design? Have you seen similar principles applied in other areas?
• How might these experiences contribute towards your future practice in more complex orbital or craniofacial reconstruction? What skills in 3D planning and custom device creation did you begin to develop?

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 Analyse and interpret patient investigations, multimodal imaging and information.
# 6	Outcome Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard.
# 7	Outcome Prepare surgical treatment plans for complex head and neck surgery.
# 8	Outcome Select appropriate biomedical materials and components/instrumentation used in the treatment of patients and the manufacture of custom-made medical devices.
# 9	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.
# 10	Outcome Apply the principals of a quality management system to their professional practice.
# 12	Outcome Assess and interpret patients’ needs to provide customised treatment dependent on medical, physical, social and psychological requirements.