Module - Prosthetic Rehabilitation for Head and Neck Cancer and Soft Tissue Injuries (SPE421)

STP

Aim of this module

To create a reconstructive scientist capable of undertaking independent practice in the area of head and neck cancer, applying their knowledge of reconstructive science in patient evaluation, manufacturing and the review of outcomes. This module will enable trainees to perform a range of treatments, interact with patients, and demonstrate safe, patient-centred practice. Trainees will be expected to build on the competence gained during rotational training developing technical expertise in planning, interpreting and communicating the design and manufacture of dental and medical devices and surgical plans. They will consolidate skills in explaining procedures to patients and gaining informed consent, enhancing and extending practical skills in undertaking maxillofacial prosthetics, and it will give  the trainee the tools to undertake case-based learning in the workplace.

Work-based learning outcomes


  1. Observe informed consent and assist in planning the treatment of the patient who has experienced maxillofacial trauma in accordance with local/professional guidelines, adapting techniques as necessary to reflect possible outcomes and influencing factors.
  2. Observe informed consent and assist in clinical assessment of a patient who has a craniofacial deformity in accordance with local/professional guidelines, adapting techniques as necessary to reflect possible outcomes and influencing factors.
  3. Record a comprehensive and contemporaneous patient history, recognising the significance of changes in the patient’s reported health status and taking appropriate action.
  4. Write a treatment plan for patients who have experienced maxillofacial trauma or have a craniofacial deformities in partnership with the patient, supporting the patient to manage their fear and anxiety, and referring to other support services for advice or alternative/adjunct treatment where appropriate.
  5. Discuss and agree treatment plans for a range of patients referred to the unit with maxillofacial trauma or craniofacial deformities with clinical colleagues, the patient and, if appropriate, relatives or carers.
  6. Plan, design, manufacture and evaluate dental devices for patients with fractures involving the mandible, maxilla and middle third of the facial skeleton.
  7. Discuss treatment options, design, plan, manufacture, fit and evaluate a range of auricular (ear) prostheses for patients with congenital absence of pinna (external part of the ear) prosthesis with the patient, their carers or relatives, and colleagues as appropriate.
  8. Discuss treatment options and plans with patients, their carers or relatives, and colleagues for bimaxillary orthognathic (jaw) surgery and generate a pre- surgical plan.
  9. Manipulate, analyse and interpret 3D digital imaging data of the head and neck, for patients requiring orthognathic surgery.
  10. Manufacture medical implants for patients requiring surgical repair.
  11. Assist in the routine maintenance, calibration and quality assurance procedures on the equipment used to plan and make medical devices.

Work-based Competencies


Learning outcome Title Knowledge
1 1, 3, 7

Explain the procedure for the provision of treatment/a prosthesis to the patient, address any procedure-related questions they may have and provide information on how to manage their prosthesis.

  • The importance of explaining the procedures to the patient.
  • Common questions and concerns of patients about procedures.
  • Risks and benefits of a prosthesis.
  • The information needs of patients following investigation.
  • The authority level and professional boundary for the provision of information to the patient.
  • The range of treatment pathways and their relevance/applicability to the patient.
  • Factors affecting selection of treatment option.
  • Local patient compliments and complaints procedure.
2 1, 3, 7

Gain informed consent and plan the clinical examination of the patient in accordance with local/professional guidelines, adapting techniques as necessary to reflect possible outcomes and influencing

  • The importance of introducing yourself to the patient, including your role and experience as a Clinical Scientist.
  • The importance of checking patient identity.
  • The importance of explaining the procedure for each investigation to the patient and gaining informed consent.
  • Clinical indications for and contraindications to each investigation.
  • Principles, guidance and law with respect to informed consent.
3 1, 3, 7

Treat patients in a way that respects their dignity, rights, privacy and confidentiality, and explain treatment options for patients requiring facial prostheses.

  • The rights of the patient with regard to consent for treatment and confidentiality of consultation and medical records.
  • Requirements of patients with disabilities and special needs.
  • Key factors influencing dignity, rights, privacy and confidentiality, including age, gender, culture and beliefs.
  • When to refer to another healthcare professional.
4 1, 3, 7

Minimise risks and hazards in compliance with health and safety policies performing effective cross contamination control and infection prevention.

  • Protocols and requirements for hygiene and infection control related to the relevant range of investigations, including preparation, conduct and completion of investigation.
  • Protocol for hand washing and how effective hand washing contributes to control of infection.
5 1

Record a comprehensive and contemporaneous patient history, recognising the significance of changes in the patient’s reported health status and taking appropriate action.

  • Clinical history-taking frameworks.
  • Patient-centred history taking, including how to build up a picture of the patient’s problems from their perspective of their physical complaints, the impact of these complaints on their lives and any psychosocial issues that are also active.
  • The importance of an accurate and complete patient history and the potential implications of missing or incorrect information.
  • Factors relevant to the range of investigations to be undertaken.
  • How to validate information provided.
  • How to communicate with patients in ways that facilitate cooperation and an understanding of requirements, including patients with special needs.
  • Investigations and management of swellings in the head and neck.
  • Tumour, Node Metastases (TNM) tumour staging system.
  • Role of MDT planning meetings for head and neck cancer.
  • Principles of treatment for stage 1 and 2 maxillary tumours.
  • Effects of irradiation damage of tissues.
  • Common surgical procedures for stage 1 and 2 maxillary tumours.
  • Interpretation of prescriptions for medical devices.
  • Where, how and when to seek advice and information from colleagues and relevant agencies.
6 2

Plan the treatment for (and with) patients with head and neck cancer, providing appropriate advice and support and referring patients for advice or alternative/adjunct treatment

  • Normal and altered anatomy of the hard and soft tissue of the head and neck.
  • Patient-centred communication skills.
  • Referral pathways.
  • How to support and advise patients, helping them to manage their fear and anxiety and referring to other support services as necessary.
  • Treatment planning for head and neck cancer.
  • Treatment planning for soft tissue injuries.
  • Structure for writing treatment plans.
  • Consequences of altered anatomy on patients’ quality of life using standard QOL measures.
7 2

Plan the treatment for (and with) patients with soft tissue injuries, providing appropriate advice and support and referring patients for advice or treatment where appropriate.

  • Normal and altered anatomy of the hard and soft tissue of the head and neck.
  • Patient-centred communication skills.
  • Referral pathways.
  • How to support and advise patients, helping them to manage their fear and anxiety and referring to other support services as necessary.
  • Treatment planning for head and neck cancer.
  • Treatment planning for soft tissue injuries.
  • Structure for writing treatment plans.
  • Consequences of altered anatomy on patients’ quality of life using standard QOL measures.
8 2

Discuss and agree treatment plans for a range of patients with head and neck cancer with clinical colleagues and the

  • Normal and altered anatomy of the hard and soft tissue of the head and neck.
  • Patient-centred communication skills.
  • Referral pathways.
  • How to support and advise patients, helping them to manage their fear and anxiety and referring to other support services as necessary.
  • Treatment planning for head and neck cancer.
  • Treatment planning for soft tissue injuries.
  • Structure for writing treatment plans.
  • Consequences of altered anatomy on patients’ quality of life using standard QOL measures.
9 2

Explain the procedure for the provision of a prosthesis to the patient, address any procedure- related questions they may have and provide information on how to manage their prosthesis.

  • The importance of explaining the procedures to the patient.
  • Common questions and concerns of patients about procedures.
  • Risks and benefits of a prosthesis.
  • The information needs of patients following investigation.
  • The authority level for provision of information to patients.
  • The range of treatment pathways and their relevance/applicability to the patient.
  • Factors affecting selection of treatment option.
10 3

Perform a systematic intra- and extra-oral clinical examination, recognising abnormalities of the oral cavity and discussing any areas of concern with colleagues where appropriate.

  • Professional limitations and the method of referral to the relevant health professional for quick review of abnormal changes.
11 4, 5, 6, 8

Use patient scanning and rapid prototype techniques suitable for the creation of analogues and present case in the required setting.

  • Protocol for scanning in terms of ethical considerations of data collection and storage.
  • Surface 3D scanning equipment to capture the required images for planning.
  • Access and retrieval and transfer of digital patient data.
  • Data processing in a format that can be used to discuss the case in a multidisciplinary setting.
12 4, 5, 6, 8

Manipulate 3D data for pre- operative planning for craniofacial patients.

  • Interpretation of normal and abnormal anatomy and identification of those structures that will be pertinent to the planning and reconstruction phases.
13 4, 5, 6, 8

Convert 3D data to model analogues.

  • Processing of the data set required.
  • Factors effecting choice of rapid prototyping (RP) materials (cost/speed/accessibility).
  • Set up 3D RP machine for manufacture of the model.
14 4, 5, 6, 8

Select and justify treatment plans for the prosthetic reconstruction.

  • Surgical planning phase (laboratory).
  • 3D model analogues usefulness in the patient consent phase for treatment (clinical).
  • Multidisciplinary 3D prototype assessment.
15 4, 5, 6, 8

Select manufacturing techniques and materials requirements for prosthetic reconstruction.

  • Methodology outlined and evidenced.
  • Material selection/justification.
  • COSHH procedures and relations to Medical Device Directives (MDD).
  • Local protocols for manufacture.
16 4, 5, 6, 8

Prepare the patient and take impressions of patients to generate analogues for a range of defects.

  • Local protocols.
  • Safety implications for the patient.
  • Hygiene protocols for patient and staff protection.
  • Communication skills in situations where patients will feel very vulnerable.
  • Theatre protocols.
  • Theatre staff roles and responsibilities.
  • Information required for peri-operative assessment different surgical procedures (CT scans, 3D models, dental casts, etc.).
  • Different surgical procedures relevant to the primary or secondary reconstruction (i.e. skin grafts, bone grafts, tissue expansion, composite flaps and resection).
  • Principles of soft tissue or hard tissue surgery.
  • Principles of tissue transfer and graft support appliances.
  • Design principles and in-service requirements of surgical splints for dentate and edentulous patients.
  • Evaluation of laboratory-constructed surgical splints.
  • Comparative treatments, evaluation of splint appliances.
  • Design principles of appliances used in tissue transfer.
  • Intermediate obturator prostheses.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in immediate devices for oral cancer resection.
17 4

Design, manufacture and evaluate a range of custom made peri- operative devices for the treatment of head and neck cancer.

  • Local protocols.
  • Safety implications for the patient.
  • Hygiene protocols for patient and staff protection.
  • Communication skills in situations where patients will feel very vulnerable.
  • Theatre protocols.
  • Theatre staff roles and responsibilities.
  • Information required for peri-operative assessment different surgical procedures (CT scans, 3D models, dental casts, etc.).
  • Different surgical procedures relevant to the primary or secondary reconstruction (i.e. skin grafts, bone grafts, tissue expansion, composite flaps and resection).
  • Principles of soft tissue or hard tissue surgery.
  • Principles of tissue transfer and graft support appliances.
  • Design principles and in-service requirements of surgical splints for dentate and edentulous patients.
  • Evaluation of laboratory-constructed surgical splints.
  • Comparative treatments, evaluation of splint appliances.
  • Design principles of appliances used in tissue transfer.
  • Intermediate obturator prostheses.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in immediate devices for oral cancer resection.
18 4

Plan and manufacture a surgical dressing plate for an edentulous patient undergoing a hemi- maxillectomy for a maxillary tumour.

  • Local protocols.
  • Safety implications for the patient.
  • Hygiene protocols for patient and staff protection.
  • Communication skills in situations where patients will feel very vulnerable.
  • Theatre protocols.
  • Theatre staff roles and responsibilities.
  • Information required for peri-operative assessment different surgical procedures (CT scans, 3D models, dental casts, etc.).
  • Different surgical procedures relevant to the primary or secondary reconstruction (i.e. skin grafts, bone grafts, tissue expansion, composite flaps and resection).
  • Principles of soft tissue or hard tissue surgery.
  • Principles of tissue transfer and graft support appliances.
  • Design principles and in-service requirements of surgical splints for dentate and edentulous patients.
  • Evaluation of laboratory-constructed surgical splints.
  • Comparative treatments, evaluation of splint appliances.
  • Design principles of appliances used in tissue transfer.
  • Intermediate obturator prostheses.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in immediate devices for oral cancer resection.
19 4

Plan and manufacture a surgical dressing plate for patients for a dentate patient undergoing a partial maxillectomy for a maxillary tumour.

  • Local protocols.
  • Safety implications for the patient.
  • Hygiene protocols for patient and staff protection.
  • Communication skills in situations where patients will feel very vulnerable.
  • Theatre protocols.
  • Theatre staff roles and responsibilities.
  • Information required for peri-operative assessment different surgical procedures (CT scans, 3D models, dental casts, etc.).
  • Different surgical procedures relevant to the primary or secondary reconstruction (i.e. skin grafts, bone grafts, tissue expansion, composite flaps and resection).
  • Principles of soft tissue or hard tissue surgery.
  • Principles of tissue transfer and graft support appliances.
  • Design principles and in-service requirements of surgical splints for dentate and edentulous patients.
  • Evaluation of laboratory-constructed surgical splints.
  • Comparative treatments, evaluation of splint appliances.
  • Design principles of appliances used in tissue transfer.
  • Intermediate obturator prostheses.
  • Dental impression materials, techniques and the factors affecting the clinical choice.
  • Design factors for immediate devices for oral cancer resection for dentate and edentulous patients
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in immediate devices for oral cancer resection.
20 5

Design, manufacture and evaluate a range of dentures, obturators and mandibular prostheses (following hemi/partial mandiblectomy) for postoperative oral rehabilitation following palatal resection.

Dentures and Obturation

  • Classification of post-surgical defects.
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Occlusal schemes for patient requiring complete dentures and obturators.
  • Use of dental implants.
  • Type and extent of records required for individual assessment.
  • Regulatory requirements for dentures, obturators and mandibular prostheses.
  • Legal, ethical, professional and technical issues associated with the provision of dentures and obturators.
  • Classification of post-surgical defects, effect of defect on prosthodontic design principles.
  • Managing restricted opening utilising devices and interventions.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Open box, hollow box, glove obturators, obturator retention and soft palate obturation.
  • Surface finish of prostheses and microbial colonisation and degradation of silicone elastomers.
  • Intermediate obturator prostheses.
  • Definitive obturator prostheses
  • Prosthodonists/Restorative dentistry involvement in planning and assessments.
  • Occlusion in relation to complete and partial prosthodontics for maxillary defects.
  • Alternative denture retention units.
  • Two-part bolt, split post and tube, hinged sectional and swing lock designs.
  • Use of implants and precision attachments.
  • Criteria for clinical presentation and patient use.
  • Occlusal schemes for patient requiring:
    • complete dentures and obturators
    • neutrocentric
    • monoplane
    • lingualised occlusion
    • balancing ramps
    • Gerber based.
  • Two-part dentures, design criteria for patients with microstomia.
21 5

Demonstrate effective compliance with regulatory requirements.

Dentures and Obturation

  • Classification of post-surgical defects.
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Occlusal schemes for patient requiring complete dentures and obturators.
  • Use of dental implants.
  • Type and extent of records required for individual assessment.
  • Regulatory requirements for dentures, obturators and mandibular prostheses.
  • Legal, ethical, professional and technical issues associated with the provision of dentures and obturators.
  • Classification of post-surgical defects, effect of defect on prosthodontic design principles.
  • Managing restricted opening utilising devices and interventions.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Open box, hollow box, glove obturators, obturator retention and soft palate obturation.
  • Surface finish of prostheses and microbial colonisation and degradation of silicone elastomers.
  • Intermediate obturator prostheses.
  • Definitive obturator prostheses
  • Prosthodonists/Restorative dentistry involvement in planning and assessments.
  • Occlusion in relation to complete and partial prosthodontics for maxillary defects.
  • Alternative denture retention units.
  • Two-part bolt, split post and tube, hinged sectional and swing lock designs.
  • Use of implants and precision attachments.
  • Criteria for clinical presentation and patient use.
  • Occlusal schemes for patient requiring:
    • complete dentures and obturators
    • neutrocentric
    • monoplane
    • lingualised occlusion
    • balancing ramps
    • Gerber based.
  • Two-part dentures, design criteria for patients with microstomia.
22 5

Plan and manufacture a maxillary denture with an acrylic hollow box obturator for an edentulous patient.

Dentures and Obturation

  • Classification of post-surgical defects.
  • Dental materials selection, baseplates, dental alloys for clasping.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Occlusal schemes for patient requiring complete dentures and obturators.
  • Use of dental implants.
  • Type and extent of records required for individual assessment.
  • Regulatory requirements for dentures, obturators and mandibular prostheses.
  • Legal, ethical, professional and technical issues associated with the provision of dentures and obturators.
  • Classification of post-surgical defects, effect of defect on prosthodontic design principles.
  • Managing restricted opening utilising devices and interventions.
  • Materials and techniques used in obturator construction.
  • Design features of obturator prostheses.
  • Open box, hollow box, glove obturators, obturator retention and soft palate obturation.
  • Surface finish of prostheses and microbial colonisation and degradation of silicone elastomers.
  • Intermediate obturator prostheses.
  • Definitive obturator prostheses
  • Prosthodonists/Restorative dentistry involvement in planning and assessments.
  • Occlusion in relation to complete and partial prosthodontics for maxillary defects.
  • Alternative denture retention units.
  • Two-part bolt, split post and tube, hinged sectional and swing lock designs.
  • Use of implants and precision attachments.
  • Criteria for clinical presentation and patient use.
  • Occlusal schemes for patient requiring:
    • complete dentures and obturators
    • neutrocentric
    • monoplane
    • lingualised occlusion
    • balancing ramps
    • Gerber based.
  • Two-part dentures, design criteria for patients with microstomia.
23 6

Design a range of radiation applicators and shields and other devices to support the radiotherapy treatment.

Effects of Irradiation on Tissues

  • Mechanisms and effects of irradiation damage of tissues, with emphasis on the head and neck.
  • Types of malignant lesions for which radiotherapy is likely to be effective.
  • Lesions for which radiotherapy/chemotherapy/other modalities are indicated and those for which it is inappropriate.
  • Effects of irradiation of relevance to the craniofacial team.
  • Radiation applicators and shields.
24 6

Manufacture and evaluate a range of radiation applicators and shields and other devices to support the radiotherapy treatment.

Effects of Irradiation on Tissues

  • Mechanisms and effects of irradiation damage of tissues, with emphasis on the head and neck.
  • Types of malignant lesions for which radiotherapy is likely to be effective.
  • Lesions for which radiotherapy/chemotherapy/other modalities are indicated and those for which it is inappropriate.
  • Effects of irradiation of relevance to the craniofacial team.
  • Radiation applicators and shields.
25 3, 4, 5, 6

Complete required records for manufactured devices.

  • MDD regulations.
  • Device audit trail and manufacturing traceability.
26 3, 4, 5, 6

Evaluate the effectiveness of the prostheses you have manufactured and fitted with and patient satisfaction/quality of life

  • Audit devices effectiveness.
  • Standard QOL measures.
27 3,6

Monitor and support the patient through the longer-term rehabilitation process, adjusting and replacing prostheses as appropriate.

Patient Management and Support

  • Patient evaluation and referrals
  • Management of patient’s fears/anxiety and ability to empathise with patients in stressful situations, and the manifestations of anxiety/pain and the range of methods available in their management and control.
  • Personal and professional interaction with terminally ill patients, including counselling skills.
  • Theories and evidence base underpinning health-related behaviour.
  • The effects of drugs, allergies and lifestyle factors on patient health and rehabilitation.
  • Risks and benefits of care/management for the patient and their family/partners/carers.
  • Common psychosocial disorders (abnormal psychology, anxiety, depression, psychoses, eating disorders, alcoholism and drug addiction).
  • Recognition and appropriate care of patients with tissue conditions (psoriasis, eczema, contact dermatitis, dry mouth and sore mouth/ mouth burning syndromes).
  • The effects of physical and mental conditions on the ability to manage devices.
  • Process of grief and loss.
  • Body image and effect of altered body image.
  • Patient-centred counselling skills, including the importance of appropriate location and the amount of time devoted to the task.
  • Role of support groups (physical and internet).
  • Principles of patient education and supporting patients to be actively involved in their care.
  • Quality of life outcome measurement and analysis.
  • Care pathways and referral for social and psychological support.
  • Quality of life outcomes.
28 7

Advise patients with deformities requiring prosthetic rehabilitation.

Patient Management and Support

  • Patient evaluation and referrals
  • Management of patient’s fears/anxiety and ability to empathise with patients in stressful situations, and the manifestations of anxiety/pain and the range of methods available in their management and control.
  • Personal and professional interaction with terminally ill patients, including counselling skills.
  • Theories and evidence base underpinning health-related behaviour.
  • The effects of drugs, allergies and lifestyle factors on patient health and rehabilitation.
  • Risks and benefits of care/management for the patient and their family/partners/carers.
  • Common psychosocial disorders (abnormal psychology, anxiety, depression, psychoses, eating disorders, alcoholism and drug addiction).
  • Recognition and appropriate care of patients with tissue conditions (psoriasis, eczema, contact dermatitis, dry mouth and sore mouth/ mouth burning syndromes).
  • The effects of physical and mental conditions on the ability to manage devices.
  • Process of grief and loss.
  • Body image and effect of altered body image.
  • Patient-centred counselling skills, including the importance of appropriate location and the amount of time devoted to the task.
  • Role of support groups (physical and internet).
  • Principles of patient education and supporting patients to be actively involved in their care.
  • Quality of life outcome measurement and analysis.
  • Care pathways and referral for social and psychological support.
  • Quality of life outcomes.
29 7

Support, teach and familiarise the patient and/or carer in the use of the prosthesis, including the development of user instructions and advice.

Patient Management and Support

  • Patient evaluation and referrals
  • Management of patient’s fears/anxiety and ability to empathise with patients in stressful situations, and the manifestations of anxiety/pain and the range of methods available in their management and control.
  • Personal and professional interaction with terminally ill patients, including counselling skills.
  • Theories and evidence base underpinning health-related behaviour.
  • The effects of drugs, allergies and lifestyle factors on patient health and rehabilitation.
  • Risks and benefits of care/management for the patient and their family/partners/carers.
  • Common psychosocial disorders (abnormal psychology, anxiety, depression, psychoses, eating disorders, alcoholism and drug addiction).
  • Recognition and appropriate care of patients with tissue conditions (psoriasis, eczema, contact dermatitis, dry mouth and sore mouth/ mouth burning syndromes).
  • The effects of physical and mental conditions on the ability to manage devices.
  • Process of grief and loss.
  • Body image and effect of altered body image.
  • Patient-centred counselling skills, including the importance of appropriate location and the amount of time devoted to the task.
  • Role of support groups (physical and internet).
  • Principles of patient education and supporting patients to be actively involved in their care.
  • Quality of life outcome measurement and analysis.
  • Care pathways and referral for social and psychological support.
  • Quality of life outcomes.
30 7

Where appropriate, provide patient counselling support as required and identify and communicate need for referral for further support as required.

Patient Management and Support

  • Patient evaluation and referrals
  • Management of patient’s fears/anxiety and ability to empathise with patients in stressful situations, and the manifestations of anxiety/pain and the range of methods available in their management and control.
  • Personal and professional interaction with terminally ill patients, including counselling skills.
  • Theories and evidence base underpinning health-related behaviour.
  • The effects of drugs, allergies and lifestyle factors on patient health and rehabilitation.
  • Risks and benefits of care/management for the patient and their family/partners/carers.
  • Common psychosocial disorders (abnormal psychology, anxiety, depression, psychoses, eating disorders, alcoholism and drug addiction).
  • Recognition and appropriate care of patients with tissue conditions (psoriasis, eczema, contact dermatitis, dry mouth and sore mouth/ mouth burning syndromes).
  • The effects of physical and mental conditions on the ability to manage devices.
  • Process of grief and loss.
  • Body image and effect of altered body image.
  • Patient-centred counselling skills, including the importance of appropriate location and the amount of time devoted to the task.
  • Role of support groups (physical and internet).
  • Principles of patient education and supporting patients to be actively involved in their care.
  • Quality of life outcome measurement and analysis.
  • Care pathways and referral for social and psychological support.
  • Quality of life outcomes.
31 10

Lead a patient assessment, identify and define individual requirements for dynamic splint therapy and discuss with the patient.

Patient Management and Support

  • Patient evaluation and referrals
  • Management of patient’s fears/anxiety and ability to empathise with patients in stressful situations, and the manifestations of anxiety/pain and the range of methods available in their management and control.
  • Personal and professional interaction with terminally ill patients, including counselling skills.
  • Theories and evidence base underpinning health-related behaviour.
  • The effects of drugs, allergies and lifestyle factors on patient health and rehabilitation.
  • Risks and benefits of care/management for the patient and their family/partners/carers.
  • Common psychosocial disorders (abnormal psychology, anxiety, depression, psychoses, eating disorders, alcoholism and drug addiction).
  • Recognition and appropriate care of patients with tissue conditions (psoriasis, eczema, contact dermatitis, dry mouth and sore mouth/ mouth burning syndromes).
  • The effects of physical and mental conditions on the ability to manage devices.
  • Process of grief and loss.
  • Body image and effect of altered body image.
  • Patient-centred counselling skills, including the importance of appropriate location and the amount of time devoted to the task.
  • Role of support groups (physical and internet).
  • Principles of patient education and supporting patients to be actively involved in their care.
  • Quality of life outcome measurement and analysis.
  • Care pathways and referral for social and psychological support.
  • Quality of life outcomes.
32 9

Assist in the design and manufacture of splints for the treatment of hypertrophic and keloid scars in a range of patients and demonstrate effective compliance with MHRA procedures.

Dynamic Splint Therapies

  • Anatomy and pathology in relation to the skin and thermal injury.
  • Patient protocols, management of the burns patient, scar review and scar indexing.
  • Keloid scar formation.
  • Hypertrophic scar formation.
  • Splinting treatment strategies.
  • Post burn trauma therapy aetiology and assessment of condition.
  • Imaging and impression techniques with and without anaesthetics.
  • Cranio- and maxillofacial appliances, neck splints, microstomia appliances and hand splints.
  • MHRA procedures.
  • Theoretical principles to the construction, fitting and review of patients requiring dynamic splint therapy.
  • Risks associated with modifying medical devices.
  • Processes and guidelines to minimise risk.
  • Practical risk management methodologies in Medical Device Risk Management and Governance.
33 4, 5, 6, 9

Assist in the evaluation of manufactured devices suitable for patient use.

Dynamic Splint Therapies

  • Anatomy and pathology in relation to the skin and thermal injury.
  • Patient protocols, management of the burns patient, scar review and scar indexing.
  • Keloid scar formation.
  • Hypertrophic scar formation.
  • Splinting treatment strategies.
  • Post burn trauma therapy aetiology and assessment of condition.
  • Imaging and impression techniques with and without anaesthetics.
  • Cranio- and maxillofacial appliances, neck splints, microstomia appliances and hand splints.
  • MHRA procedures.
  • Theoretical principles to the construction, fitting and review of patients requiring dynamic splint therapy.
  • Risks associated with modifying medical devices.
  • Processes and guidelines to minimise risk.
  • Practical risk management methodologies in Medical Device Risk Management and Governance.
34 1, 2, 8

Plan and manufacture an auricular prosthesis.

  • Principles of the clinical management of facial prostheses.
  • Impression technique and materials for an auricular prosthesis.
  • Management of patient during impression procedures.
  • Principles of treatment planning.
  • Retention options.
  • Sculptured anatomical form to match patients missing anatomical parts.
  • Colour science.
  • Introduction to silicone elastomers.
  • Processing prostheses.
  • Skin contact adhesives: pressure-sensitive adhesives.
  • Main types of adhesives and removers used to attach.
  • Recognise both the normal and impaired anatomy.
  • Skin care and barrier materials to protect compromised skin.
  • Clinical management of skin/implant interface.
35 1, 2, 8

Plan and manufacture a nasal prosthesis.

  • Principles of the clinical management of facial prostheses.
  • Impression technique and materials for an auricular prosthesis.
  • Management of patient during impression procedures.
  • Principles of treatment planning.
  • Retention options.
  • Sculptured anatomical form to match patients missing anatomical parts.
  • Colour science.
  • Introduction to silicone elastomers.
  • Processing prostheses.
  • Skin contact adhesives: pressure-sensitive adhesives.
  • Main types of adhesives and removers used to attach.
  • Recognise both the normal and impaired anatomy.
  • Skin care and barrier materials to protect compromised skin.
  • Clinical management of skin/implant interface.
36 1, 2, 8

Assist in the planning and manufacture an indwelling ocular prosthesis.

  • Anatomy of enucleated socket.
  • Ocular implants.
  • Ocular microbiology.
  • Ocular plastic surgery.
  • UK provision.
  • Manufacturing techniques.
  • Material selection.
  • Clinical management and procedures.
37 10

Lead a patient assessment, identify and define individual requirements for facial prosthetic reconstruction and discuss with the patient.

  • Consent.
  • Full history pertinent to treatment.
  • Risks highlighted.
  • Developed communication skills.
  • Confidence in a clinical setting.
  • Clear concise explanations of treatment options.
  • Defined treatment plan based on examination.
38 10

Lead a patient assessment, identify and define individual requirements for nipple areola complex prosthesis and discuss with the patient.

  • Consent.
  • Full history pertinent to treatment.
  • Risks highlighted.
  • Developed communication skills.
  • Confidence in a clinical setting.
  • Clear concise explanations of treatment options.
  • Defined treatment plan based on examination.
39 10

Lead a patient assessment, identify and define individual requirements for contour or digit prostheses and discuss with the patient.

  • Consent.
  • Full history pertinent to treatment.
  • Risks highlighted.
  • Developed communication skills.
  • Confidence in a clinical setting.
  • Clear concise explanations of treatment options.
  • Defined treatment plan based on examination.
40 10

Lead a patient assessment, identify and define individual requirements for ocular prosthetic reconstruction and discuss with the patient.

  • Consent.
  • Full history pertinent to treatment.
  • Risks highlighted.
  • Developed communication skills.
  • Confidence in a clinical setting.
  • Clear concise explanations of treatment options.
  • Defined treatment plan based on examination.
41 11

Identify a topic area, gain the appropriate permissions and perform a clinical audit with associated medical device-related risk assessments.

  • Audit cycle.
  • Governance, data protection, registering audits, use of patient notes. 
  • Data collection and ensuring data accuracy.
  • Methods of data analysis.
  • Report writing.
  • Presentation skills.
  • Process to ensure recommendations are acted upon.
42 11

Analyse the results and develop recommendations to consolidate good practice and rectify any issues identified.

  • Audit cycle.
  • Governance, data protection, registering audits, use of patient notes. 
  • Data collection and ensuring data accuracy.
  • Methods of data analysis.
  • Report writing.
  • Presentation skills.
  • Process to ensure recommendations are acted upon.
43 11

Present your clinical audit as a written report and discuss the recommendations with colleagues.

  • Audit cycle.
  • Governance, data protection, registering audits, use of patient notes. 
  • Data collection and ensuring data accuracy.
  • Methods of data analysis.
  • Report writing.
  • Presentation skills.
  • Process to ensure recommendations are acted upon.

Work-based assessment


Complete 5 Case-Based Discussion(s)
Complete 5 of the following DOPS and/or OCEs
Type Title
DOPS Produce mould for orbitofacial prosthesis.
DOPS Prepare and pour up an impression taken from a maxillary defect case.
DOPS Select and paint a pupil iris unit.
OCE Fit an orbitofacial or nasal prosthesis and instruct patient in use of fixation system.
OCE Examine patient with an oroantral, oronasal or orofacial defect.
OCE Take an ocular impression.
OCE Fit a postburn or keloid splint.