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Version 2 2015
Dental Care Professionals Additional Skills Record of Competency
Impression Taking 2016
Clinical Knowledge & Skills Competency Guidance for Trainers & Participants
This record of competency is designed to verify the achievement of knowledge and skills in performing additional clinical duties to comply with the General Dental Council (GDC) Scope of Practice Guidance. Training for these competencies could be provided by:
NHS Education for Scotland (NES) Private Provider Further Education Provider In Practice (GDP/DCP with additional knowledge and skills in relevant
clinical area) Guidance for Trainers The aim of the record of competency for additional clinical duties is to standardise the recording of this evidence within the workforce. GDC Scope of Practice (2013) states: ‘You should only carry out a task or type of treatment or make decisions about a patient’s care if you are sure that you have the necessary skills and are appropriately trained, competent and indemnified’. Successful completion of this record will allow the holder to demonstrate their additional skills and knowledge in the appropriate area. Trainers will be required to:
allow observation of 5 cases by the participant observe 10 cases carried out by the participant discuss procedure and level of competency with participant complete observation checklist on the date that the procedure is carried
out
If you undertake the role of the workplace trainer you are responsible for the competency of the participant during training. Trainers falsely verifying a participant’s competency will be deemed as acting in an unprofessional manner. This may have implications on registration with the regulatory body (Standards for the Dental Team, 2013, GDC). Where the trainer identifies that the competency has not been met, appropriate further training should be given.
Flow chart for participants undertaking training in additional skills
Training
Theory/
Practical
Observed
cases
Supervised
cases
Evaluation
&
Reflection
Competent?
STOP HERE
Further
training
required
Guidance for Participants Prior to commencing additional skills training it is recommended that the participants familiarise themselves with the GDC document ‘Standards for the Dental Team’, 2013. This record of competency must align with:
appropriate training in the topic support from a workplace trainer adequate cases available for assessment
As a participant you must:
undertake theoretical and practical training observe a skilled clinician carrying out the relevant procedure on a
minimum of 5 occasions be supervised by the named workplace trainer and achieve
competency on a minimum of 10 occasions complete a record of competency for each observation be deemed competent by the workplace trainer
Guidance note for competencies Check patient’s referral details
Participants must ensure they understand the prescription from the clinician and they have checked all personal and medical details at the time of treatment.
Clinical Judgement
Participants should be confident in using their clinical judgement to identify any reasons why treatment should not proceed. An appropriate referral protocol should be available to ensure correct procedure takes place.
Knowledge
The participants should have completed and be able to demonstrate the use of knowledge gained with patients and dental team members in the topic area.
Technical Ability & Manual Dexterity
Training should include simulation to allow participant to develop necessary skills. Participants should undertake supervised cases until they are confident in the procedure.
Professionalism
Participants should be aware of the GDC document Standards for the Dental Team, 2013, and adhere to guidance in relation to patient care.
Communication Skills
Effective communication methods should encompass dental team members and patients at the appropriate level.
Organisation
Participants should at all times be working in an organised and logical fashion.
Self Reflection
This section is for participants to look at the session and evaluate their own performance for example- ‘what did I do well’, ‘what didn’t go well’ and ‘what would I do to improve/change for the future’.
Observed Cases
Observed Cases Participants should record the cases undertaken by their trainer. Note constructive observation from the procedure.
Case Constructive Comments
Example
Patient attended for study model impressions.
The dentist demonstrated good communication
skills and explained clearly the procedure.
Patient’s medical history indicated they were
asthmatic; she was asked if she had her inhaler
before starting treatment. The dentist carried
out the treatment while reassuring the patient.
The impressions were taken quickly and she was
not stressed by the experience.
1
2
Observed Cases (continued)
3
4
5
Supervised Cases
Supervised Case Number 1 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 2 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 3 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 4 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent Not yet Competent
Further training required? (please state specific area)
Supervised Case Number 5 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 6 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 7 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 8 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 9 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number 10 Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand
Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number (additional cases) Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Supervised Case Number (additional cases) Competencies
Comments
Check patient referral details: Understood prescription & purpose of impressions e.g.
study models, primary denture impressions, orthodontic appliance, mouthguard, temporary crown/bridge
Checked patient’s medical history
Clinical Judgement: Anxiety Age Size Intra-oral Condition
Knowledge: Correct tray selection, materials Correct Health & Safety and Infection Control procedures Preparation of patient (bib, safety glasses) Staff PPE (gloves, mask/visor, safety glasses) Setting time Adjustment of impression tray Appropriate decontamination of impression
Technical Ability & Manual Dexterity: Adjusting stock trays – deforming or adding wax Correct use and placement of handles Material mixed to correct consistency Patient correctly positioned Tray correctly positioned and seated, controlling soft
tissues
Professionalism: Obtained and recorded consent Patient’s health, safety and wellbeing – priority Courtesy shown to patient Updated patient notes accurately
In general adherence to GDC Professional Standards
Communication Skills: Good verbal communication and body language Asks patient if they have had an impression before,
previous gagging, or have any concerns/fears. Inform patient of process in a manner which they
understand Reassures patient throughout procedure
Organisation: Prepared materials and equipment ready for use in
advance Makes themselves familiar with patients notes and
patient’s previous dental and medical history. Reviews prescription Liaised with laboratory and arranged collection of
impression Lab ticket completed accurately
Self Reflection: Able to decide if impression is fit for purpose If not, recognises faults and retakes correct impression on
second attempt Reflects on the delivery of care provided to the patient
Assessment Decision and Overall Feedback to the participant Supervising Registrant’s Signature:
Competent
Not yet Competent Further training required? (please state specific area)
Record of Self Reflection
Record of Self Reflection following Supervised Cases
Reflective practice is seen as one of the ways that professionals learn from
experience in order to understand and develop their practice. It enables us to
learn by thinking about past events and seeing them in a different way to
identify changes and improvements to make to future practice.
Please reflect on your performance following each of your supervised cases
and using the headings provided to focus your reflections.
Reflections: Supervised Case Number 1
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 2
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 3
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 4
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 5
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 6
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 7
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 8
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 9
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number 10
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number (additional cases)
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number (additional cases)
What went well?
What could have been better?
What will I do differently next time?
Reflections: Supervised Case Number (additional cases)
What went well?
What could have been better?
What will I do differently next time?
Completion of Training Forms
Impression Taking This Completion of Training Form must be completed and signed by your supervising dentist when you have achieved the necessary level of skills as listed in the training pack.
Dental Care Professional - Participant
Name
Full Postal Address
GDC Reg. No.____________ Participant’s Professional Qualification(s)
Supervisor’s details
Name
Practice Address
GDC Reg. No.____________ Supervisor’s Professional Qualification(s)
I confirm that I have completed NHS Education for Scotland’s Impression Skills Training Session and my supervising dentist has signed the declaration of this form to attest to my clinical competence in taking dental impressions.
Signature____________________________________Date____________
To be signed by the Supervising Dentist I confirm that _________________________________ has: FULL NAME OF PARTICIPANT IN BLOCK CAPITALS
completed NHS Education for Scotland’s impression skills training session
observed a skilled clinician take dental impressions (on a minimum of 5 occasions)
been supervised and deemed competent by a skilled clinician (on a minimum of 10 occasions).
1. Learning Outcomes Competent?
YES NO a) Apply legal and ethical principles, Health & Safety,
Infection Control and Medical Emergencies guidelines/protocols throughout the procedure.
b) State the reasons and contra-indications for taking dental impressions.
c) Use effective communication skills in allaying anxiety and managing difficult situations.
d) Discuss the principles and procedures of accurate dental impression taking.
e) Identify the equipment and the most suitable materials that can be used for taking an impression.
f) Demonstrate proficiency in the clinical procedures involved in the taking of basic dental impressions under the prescription of a dentist.
g) Identify learning which has occurred and areas of further learning.
Name
GDC Reg. No
Signature
Date
This document is for information and guidance only and implies no endorsement of assessment undertaken. NHS Education for Scotland (NES) does not quality assure any training using this document and cannot be held responsible for inappropriate use. (March 2012 NES Dental)
