Early Career Researchers

Rachael Jablonski is a NIHR Academic Clinical Lecturer and Specialty Registrar in Restorative Dentistry based at the Leeds School of Dentistry and Leeds Dental Institute.

Rachael’s clinical academic training has a focus on the oral and dental rehabilitation of patients with head and neck cancer, developmental conditions, or facial trauma.

Leeds Hospitals Charity supported this research project with £25,000 funding towards the IMPRESSeD study, led by Rachael during her NIHR Doctoral Fellowship.

The study explored the digital manufacturing of facial prostheses - bespoke removable silicone devices that replace a facial part such as an eye or nose - from a patient, clinical and wider healthcare perspective.

Rachael explains: “Working as a clinical academic is a huge privilege. As a clinician, you gain an insight into unresolved healthcare needs and current challenges in rehabilitation processes. As an academic, you can use this insight to co-design and deliver patient centred research.”

Making facial prostheses is resource intensive. It relies on the technical and artistic skills of a small number of highly trained professionals (maxillofacial prosthetists). Some patients can also find some of the stages uncomfortable or claustrophobic.

Rachael says: “When I started to explore ideas for research, I worked with a dedicated and supportive group of patients who had previously received treatment for head and neck cancer. They brought their lived experience of wearing facial prostheses and helped identify priorities for improvement in the manufacturing process.”

Patients wanted to improve the comfort, aesthetic outcomes, and speed of the rehabilitation process.

Rachael’s research explored digital manufacturing workflows involving 3D facial scanning, virtual design, and 3D printing to try to improve the comfort and speed of manufacture.

She says: “It has been a fantastic opportunity to collaborate with a dedicated and enthusiastic group of people who wanted to make a difference to the rehabilitation processes, patient experiences and treatment outcomes. Together, we explored the impact of digital innovations through a range of research methods including evidence synthesis, laboratory-based research, a multicentre feasibility trial, qualitative research, and early health economic modelling.”

The research showed that most patients preferred the digital manufacturing approach compared with traditional techniques and gathered early data to explore whether digital manufacturing of facial prostheses could be cost effective to the NHS.

“There are still some limitations to digital manufacturing workflows,” she says, “but further research can help us better understand the indications, strengths and limitations of introducing new techniques and approaches.”

“Research is important to help us find the best way to treat health conditions, improve patient care outcomes, and provide staff with different opportunities and variation in their work.”

The final stage of her PhD involved the co-production of the I’m Still Me public engagement project to disseminate research findings and share the lived experience of people who wear facial prostheses.

Rachael adds: “A key message from the project is one of face equality - that we should treat everyone fairly, regardless of visible facial differences, and value people based on their unique stories. I’m Still Me helps share people’s lived experience, makes science more accessible to the wider community, highlights the significant difference patients make to research and public engagement, and illustrates some of the progress we are making together.”

All photo credits: Ruby Lee
@ruby.angelaleephoto
rubyangelalee.myportfolio.com