Just as practitioners are responsible for the safety and wellbeing of their patients, trainers are responsible for preparing their delegates as best they can for aesthetic practice. Many of us are used to witnessing rogue lay persons practising in aesthetics, and now an emerging trend is undeniably ‘training academies’ with undiscerning acceptance criteria, poor due diligence and very little in the way of theoretical and practical content or support for paying delegates. While lay to lay person teaching is becoming rampant, we must also accept that with no set criteria or auditing other than OFQUAL authorised Level 7 and 6 courses, many medical-led courses are also falling short in their duties. Here are some of the most valuable attributes in a training course.
Delegate to tutor ratio
There is no set formula for how many delegates per tutor there should be, and for some training schools, the prerogative can depend on the complexity and content of the course, as well as the competency levels of the delegates. On a typical foundation toxin or filler course, the author would recommend no more than 4 delegates per trainer, but with something more advanced and demanding, such as PDO thread lifting, a 2:1 delegate to trainer ratio is preferable.
Hands-on experience
The significance of treating real-life models during training should never be underestimated. We would never expect a nurse or doctor to enter a ward alone without first having learnt to assess and treat a real patient, and this should also be the case in aesthetics. It is disappointing to see that many medical trainers are still not guaranteeing hands-on injecting with real models; this is a vital component to look for when selecting a trainer, as this aspect of training will be crucial to the practitioner's confidence as they embark on their career. Again, it is difficult to set a criteria for this, but taking a foundation toxin course as an example, typically a Facethetics delegate would expect to observe around 5 treatments and perform all three upper face indications. When teaching dermal fillers from foundation upwards, we ensure that all practitioners are exposed to using both needle and cannula, and that full treatments are carried out, for example, treating the whole lip, rather than allocating just one segment of the lip per delegate.
Pre-course screening and learning
As this unique sector expands, the challenges that come with it persist, and even grow. It is important not only for the eventual patient, but also for the delegate themselves, that you understand their initial level of competence and their motives. Aesthetics is a tough sector; not only must practitioners be prepared to treat the public safely, but also trainers must protect potential delegates from following an expensive pathway into a career that may not be the right choice for them. One way of preparing them is by providing advanced tested theoretical learning, which puts all delegates at the same level, and also screens those who are not at a satisfactory level or are unable to commit to the syllabus.
Post-course support
The issue of providing post-course support is a difficult balancing act between avoiding hand-holding so much that it stunts independent development, but not completely severing the umbilical cord so that when the time comes when a new practitioner needs support, there is none to be found. Delegates should ideally have some sort of community to look to and discuss issues, such as the closed Facebook forums that several trainers hold, and additional support from the trainers, who can be contacted in case of an emergency. It is important that practitioners can get reliable answers in good time; we aim for a 24-hour or less response time to all patient-related enquiries. Learning materials should also remain available to revisit for a good period of time after the course has been completed, which will help the new practitioner to cement their own learning.
Basics to complications
As simplistic as it may sound, it has been reported that many training academies do not teach the reconstitution of toxin, even though this is the cornerstone to a safe and effective treatment. Delegates should be provided with the know-how to do this, ideally across all three major toxins. This should also be true of hyaluronidase in both emergency and non-emergency situations. Absolutely no aesthetic course should be taught without a full understanding of complications, from how to recognise to how to treat.
Emergency kit
Finally, when the delegates are feeling equipped, informed and ready to practise, a physical emergency kit with instructions for use and contact details for support should be provided to each new practitioner. This will ensure that, should a complication occur, they are adequately equipped to manage it safely.
Conclusion
Setting out in a career in aesthetic medicine can be daunting, and there is certainly a lot to learn before practitioners are able to practise safely and effectively. However, a good training course will prepare delegates for this challenging career, and provide support going forwards. It is the duty of the ethical aesthetic trainer to ensure that all delegates meet the minimum entry requirements for training and are provided with adequate theoretical and practical learning to enable them to practise safely.