The control framework reveals a critical juncture for advanced Mediterranean obstetric and gynecologic ultrasound practitioners: translating simulation, quality improvement, and research findings into tangible improvements in patient care and professional development. This scenario is professionally challenging because it requires balancing the pursuit of innovation and evidence-based practice with the immediate demands of patient safety, resource allocation, and the ethical imperative to disseminate knowledge responsibly. Practitioners must navigate the complexities of integrating new techniques learned in simulation, implementing quality assurance measures derived from research, and ensuring that research findings are ethically and effectively translated into clinical practice, all within the specific regulatory and professional guidelines applicable to their practice in the Mediterranean region. The best approach involves a systematic and collaborative strategy for integrating simulation-based training and research findings into clinical practice. This includes establishing formal protocols for validating simulation-acquired skills against real-world performance, developing robust quality improvement initiatives informed by research data on diagnostic accuracy and patient outcomes, and creating mechanisms for peer review and continuous professional development. This approach is correct because it aligns with the ethical obligations of medical professionals to provide the highest standard of care, grounded in evidence and best practices. It also adheres to the principles of lifelong learning and professional accountability, ensuring that advancements in ultrasound technology and understanding are translated into tangible benefits for patients. Furthermore, it fosters a culture of continuous improvement and research translation, which is essential for maintaining competency and advancing the field. An incorrect approach would be to solely rely on anecdotal evidence from simulation sessions to alter clinical protocols without rigorous validation. This fails to meet the standard of evidence-based practice and could potentially introduce unproven or even detrimental changes to patient care. It bypasses the crucial step of quality assurance and research translation, neglecting the ethical responsibility to ensure that any changes are demonstrably beneficial and safe. Another incorrect approach is to implement quality improvement measures based on research findings without considering the specific context and resources of the local Mediterranean healthcare setting. This can lead to the adoption of protocols that are impractical, unaffordable, or not culturally appropriate, rendering them ineffective and potentially creating disparities in care. It neglects the practicalities of research translation and the ethical consideration of equitable access to high-quality ultrasound services. A further incorrect approach is to prioritize individual research publication over the systematic integration of findings into clinical practice and quality improvement frameworks. While research is vital, its ultimate value lies in its application. Failing to translate research into actionable changes in simulation training, quality metrics, or clinical protocols means that the potential benefits for patient care and professional development are not fully realized. This represents a missed opportunity for both individual and collective professional growth and a failure to fully meet the ethical mandate to advance medical knowledge for the betterment of patients. Professionals should adopt a decision-making process that begins with identifying areas for improvement through a combination of simulation debriefing, quality audits, and literature review. This should be followed by a structured plan for validating new techniques or protocols, potentially through pilot studies or further simulation. The integration of research findings should be a collaborative effort involving multidisciplinary teams, with clear metrics for success and ongoing evaluation. Ethical considerations, including patient consent for research and the responsible dissemination of findings, must be paramount throughout the process.

The evaluation methodology shows a critical need for clarity regarding the purpose and eligibility for the Advanced Mediterranean Obstetric and Gynecologic Ultrasound Competency Assessment. This scenario is professionally challenging because it requires healthcare professionals to navigate potentially ambiguous criteria for advanced training, impacting their ability to provide specialized care and meet professional development standards within the Mediterranean region’s specific healthcare context. Misinterpreting the assessment’s purpose or eligibility can lead to wasted resources, delayed career progression, and ultimately, suboptimal patient care. The best approach involves a thorough understanding of the assessment’s stated objectives and the specific professional and educational prerequisites outlined by the governing body. This includes recognizing that the assessment is designed to validate a higher level of skill and knowledge beyond foundational competency, specifically tailored to the obstetric and gynecologic ultrasound needs prevalent in the Mediterranean region. Eligibility is typically determined by prior qualifications, documented experience, and potentially specific regional training mandates. Adhering to these defined parameters ensures that only those adequately prepared and whose practice aligns with the assessment’s advanced scope are admitted, thereby upholding the integrity of the competency framework and ensuring that certified professionals possess the requisite expertise for advanced diagnostic and interventional procedures in this specialized field. An incorrect approach would be to assume the assessment is a general refresher course for all ultrasound practitioners. This fails to acknowledge the “Advanced” designation and the specific regional focus, potentially leading individuals with only basic competency to apply, thus misallocating assessment resources and undermining the purpose of identifying highly skilled practitioners. Another incorrect approach is to bypass the stated eligibility criteria based on anecdotal evidence or perceived equivalence of experience from different healthcare systems. This disregards the structured pathway established by the assessment framework, which is designed to ensure a standardized level of advanced competency relevant to the Mediterranean context. Furthermore, assuming the assessment is solely a bureaucratic hurdle rather than a quality assurance mechanism for specialized care is a flawed perspective. This mindset can lead to a superficial engagement with the assessment’s requirements, potentially resulting in individuals who meet the letter of the law but not the spirit of advanced competency. Professionals should approach such competency assessments by first meticulously reviewing all official documentation from the certifying body. This includes understanding the stated purpose, the target audience, the specific learning outcomes, and the detailed eligibility requirements. If any ambiguity exists, direct communication with the assessment administrators or relevant professional bodies is crucial. Professionals should then honestly self-assess their qualifications and experience against these criteria before applying, ensuring their application aligns with the assessment’s intent to recognize advanced expertise within the specified regional context.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate need for accurate diagnostic information with the ethical and regulatory obligations to protect patient privacy and ensure informed consent, particularly when dealing with sensitive medical imaging data. The rapid advancement of AI in medical imaging presents new opportunities but also necessitates careful consideration of data handling and patient rights. Correct Approach Analysis: The best professional practice involves obtaining explicit, informed consent from the patient for the use of their medical imaging data in AI development, clearly outlining the purpose, potential risks, and benefits, and ensuring robust anonymization or de-identification of the data prior to its use. This approach is correct because it directly aligns with fundamental ethical principles of patient autonomy and beneficence, as well as regulatory frameworks such as the General Data Protection Regulation (GDPR) if applicable in the Mediterranean context, which mandates explicit consent for processing personal data, especially sensitive health information. It upholds the patient’s right to control their own medical information and ensures transparency in the use of their data for research and development. Incorrect Approaches Analysis: Using patient imaging data without explicit consent, even if anonymized, is ethically problematic and potentially violates data protection regulations. While anonymization is a crucial step, the initial processing and collection of data for purposes beyond direct patient care typically require a legal basis, which is often explicit consent. Relying solely on implied consent or the argument that the data is for a beneficial research purpose bypasses the patient’s right to make an informed decision about their sensitive health information. Sharing anonymized imaging data with AI developers under a general research agreement without specific patient consent for AI development purposes is also professionally unacceptable. While research agreements are standard, they do not supersede the specific requirements for consent when dealing with sensitive personal data for novel applications like AI training. The scope of consent must be clearly defined, and a general research agreement may not cover the specific use case of AI development, potentially leading to a breach of trust and regulatory non-compliance. Developing AI algorithms using publicly available medical imaging datasets without verifying the original consent procedures for those datasets is a significant ethical and regulatory risk. Publicly available datasets may have been collected under specific consent terms that do not permit their use for AI algorithm development. Professionals have a responsibility to ensure that all data used in their work, regardless of its source, has been ethically and legally obtained and is being used in accordance with its original consent provisions. Professional Reasoning: Professionals should adopt a decision-making framework that prioritizes patient autonomy and data privacy. This involves a proactive approach to obtaining informed consent for any use of patient data beyond direct clinical care, especially for research and development purposes. When considering the use of AI in medical imaging, professionals must thoroughly understand the data requirements, potential risks, and the applicable regulatory landscape. They should always err on the side of caution, seeking explicit consent and ensuring robust data anonymization and security measures are in place. If there is any ambiguity regarding consent or data usage rights, seeking legal and ethical counsel is paramount.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the potential benefits of contrast agents in obstetric and gynecologic ultrasound against the inherent risks, particularly in a pregnant patient. The decision-making process must be guided by robust evidence, patient-specific factors, and adherence to established safety protocols and regulatory guidelines. The limited data on contrast agents in pregnancy necessitates a highly cautious and evidence-based approach. Correct Approach Analysis: The best professional practice involves a thorough, individualized risk-benefit assessment, prioritizing the use of contrast agents only when the diagnostic information gained is essential for immediate patient management and cannot be obtained through safer alternative methods. This approach aligns with the ethical principle of non-maleficence (do no harm) and beneficence (act in the patient’s best interest). Specifically, it requires consulting the most up-to-date, pregnancy-specific literature and any available regulatory guidance (e.g., from the European Medicines Agency or national competent authorities) regarding the use of the specific contrast agent in pregnant women. The decision must be made in consultation with the referring clinician and the patient, ensuring informed consent regarding the known and unknown risks. This meticulous evaluation ensures that the potential diagnostic gain clearly outweighs the potential fetal and maternal risks, which are often not fully characterized in this population. Incorrect Approaches Analysis: One incorrect approach involves proceeding with contrast administration based solely on the general safety profile of the agent in non-pregnant adults, without specific consideration for the unique physiological changes and potential teratogenic or fetotoxic effects in pregnancy. This fails to acknowledge the heightened vulnerability of the fetus and the lack of comprehensive safety data in this population, violating the principle of caution and potentially exposing the fetus to unnecessary risk. Another incorrect approach is to defer contrast administration indefinitely due to a lack of absolute certainty regarding fetal safety, even when the diagnostic information is critical for urgent maternal care. This can lead to delayed diagnosis and suboptimal management, potentially harming the mother and, indirectly, the fetus, by failing to act in the patient’s best interest when a calculated risk might be warranted. A further incorrect approach is to rely on anecdotal evidence or the experience of colleagues without consulting peer-reviewed literature or official guidance. This bypasses the established scientific and regulatory framework for evaluating the safety and efficacy of medical interventions, particularly in vulnerable populations, and can lead to decisions based on incomplete or biased information. Professional Reasoning: Professionals should adopt a systematic decision-making process that begins with identifying the clinical question and the potential role of contrast-enhanced ultrasound. This is followed by a comprehensive literature search for pregnancy-specific data on the proposed contrast agent, including any contraindications or warnings from regulatory bodies. A thorough risk-benefit analysis, considering the gestational age, maternal health, and the criticality of the diagnostic information, is paramount. This analysis must be shared with the patient and the referring physician to facilitate informed consent and collaborative decision-making. If the benefits clearly outweigh the risks, the procedure should be performed with meticulous monitoring. If significant uncertainties remain or risks are deemed too high, alternative diagnostic pathways must be explored.

The risk matrix shows a moderate likelihood of a candidate experiencing suboptimal preparation for the Advanced Mediterranean Obstetric and Gynecologic Ultrasound Competency Assessment due to insufficient time allocation for resource review. This scenario is professionally challenging because it requires the candidate to balance extensive learning requirements with practical time constraints, potentially impacting their ability to demonstrate competency and patient safety. Careful judgment is required to ensure adequate preparation without compromising other professional or personal responsibilities. The best approach involves a structured, phased timeline that prioritizes foundational knowledge acquisition, followed by targeted practice and simulation, and concludes with a review of specific assessment requirements and potential challenging scenarios. This phased approach ensures that candidates build a robust understanding of core principles before delving into complex applications. Regulatory and ethical justification for this approach lies in the principle of professional competence, which mandates that practitioners possess the necessary knowledge and skills to provide safe and effective care. Adequate preparation, as facilitated by a structured timeline, directly supports this principle by minimizing the risk of errors stemming from insufficient knowledge or skill. It aligns with the ethical obligation to patients to receive care from well-prepared practitioners. An approach that involves cramming all study materials in the final week before the assessment is professionally unacceptable. This method significantly increases the risk of knowledge retention issues and superficial understanding, failing to meet the standard of professional competence. It ethically compromises patient safety by potentially leading to diagnostic inaccuracies or missed findings during actual practice. Another unacceptable approach is to rely solely on attending a single, broad overview workshop without subsequent independent study or practice. While workshops can provide valuable insights, they are rarely sufficient on their own to achieve competency in a specialized field like advanced obstetric and gynecologic ultrasound. This approach neglects the individual learning needs and the depth of understanding required for complex diagnostic procedures, thereby failing to uphold the professional standard of care and potentially endangering patients. A further professionally unacceptable approach is to assume prior general ultrasound knowledge is sufficient without reviewing specific guidelines and best practices relevant to the Mediterranean region or the advanced competencies being assessed. Medical practice is dynamic, and specific regional or advanced competencies often involve nuanced protocols, equipment considerations, or common pathologies that differ from general knowledge. This assumption can lead to outdated or inappropriate practice, directly impacting patient care quality and safety. The professional decision-making process for similar situations should involve a proactive assessment of learning needs, a realistic evaluation of available time, and the development of a personalized, structured study plan. This plan should incorporate diverse learning resources, practical application, and regular self-assessment to ensure mastery of the required competencies. Prioritizing patient safety and ethical obligations should always guide the preparation process.

The assessment process reveals a critical juncture for a candidate seeking advanced competency in Mediterranean Obstetric and Gynecologic Ultrasound. The scenario presents a challenge because it requires the candidate to understand not just the technical aspects of ultrasound but also the administrative and ethical framework governing competency assessments, specifically concerning blueprint weighting, scoring, and retake policies. This is professionally challenging because misinterpreting or disregarding these policies can lead to unfair assessment outcomes, erode trust in the certification process, and potentially impact patient care if unqualified individuals are certified. Careful judgment is required to navigate the candidate’s performance against established, transparent criteria. The best professional approach involves a thorough review of the official assessment blueprint and associated policies. This includes understanding how different domains of knowledge and skill are weighted, the specific scoring rubric used, and the defined criteria for passing. Crucially, it requires adherence to the stated retake policy, which typically outlines the number of allowed attempts, the waiting period between attempts, and any remedial training required. This approach is correct because it aligns with principles of fairness, transparency, and due process inherent in professional certification. Regulatory bodies and professional organizations mandate that assessments are conducted according to pre-defined, published standards to ensure objectivity and validity. Adhering to these policies protects the integrity of the certification and upholds the ethical obligation to ensure only competent practitioners are recognized. An incorrect approach would be to deviate from the established scoring rubric based on a subjective feeling about the candidate’s overall performance. This fails to acknowledge the importance of objective measurement and can lead to biased evaluations. Ethically, it undermines the principle of equitable assessment. Another incorrect approach is to ignore the stated retake policy, perhaps allowing an immediate second attempt without the required waiting period or remedial work. This violates the established rules of the assessment, potentially giving the candidate an unfair advantage or bypassing necessary skill development, which is a regulatory failure. Finally, an incorrect approach would be to adjust the blueprint weighting post-assessment to accommodate the candidate’s performance. This is a severe breach of procedural integrity, as the blueprint should be fixed and transparent before the assessment begins, and altering it retrospectively invalidates the entire assessment process and erodes confidence in the certifying body. Professionals should approach such situations by prioritizing adherence to established policies and procedures. A decision-making framework would involve: 1) Clearly understanding the assessment blueprint and scoring criteria before evaluation. 2) Applying the scoring rubric consistently and objectively. 3) Strictly following the defined retake policy. 4) Consulting with assessment administrators or relevant governing bodies if ambiguities arise, rather than making unilateral decisions. 5) Maintaining meticulous documentation of the assessment process and outcomes.

Scenario Analysis: This scenario presents a professional challenge because it requires balancing the immediate need for diagnostic imaging with the long-term imperative of maintaining equipment integrity and patient safety, all within a regulated environment. The challenge lies in discerning the most appropriate course of action when faced with a potential equipment malfunction that could impact image quality and potentially expose patients to unnecessary radiation. Careful judgment is required to avoid delaying essential care while also upholding quality assurance standards and regulatory compliance. Correct Approach Analysis: The best professional practice involves immediately ceasing the use of the ultrasound machine exhibiting the suspected malfunction and initiating a formal quality assurance (QA) protocol. This approach is correct because it prioritizes patient safety by preventing the acquisition of potentially diagnostic-inaccurate images and minimizing unnecessary radiation exposure. It aligns with the fundamental principles of medical imaging ethics and regulatory requirements that mandate rigorous QA procedures to ensure equipment is functioning optimally and safely. Promptly reporting and addressing the malfunction prevents the propagation of errors and ensures that the equipment is repaired and recalibrated before further use, thereby safeguarding future patient care and maintaining the integrity of diagnostic services. Incorrect Approaches Analysis: Continuing to use the ultrasound machine without immediate investigation, despite the technician’s suspicion, is professionally unacceptable. This approach fails to adhere to the principle of “do no harm” by potentially providing misleading diagnostic information and exposing patients to radiation without a clear diagnostic benefit. It also disregards the importance of proactive quality assurance, which is a cornerstone of safe and effective medical practice. Attempting to troubleshoot the issue independently without following established QA protocols or involving qualified biomedical engineering personnel is also professionally unsound. While well-intentioned, this can lead to improper adjustments, exacerbation of the problem, or a false sense of resolution, all of which compromise patient safety and regulatory compliance. It bypasses the structured and documented processes designed to ensure equipment reliability and accuracy. Delaying the QA investigation until a more convenient time or until multiple patients have been scanned with the potentially faulty equipment is ethically and regulatorily indefensible. This approach prioritizes convenience over patient well-being and regulatory adherence. It increases the risk of widespread diagnostic errors and necessitates potentially complex and resource-intensive retrospective reviews, undermining the proactive nature of effective quality assurance. Professional Reasoning: Professionals facing such a situation should employ a decision-making framework that prioritizes patient safety, adheres to established protocols, and ensures regulatory compliance. This framework involves: 1) Recognizing and acknowledging potential equipment malfunctions or deviations from expected performance. 2) Immediately halting the use of the suspect equipment to prevent harm. 3) Activating the facility’s established Quality Assurance (QA) protocols for equipment evaluation. 4) Documenting the suspected issue and the steps taken. 5) Engaging appropriate technical personnel (e.g., biomedical engineers) for diagnosis and repair. 6) Ensuring that all actions are in line with relevant regulatory guidelines and professional ethical standards.

This scenario presents a professional challenge because the clinician must balance the need for comprehensive obstetric and gynecologic assessment with the specific clinical question posed by the referring physician. Failure to tailor the ultrasound protocol can lead to inefficient use of resources, patient anxiety due to unnecessary or irrelevant findings, and potentially delayed or incorrect management if the primary question is not adequately addressed. Careful judgment is required to select and optimize the protocol to directly answer the clinical query while remaining within the scope of advanced competency. The best approach involves a systematic review of the referring physician’s documentation to identify the precise clinical question. Subsequently, the clinician should select and optimize an ultrasound protocol that directly addresses this question, incorporating specific views or measurements as indicated by the clinical context. This might involve focusing on a particular organ or region, or employing specific Doppler techniques, rather than performing a routine, comprehensive scan. This approach is correct because it prioritizes patient care by ensuring the diagnostic investigation is targeted and efficient, aligning with ethical principles of beneficence and non-maleficence by avoiding unnecessary procedures and focusing on obtaining relevant diagnostic information. It also respects professional responsibility to utilize resources judiciously. An incorrect approach would be to perform a standard, comprehensive obstetric and gynecologic ultrasound without considering the specific clinical question. This fails to optimize the protocol for the stated clinical need, potentially leading to a scan that is either insufficient to answer the question or includes extensive, irrelevant data, thus being inefficient and potentially misleading. Another incorrect approach is to assume the clinical question based on the patient’s presenting symptoms without explicitly reviewing the referring physician’s documentation. This introduces a risk of misinterpretation and may lead to an incomplete or misdirected investigation. Finally, deviating significantly from established protocols without clear clinical justification, even if attempting to be thorough, can compromise diagnostic accuracy and comparability of findings, potentially violating professional standards of care. Professionals should employ a decision-making framework that begins with a thorough understanding of the clinical context and the specific question being asked. This involves active communication with the referring physician if clarity is needed. The next step is to identify the most appropriate and evidence-based ultrasound protocol that directly addresses the question. Optimization involves tailoring the protocol’s parameters, such as transducer selection, imaging depth, gain settings, and Doppler interrogation, to the specific clinical scenario. This ensures that the investigation is both diagnostically effective and resource-efficient.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between adopting innovative technological solutions for improved patient care and ensuring strict adherence to regulatory frameworks governing medical imaging and data privacy. The rapid evolution of AI in ultrasound necessitates a proactive approach to compliance, requiring careful consideration of accreditation standards, data security, and the ethical implications of integrating new informatics systems. Failure to navigate these complexities can lead to significant legal repercussions, loss of accreditation, and erosion of patient trust. Correct Approach Analysis: The best professional practice involves a comprehensive impact assessment that prioritizes regulatory compliance and accreditation standards from the outset. This approach mandates a thorough review of existing accreditation requirements (e.g., those set by relevant national bodies or professional societies overseeing ultrasound services) and data protection laws (e.g., GDPR in Europe, HIPAA in the US, or equivalent national legislation) before implementing any new informatics system or AI integration. It requires engaging with accreditation bodies to understand their evolving stance on AI and informatics, and proactively seeking guidance on how proposed systems align with current and anticipated standards. This ensures that the technology serves to enhance, rather than compromise, the quality and legality of obstetric and gynecologic ultrasound services. Ethical considerations regarding patient consent for data usage and algorithm transparency are also integrated into this assessment. Incorrect Approaches Analysis: Implementing a new informatics system without a prior, thorough regulatory and accreditation impact assessment is professionally unacceptable. This approach risks non-compliance with established standards, potentially leading to the loss of accreditation and significant penalties. It also fails to adequately address data privacy concerns, exposing patient information to unauthorized access or misuse, which violates ethical and legal obligations. Adopting an informatics system based solely on its perceived technological advancement and potential for efficiency, without verifying its compatibility with current accreditation requirements or data protection laws, is also a flawed strategy. This overlooks the critical need for regulatory alignment and can result in costly retrofitting or complete system replacement if it fails to meet mandated standards. Relying on vendor assurances alone regarding regulatory compliance, without independent verification and internal assessment, is insufficient. While vendors may provide information, the ultimate responsibility for compliance rests with the healthcare provider. This approach neglects due diligence and can lead to unforeseen regulatory breaches if vendor claims are inaccurate or incomplete. Professional Reasoning: Professionals should adopt a risk-based, proactive approach to technology integration. This involves: 1. Identifying all relevant regulatory frameworks and accreditation standards applicable to obstetric and gynecologic ultrasound services and informatics systems. 2. Conducting a detailed impact assessment that evaluates how the proposed informatics system and AI integration will affect compliance with these regulations and standards. 3. Engaging with regulatory bodies and accreditation agencies to seek clarification and ensure alignment. 4. Developing robust data security and privacy protocols that meet or exceed legal requirements. 5. Establishing clear ethical guidelines for the use of AI and informatics in patient care, including informed consent and transparency. 6. Implementing a phased rollout with continuous monitoring and evaluation to ensure ongoing compliance and optimal performance.

This scenario presents a professional challenge due to the inherent conflict between a clinician’s duty to provide accurate and timely information and the patient’s right to privacy and informed consent, particularly when sensitive medical information is involved. The need for advanced obstetric and gynecologic ultrasound competency assessment implies a high standard of care and ethical responsibility. Careful judgment is required to navigate situations where sharing information, even for perceived benefit, could breach confidentiality or undermine patient autonomy. The best approach involves obtaining explicit, informed consent from the patient before sharing any ultrasound findings with a third party, even if that third party is a referring physician or a specialist involved in the patient’s care. This aligns with fundamental ethical principles of patient autonomy and confidentiality, as well as regulatory frameworks that protect patient health information. Obtaining consent ensures the patient understands what information will be shared, with whom, and for what purpose, allowing them to make an informed decision. This respects their right to control their own medical data and fosters trust in the healthcare provider. Sharing ultrasound findings with the referring physician without first obtaining the patient’s explicit consent represents a breach of confidentiality. While the referring physician is part of the patient’s care team, the duty of confidentiality extends to all medical information, and disclosure requires authorization. This action undermines patient trust and could have legal ramifications under data protection regulations. Discussing the ultrasound findings with a colleague in a casual, non-patient-specific manner, even if intended for educational purposes or to seek advice on a complex case, still carries a risk of inadvertent disclosure or a breach of professional etiquette regarding patient privacy. Without anonymization or explicit consent, such discussions can violate the spirit, if not the letter, of confidentiality requirements. Proceeding with the ultrasound examination and documenting findings without a clear understanding of how those findings will be communicated or used by other parties, especially if the patient has expressed reservations about sharing information, is professionally negligent. It fails to uphold the principle of informed consent regarding the broader implications of the diagnostic process and the subsequent use of the data. Professionals should employ a decision-making framework that prioritizes patient autonomy and confidentiality. This involves: 1) Clearly explaining the purpose and scope of the ultrasound examination to the patient. 2) Discussing how the findings will be communicated and to whom. 3) Actively seeking and documenting explicit, informed consent for any disclosure of information to third parties. 4) Respecting the patient’s decision regarding information sharing, even if it means a delay or a different pathway in their care. 5) Consulting relevant professional guidelines and ethical codes when in doubt.