Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate need for operational readiness in a global care network with the imperative of maintaining robust quality and safety standards. The complexity arises from coordinating diverse healthcare systems, varying regulatory landscapes, and potential cultural differences, all while ensuring patient safety is paramount. Effective judgment is required to identify and implement processes that are both efficient and ethically sound, preventing a “race to the bottom” in quality due to rapid integration. Correct Approach Analysis: The best professional practice involves establishing a unified, evidence-based framework for quality and safety review that is adaptable to local contexts but anchored in globally recognized best practices. This approach prioritizes the development of standardized protocols for data collection, incident reporting, and performance benchmarking across all participating sites within the global network. It emphasizes continuous learning and improvement cycles, ensuring that lessons learned from one region are systematically integrated into the operational readiness plans of others. This aligns with ethical principles of beneficence and non-maleficence by proactively identifying and mitigating risks to patient care, and with regulatory expectations for robust quality management systems in healthcare. Incorrect Approaches Analysis: Adopting a decentralized approach where each regional entity independently defines its quality and safety review processes, without a unifying global standard, is professionally unacceptable. This failure stems from the inherent risk of inconsistent patient care and safety outcomes across the network, potentially leading to significant ethical breaches and regulatory non-compliance if a lower standard is adopted in any region. It undermines the very purpose of a global care network, which is to leverage collective expertise for improved patient outcomes. Implementing a review process that relies solely on self-reported data from individual sites, without independent verification or standardized auditing mechanisms, is also professionally unsound. This approach is ethically deficient as it lacks accountability and transparency, potentially masking systemic issues and jeopardizing patient safety. It fails to meet regulatory requirements for objective quality assurance and risk management. Focusing exclusively on the speed of integration and operational deployment, with quality and safety reviews being a secondary, post-implementation concern, is a critical professional and ethical failure. This prioritizes expediency over patient well-being, directly contravening the fundamental ethical duty of care and potentially violating numerous healthcare regulations that mandate proactive safety measures. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with a thorough understanding of the core mission of the global care network – to enhance patient care through collaboration. This involves prioritizing the development of a comprehensive, globally applicable quality and safety framework that respects local nuances but upholds universal standards. The process should involve stakeholder engagement from all participating regions to ensure buy-in and practical applicability. Continuous monitoring, independent auditing, and a commitment to transparent reporting are essential components. Ethical considerations, such as patient autonomy and justice, must be woven into every aspect of the review process, ensuring equitable access to high-quality care regardless of location. Regulatory compliance should be viewed not as a burden, but as a baseline for ethical practice.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate need for surgical intervention with the imperative to ensure patient safety and adherence to established quality improvement protocols. The pressure to operate quickly in a trauma setting can sometimes lead to bypassing standard procedural checks, which, while understandable, can compromise long-term quality and safety outcomes. Careful judgment is required to integrate these competing demands effectively. Correct Approach Analysis: The best professional practice involves a structured approach that prioritizes immediate patient care while simultaneously initiating a formal quality improvement process. This approach involves the trauma team leader, upon stabilization of the patient, initiating a debriefing session. This session would focus on identifying any deviations from standard protocols during the resuscitation and surgical phases, documenting these deviations, and collaboratively developing actionable strategies for improvement. This aligns with the principles of continuous quality improvement mandated by regulatory bodies and professional surgical societies, which emphasize learning from adverse events or near misses to enhance future patient care and system efficiency. It directly addresses the need to optimize processes by systematically reviewing and refining the steps taken. Incorrect Approaches Analysis: One incorrect approach involves the trauma team leader deciding to address the observed deviation informally with the involved staff members after the immediate crisis has passed, without initiating a formal documentation or review process. This fails to establish a clear record of the event, hindering systematic analysis and preventing the identification of systemic issues that may have contributed to the deviation. It also bypasses established quality improvement frameworks that require formal reporting and review to ensure accountability and drive meaningful change. Another incorrect approach is to dismiss the observed deviation as a minor issue, attributing it solely to the high-pressure environment of trauma surgery, and taking no further action. This approach neglects the fundamental principle of quality assurance that even minor deviations can indicate underlying systemic vulnerabilities or training gaps. It fails to leverage the opportunity for learning and improvement, potentially allowing similar deviations to recur and negatively impact patient safety or surgical outcomes. A further incorrect approach is to immediately initiate disciplinary action against the staff members involved without a thorough review of the circumstances and contributing factors. While accountability is important, a punitive approach without a preceding objective quality review can foster a culture of fear, discouraging open reporting of errors or near misses. This undermines the collaborative spirit necessary for effective process optimization and can lead to the concealment of problems rather than their resolution. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes patient safety and quality of care. This involves recognizing that trauma surgery is a high-stakes environment where deviations from protocol can occur. The critical step is to move from immediate crisis management to systematic learning. This requires a commitment to established quality improvement methodologies, including structured debriefing, objective event analysis, and the development of evidence-based interventions. Professionals should foster a culture of psychological safety where reporting and discussing deviations are encouraged, enabling continuous learning and the optimization of surgical processes for the benefit of all patients.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate need for process improvement with the established protocols and potential resistance to change within a high-stakes surgical environment. Ensuring patient safety and quality of care are paramount, but implementing changes without proper validation and stakeholder buy-in can lead to unintended consequences, decreased morale, and a failure to achieve the desired outcomes. Careful judgment is required to navigate these complexities effectively. Correct Approach Analysis: The best professional practice involves a systematic, data-driven approach to process optimization. This begins with a thorough review of existing data to identify specific areas of concern within the trauma surgery pathway. Following this, a multidisciplinary team, including surgeons, nurses, anesthesiologists, and quality improvement specialists, should collaborate to develop targeted interventions. These interventions must then be piloted, rigorously evaluated for their impact on key performance indicators (e.g., time to intervention, complication rates, patient outcomes), and refined based on the pilot data before full implementation. This approach aligns with principles of evidence-based practice and continuous quality improvement, which are foundational to patient safety and regulatory compliance in healthcare. It ensures that changes are not only well-intentioned but also effective and sustainable, minimizing disruption and maximizing positive impact. Incorrect Approaches Analysis: One incorrect approach involves immediately implementing a new, unvalidated protocol based on anecdotal evidence or a single outlier case. This fails to adhere to the principles of evidence-based practice and quality improvement. It bypasses the crucial steps of data collection, analysis, and multidisciplinary consensus, potentially introducing new risks or inefficiencies without a clear understanding of their impact. This can lead to regulatory non-compliance if the changes are not demonstrably improving patient care or safety. Another unacceptable approach is to focus solely on individual performance without examining the systemic factors contributing to variations in care. While individual accountability is important, a process optimization initiative must look at the entire system. Blaming individuals without understanding the workflow, resource availability, or communication breakdowns is counterproductive and ethically unsound. It can foster a culture of fear rather than collaboration and improvement, and it fails to address the root causes of quality and safety issues. A third flawed approach is to adopt a “best practice” from another institution without adapting it to the specific context and resources of the current trauma center. While external benchmarks are valuable, direct transplantation of protocols can be ineffective or even harmful if the underlying patient populations, available technology, or team dynamics differ significantly. This approach neglects the critical step of local validation and adaptation, which is essential for successful and safe implementation. Professional Reasoning: Professionals should employ a structured decision-making framework for process optimization. This framework should prioritize data collection and analysis to identify specific problems. Next, it should involve engaging a multidisciplinary team to brainstorm and develop potential solutions. Crucially, any proposed changes must undergo a pilot phase with clear metrics for success and a plan for rigorous evaluation. Feedback loops should be established to allow for iterative refinement of interventions. Finally, a comprehensive implementation plan, including training and ongoing monitoring, is essential for sustained improvement. This systematic approach ensures that decisions are evidence-based, collaborative, and ultimately focused on enhancing patient safety and quality of care.

Scenario Analysis: This scenario is professionally challenging because it involves a critical juncture in patient care where established protocols for trauma resuscitation are being questioned due to an unexpected outcome. The pressure to act decisively while also ensuring adherence to quality and safety standards, especially when a deviation from protocol might have contributed to a suboptimal result, requires careful judgment. Balancing immediate patient needs with the imperative for systemic learning and improvement is paramount. Correct Approach Analysis: The best professional practice involves a structured, multi-disciplinary review of the entire resuscitation process, from initial patient arrival to the point of deviation. This approach prioritizes a thorough understanding of the events, identifying specific points where protocol adherence may have faltered or where the protocol itself might have been insufficient for the unique patient presentation. This aligns with the core principles of quality improvement in healthcare, which mandate systematic analysis of adverse events or near misses to prevent recurrence. Regulatory frameworks governing trauma care emphasize continuous quality improvement and patient safety, requiring institutions to have robust mechanisms for reviewing critical incidents and implementing evidence-based changes. Ethically, this approach respects the patient’s right to receive care that is continuously evaluated for effectiveness and safety, and it upholds the professional responsibility to learn from experience. Incorrect Approaches Analysis: One incorrect approach would be to immediately attribute the suboptimal outcome solely to the attending physician’s deviation from the established protocol without further investigation. This fails to consider other potential contributing factors, such as patient-specific physiology, equipment malfunction, or communication breakdowns within the team. It bypasses the systematic review process mandated by quality improvement initiatives and could lead to unfair blame rather than constructive learning. Another incorrect approach would be to dismiss the deviation as inconsequential because the patient ultimately stabilized, focusing only on the immediate outcome rather than the process. This ignores the potential for latent system failures that, while not causing immediate harm in this instance, could lead to more severe consequences in future cases. It undermines the proactive nature of trauma quality and safety reviews, which aim to identify and mitigate risks before they result in significant harm. A third incorrect approach would be to implement a blanket policy change based on this single event without a comprehensive review. This reactive measure may not address the root cause of the issue and could inadvertently create new problems or hinder effective care in other situations. It lacks the evidence-based foundation required for meaningful process optimization and may not align with established best practices or regulatory guidance for quality improvement. Professional Reasoning: Professionals should approach such situations by first ensuring immediate patient stability. Following this, a formal, non-punitive review process should be initiated. This process should involve all relevant team members, a review of the patient’s clinical data, and an assessment of protocol adherence and potential contributing factors. The goal is to identify lessons learned and implement sustainable improvements to the trauma resuscitation protocol and its implementation, thereby enhancing overall patient care and safety.

The evaluation methodology shows a scenario that is professionally challenging due to the inherent unpredictability of complex trauma cases and the critical need for immediate, evidence-based decision-making under pressure. Managing complications requires not only deep subspecialty procedural knowledge but also a robust understanding of quality and safety frameworks to ensure patient well-being and adherence to best practices. Careful judgment is required to balance emergent needs with established protocols and to communicate effectively with the multidisciplinary team. The best professional approach involves a systematic and collaborative review of the complication, focusing on identifying the root cause through a structured debriefing process that includes all involved team members. This approach is correct because it directly aligns with principles of patient safety and continuous quality improvement mandated by regulatory bodies and professional organizations. Specifically, it fosters a non-punitive environment for learning, which is essential for identifying systemic issues rather than individual blame. This aligns with the ethical imperative to provide the highest standard of care and to learn from adverse events to prevent recurrence. Such a process encourages open communication, which is a cornerstone of effective teamwork in high-stakes medical environments. An incorrect approach would be to dismiss the complication as an unavoidable outcome without further investigation. This fails to meet the ethical obligation to scrutinize all adverse events for learning opportunities and potentially violates quality assurance mandates that require root cause analysis of significant patient safety events. Another incorrect approach is to focus solely on the individual surgeon’s performance without considering the broader system factors, such as equipment, staffing, or communication breakdowns. This is ethically problematic as it can lead to unfair blame and does not address systemic vulnerabilities that could lead to future complications. Finally, an approach that involves delaying or avoiding a formal review of the complication due to time constraints or fear of scrutiny undermines the principles of accountability and continuous improvement, which are fundamental to maintaining high standards of trauma care. Professionals should employ a decision-making framework that prioritizes patient safety and learning. This involves immediate stabilization of the patient, followed by a structured and timely review of any significant complications. This review should be multidisciplinary, non-punitive, and focused on identifying actionable insights to improve future care. Adherence to established quality improvement methodologies and open communication channels are paramount.

The efficiency study reveals a significant disparity in the scoring of trauma cases across different surgical teams, impacting the perceived quality and safety metrics. This scenario is professionally challenging because it directly affects patient care outcomes, resource allocation, and the reputation of the trauma center. It requires a nuanced understanding of quality metrics, adherence to established protocols, and transparent communication among teams. Careful judgment is required to ensure that scoring accurately reflects case complexity and outcomes without introducing bias or compromising patient safety. The best approach involves a thorough review of the scoring methodology by a multidisciplinary quality assurance committee, including trauma surgeons, quality improvement specialists, and data analysts. This committee should analyze the blueprint weighting and scoring criteria against established national trauma quality indicators and best practices. They should then propose revisions to the scoring rubric based on evidence and consensus, ensuring clarity, objectivity, and alignment with the goals of improving trauma care quality and safety. This approach is correct because it leverages expert consensus, adheres to established quality frameworks, and promotes a systematic, evidence-based revision process. It ensures that any changes to the scoring and blueprint are well-justified, transparent, and aimed at genuinely enhancing the accuracy of quality and safety assessments, thereby supporting informed decision-making regarding retake policies and resource allocation. An incorrect approach would be to unilaterally adjust the scoring weights based on anecdotal evidence or pressure from specific surgical teams. This fails to adhere to established quality frameworks and lacks the objective validation necessary for reliable quality assessment. It risks introducing bias and undermining the integrity of the quality and safety review process. Another incorrect approach would be to implement a blanket retake policy for all surgeons whose cases fall below a certain scoring threshold without investigating the root causes of the scoring disparities. This punitive measure does not address potential flaws in the scoring blueprint itself or systemic issues in data collection and reporting. It can lead to demoralization and does not foster a culture of continuous improvement. A further incorrect approach would be to ignore the scoring disparities, attributing them to inherent variations in surgical skill or case complexity without further investigation. This abdication of responsibility fails to acknowledge the potential for systemic issues in the scoring methodology or data interpretation, thereby missing opportunities to improve the overall quality and safety of trauma care. Professionals should employ a decision-making framework that prioritizes data-driven analysis, adherence to established quality standards, and collaborative problem-solving. This involves: 1) acknowledging and investigating discrepancies; 2) engaging relevant stakeholders in a transparent review process; 3) grounding any revisions in evidence and best practices; and 4) implementing changes systematically with clear communication and ongoing monitoring.

The efficiency study reveals a critical need to enhance candidate preparation for the Advanced Trauma Surgery Quality and Safety Review. This scenario is professionally challenging because the review’s effectiveness hinges on the candidates’ thorough understanding and application of complex quality and safety principles within a high-stakes surgical environment. Inadequate preparation can lead to superficial engagement with the material, a failure to identify systemic risks, and ultimately, compromised patient safety. Careful judgment is required to balance the need for comprehensive preparation with the practical constraints of busy surgical schedules. The best approach involves a structured, multi-faceted preparation strategy that integrates theoretical learning with practical application and peer engagement, allowing ample time for assimilation and reflection. This method is correct because it aligns with best practices in professional development and quality improvement initiatives. It acknowledges that mastering trauma surgery quality and safety is not merely about memorizing guidelines but about developing a critical mindset and practical skills. Regulatory frameworks, such as those promoted by professional surgical bodies and patient safety organizations, emphasize continuous learning, risk assessment, and the implementation of evidence-based practices. A phased approach, incorporating dedicated study time, case-based learning, and collaborative review sessions, ensures that candidates not only understand the material but can also apply it effectively in real-world scenarios, thereby fulfilling ethical obligations to patient care and professional standards. An approach that relies solely on a brief, last-minute review of guidelines without practical application or peer discussion is professionally unacceptable. This fails to address the depth of understanding required for advanced trauma surgery quality and safety. It neglects the ethical imperative to be fully prepared to identify and mitigate risks, potentially leading to patient harm. Such a superficial preparation method also contravenes professional development expectations that encourage a deeper, more integrated learning process. Another unacceptable approach is to delegate preparation entirely to junior team members without direct senior oversight or engagement. While delegation can be a useful tool, in this context, it abdicates the senior surgeon’s ultimate responsibility for quality and safety. It risks a disconnect between theoretical knowledge and practical implementation, and it fails to foster a culture of shared learning and accountability, which is crucial for effective quality improvement. This approach also overlooks the ethical duty of senior clinicians to mentor and ensure the competency of their teams in critical areas. Finally, an approach that prioritizes personal research and individual learning without any structured review or collaborative discussion is also professionally deficient. While individual initiative is valuable, the complexity of trauma surgery quality and safety demands a shared understanding and the identification of common challenges and solutions. Without structured review, there is a risk of misinterpretation of guidelines, a lack of exposure to diverse perspectives, and an inability to collectively address systemic issues. This isolated learning style hinders the development of a cohesive team approach to quality and safety, which is essential in a trauma setting. Professionals should adopt a decision-making framework that prioritizes a structured, comprehensive, and collaborative preparation process. This involves allocating sufficient time for learning, incorporating diverse learning modalities (reading, case studies, simulations), and fostering peer-to-peer learning and discussion. The framework should also include mechanisms for self-assessment and feedback to ensure that preparation is effective and addresses identified gaps in knowledge or skills.

Scenario Analysis: This scenario presents a professional challenge due to the inherent complexity and potential for unforeseen complications in advanced trauma surgery. The surgeon must balance the urgency of intervention with the need for meticulous preparation to minimize risks to the patient. The ethical imperative to provide the highest standard of care, coupled with the professional responsibility to anticipate and mitigate potential adverse events, necessitates a structured and comprehensive approach to operative planning. Correct Approach Analysis: The best professional practice involves a comprehensive, multi-disciplinary pre-operative planning session that includes a detailed review of imaging, patient comorbidities, and potential intraoperative challenges. This session should culminate in the development of a clear operative plan, including contingency strategies for anticipated risks such as significant bleeding, organ injury, or difficult anatomy. This approach aligns with the principles of patient safety and quality improvement, emphasizing proactive risk identification and mitigation, which are core tenets of advanced surgical practice and are implicitly supported by professional guidelines promoting evidence-based care and minimizing iatrogenic harm. Incorrect Approaches Analysis: One incorrect approach is to proceed with surgery based solely on a brief review of imaging and the surgeon’s extensive personal experience, without a formal team discussion or explicit contingency planning. This fails to adequately address the unique aspects of the current case and neglects the opportunity for collective expertise to identify potential risks. It deviates from best practices that advocate for collaborative decision-making and thorough preparation, potentially leading to unexpected complications that were not adequately prepared for. Another unacceptable approach is to delegate the detailed operative planning to junior team members without direct senior surgeon oversight and final approval. While delegation is important, critical planning for complex trauma cases requires the experience and judgment of the senior surgeon to ensure all risks are appropriately assessed and mitigation strategies are robust. This approach risks overlooking crucial details or failing to implement appropriate safeguards, compromising patient safety. A further professionally unacceptable approach is to focus primarily on the technical aspects of the primary surgical procedure, with minimal consideration for potential complications or post-operative management. Operative planning in advanced trauma surgery must be holistic, encompassing not only the immediate surgical steps but also anticipating potential intraoperative and immediate post-operative challenges and developing strategies to address them. This narrow focus ignores the interconnectedness of surgical care and the importance of anticipating the patient’s overall recovery trajectory. Professional Reasoning: Professionals should employ a systematic decision-making framework that prioritizes patient safety and optimal outcomes. This involves: 1) Thoroughly understanding the patient’s condition and all available diagnostic information. 2) Engaging in collaborative planning with the entire surgical team, leveraging diverse expertise. 3) Proactively identifying and assessing potential risks and developing specific mitigation strategies. 4) Documenting the operative plan and contingency measures. 5) Continuously evaluating and adapting the plan as new information becomes available or intraoperative circumstances change.

Scenario Analysis: This scenario is professionally challenging because it involves a critical patient outcome (death) following a complex surgical procedure, necessitating a thorough and unbiased review. The challenge lies in balancing the need for accountability and learning with the potential for defensiveness or premature judgment from the involved parties. Ensuring a fair, transparent, and evidence-based review process is paramount to maintaining trust within the surgical team and with the institution. Correct Approach Analysis: The best professional approach involves initiating a formal, multidisciplinary morbidity and mortality (M&M) conference specifically focused on the case. This conference should be conducted in a non-punitive environment, adhering to established institutional protocols for quality improvement and patient safety. The purpose is to systematically review all aspects of the patient’s care, from pre-operative assessment through post-operative management, identifying any deviations from best practices, potential system failures, or areas for improvement. This approach is correct because it aligns with the core principles of quality assurance in healthcare, emphasizing continuous learning and systemic improvement rather than individual blame. Regulatory frameworks and professional guidelines universally advocate for such structured reviews to enhance patient safety and surgical outcomes. Incorrect Approaches Analysis: Initiating an immediate, informal discussion with the lead surgeon to “understand what went wrong” without a structured review process is professionally unacceptable. This approach risks creating a defensive atmosphere, potentially leading to incomplete information gathering and a failure to identify broader systemic issues. It bypasses established quality improvement mechanisms and may not provide the objective, comprehensive analysis required. Conducting a review solely through the analysis of the operative report and immediate post-operative notes, without input from the wider care team or a formal conference, is also professionally unacceptable. This limited scope fails to capture the full patient journey, including critical nursing interventions, anaesthetic management, and the nuances of post-operative care that may have contributed to the outcome. It neglects the collaborative nature of trauma surgery and patient management. Focusing the review exclusively on identifying a single individual to blame for the adverse outcome is professionally unacceptable and ethically unsound. Trauma surgery is a complex, team-based endeavor. Adverse events often result from a confluence of factors, including system vulnerabilities, communication breakdowns, and resource limitations, not solely individual error. This approach undermines the principles of a just culture and hinders genuine learning and improvement. Professional Reasoning: Professionals should approach adverse events with a commitment to learning and improvement. The decision-making process should involve: 1) Recognizing the event as an opportunity for learning, not blame. 2) Activating established institutional protocols for adverse event review. 3) Ensuring a multidisciplinary approach involving all relevant care providers. 4) Maintaining a non-punitive environment to encourage open and honest reporting. 5) Focusing on identifying system-level factors and actionable recommendations for future prevention.

Scenario Analysis: This scenario presents a professional challenge due to the inherent risks associated with advanced trauma surgery, specifically the potential for unintended tissue injury from energy devices. The surgeon must balance the need for effective hemostasis and tissue dissection with the imperative to minimize collateral damage and ensure patient safety. The choice of energy device and its application technique directly impacts operative outcomes and patient safety, requiring meticulous judgment and adherence to established protocols. Correct Approach Analysis: The best professional practice involves a systematic approach to energy device selection and application, prioritizing patient safety and operative efficacy. This includes pre-operative planning to anticipate tissue types and bleeding risks, selecting the appropriate energy device and mode based on these considerations, and employing meticulous surgical technique to minimize thermal spread and unintended injury. This approach aligns with the fundamental ethical principle of non-maleficence (do no harm) and the professional responsibility to provide the highest standard of care. Regulatory guidelines, such as those promoted by surgical quality organizations, emphasize the importance of understanding and appropriately utilizing surgical technologies to prevent adverse events. Incorrect Approaches Analysis: Utilizing a high-power setting on an energy device for all tissue types without considering the specific characteristics of the tissue or the potential for thermal spread represents a failure to adhere to best practices. This can lead to excessive thermal damage to adjacent structures, increasing the risk of complications such as fistulas, delayed healing, or nerve injury. Such an approach disregards the principle of using the least invasive and safest effective method. Employing an energy device with a broad cutting or coagulation field without precise control, especially in close proximity to vital structures or delicate tissues, is also professionally unacceptable. This lack of precision increases the likelihood of unintended thermal injury to unintended tissues, violating the duty of care and potentially leading to significant patient harm. Failing to adequately assess the surgical field for potential hazards, such as the presence of flammable materials or the proximity of critical anatomical structures, before activating an energy device demonstrates a lapse in due diligence. This oversight can result in catastrophic complications, including fires or inadvertent damage to nerves, blood vessels, or organs, directly contravening the core tenets of patient safety and professional responsibility. Professional Reasoning: Professionals should adopt a decision-making framework that prioritizes patient safety through a thorough understanding of surgical technologies and their potential risks. This involves a continuous learning process, adherence to institutional protocols, and a commitment to evidence-based practice. When faced with choices regarding energy device use, surgeons should ask: What is the specific tissue I need to manipulate? What is the risk of thermal injury to adjacent structures? Which energy device and setting offer the most precise and safest control for this specific task? Is there a safer alternative? This systematic evaluation ensures that the chosen method aligns with the principles of beneficence and non-maleficence.