Scenario Analysis: This scenario presents a common challenge in operative orthopaedic trauma surgery: managing intraoperative bleeding during a complex fracture fixation. The professional challenge lies in balancing the immediate need to control hemorrhage to ensure patient safety and surgical progress with the imperative to utilize energy devices in a manner that minimizes iatrogenic injury and adheres to established safety protocols. The surgeon must make rapid, informed decisions under pressure, considering the potential risks and benefits of different energy device settings and techniques. Careful judgment is required to select the most appropriate method that is both effective and safe, preventing complications such as thermal damage to vital structures or inadequate haemostasis. Correct Approach Analysis: The best professional practice involves a systematic, stepwise approach to haemostasis, prioritizing patient safety and tissue preservation. This begins with direct pressure and appropriate haemostatic agents. When an energy device is deemed necessary, the surgeon should utilize the lowest effective setting for the shortest duration required to achieve haemostasis, employing a precise application technique. This approach minimizes thermal spread and collateral tissue damage, aligning with the principles of patient care and the manufacturer’s guidelines for energy device use. Regulatory bodies and professional guidelines emphasize the importance of using energy devices judiciously and safely, focusing on minimizing harm. This approach directly addresses the immediate surgical need while upholding the ethical obligation to “do no harm.” Incorrect Approaches Analysis: Utilizing the highest energy setting without prior attempts at direct pressure or haemostatic agents is professionally unacceptable. This approach risks significant thermal damage to surrounding tissues, including nerves, vessels, and bone, potentially leading to delayed healing, increased pain, or functional deficits. It demonstrates a failure to follow best practices for energy device management and a disregard for patient safety. Employing a broad, sweeping application of the energy device across the bleeding area without precise targeting is also professionally unsound. This indiscriminate use increases the area of thermal injury, potentially damaging healthy tissue and compromising the overall surgical outcome. It fails to adhere to the principle of precise application, which is crucial for effective and safe haemostasis with energy devices. Ignoring the bleeding and proceeding with fracture fixation without adequate haemostasis is a critical failure in professional judgment and patient care. Uncontrolled bleeding can lead to haemodynamic instability, requiring blood transfusions, increasing operative time, and elevating the risk of infection and other complications. This approach directly violates the fundamental duty to ensure patient safety and achieve adequate surgical conditions before proceeding with definitive treatment. Professional Reasoning: Professionals faced with intraoperative bleeding should employ a structured decision-making process. First, assess the severity and source of bleeding. Second, attempt non-energy-based haemostatic methods (direct pressure, haemostatic agents). Third, if energy devices are necessary, select the appropriate device and utilize the lowest effective setting for the shortest duration, with precise application. Fourth, continuously reassess the effectiveness of the chosen method and be prepared to adapt the strategy if bleeding persists or complications arise. This systematic approach, grounded in patient safety and adherence to established protocols, is paramount.

The control framework reveals the critical importance of understanding the purpose and eligibility criteria for advanced practice examinations in specialized fields like orthopaedic trauma surgery. This scenario is professionally challenging because misinterpreting or misapplying these foundational requirements can lead to significant professional setbacks, including wasted time, financial loss, and damage to one’s career trajectory. Careful judgment is required to ensure alignment with the examination’s stated objectives and the governing body’s standards. The best professional practice involves a thorough and proactive review of the official examination documentation, including purpose statements, eligibility prerequisites, and any associated guidelines published by the examination’s governing body. This approach ensures that an applicant possesses a clear and accurate understanding of what the examination aims to assess and whether their qualifications and experience meet the defined standards. Regulatory justification lies in adhering to the established pathways for professional advancement, which are designed to maintain standards of competence and patient safety. Ethically, it demonstrates diligence and respect for the examination process and the profession. An incorrect approach involves making assumptions about eligibility based on anecdotal evidence or the requirements of similar, but distinct, examinations. This fails to acknowledge the specific mandates of the Applied Global Orthopaedic Trauma Surgery Advanced Practice Examination and can lead to an applicant pursuing a path for which they are not qualified, thereby wasting resources and potentially facing disqualification. This approach violates the principle of due diligence and can be seen as a lack of professional integrity in preparing for a high-stakes assessment. Another incorrect approach is to focus solely on the perceived “advanced” nature of one’s current practice without verifying if that practice directly aligns with the specific competencies and knowledge domains targeted by the examination. The purpose of such examinations is not merely to recognize seniority but to validate a specific set of advanced skills and knowledge relevant to the defined scope of practice. Failing to confirm this alignment means an applicant might be overqualified in some areas and underqualified in others, leading to an unsuccessful outcome and a misunderstanding of the examination’s intent. This demonstrates a failure to critically self-assess against objective criteria. A further incorrect approach is to prioritize the acquisition of additional clinical experience without first confirming that this experience directly addresses any potential gaps identified after a thorough review of the examination’s purpose and eligibility. While experience is crucial, it must be targeted and relevant to the examination’s specific requirements. Pursuing experience that does not directly contribute to meeting the stated eligibility criteria is inefficient and misaligned with the examination’s purpose, which is to assess a defined level of advanced practice in orthopaedic trauma surgery. The professional decision-making framework for similar situations should begin with a commitment to understanding the explicit requirements of any professional examination or certification. This involves actively seeking out and meticulously reviewing official documentation from the governing body. Applicants should then engage in honest self-assessment against these criteria, seeking clarification from the examination administrators if any ambiguities exist. Finally, any further professional development or experience acquisition should be strategically planned to directly address identified eligibility requirements and align with the examination’s stated purpose.

Scenario Analysis: This scenario presents a significant professional challenge due to the inherent tension between advancing surgical techniques and ensuring patient safety and resource allocation within a publicly funded healthcare system. The surgeon must balance the potential for improved patient outcomes with the ethical obligation to utilize resources judiciously and transparently, especially when a novel, unproven technique is considered. The lack of robust comparative data and the potential for unforeseen complications necessitate a rigorous evaluation process that prioritizes evidence-based practice and patient well-being over individual enthusiasm for innovation. Correct Approach Analysis: The best professional practice involves a comprehensive, multi-faceted evaluation that prioritizes patient safety, evidence generation, and ethical resource stewardship. This approach begins with a thorough literature review to identify any existing evidence, however limited, for the proposed technique. It then necessitates a formal proposal to the relevant institutional review board (IRB) or ethics committee, outlining the rationale, potential risks and benefits, patient selection criteria, and a plan for data collection and analysis. Collaboration with experienced colleagues and the establishment of a clear protocol for informed consent are paramount. This systematic process ensures that any deviation from standard care is carefully scrutinized, ethically sound, and contributes to the broader body of medical knowledge, aligning with principles of beneficence, non-maleficence, and justice. Incorrect Approaches Analysis: Proposing the technique directly to patients without prior institutional review or ethical committee approval represents a significant ethical failure. It bypasses essential safeguards designed to protect vulnerable individuals and undermines the principle of informed consent by not fully disclosing the experimental nature of the intervention and the lack of established safety and efficacy data. This approach prioritizes the surgeon’s desire to innovate over patient welfare and institutional oversight. Implementing the technique on a small number of patients without a formal research protocol or IRB approval, even with the intention of gathering preliminary data, is ethically problematic. While seemingly a step towards evidence generation, it lacks the rigorous methodology required for valid scientific inquiry and fails to provide adequate oversight for patient safety. This approach risks exposing patients to unvalidated risks without the structured protections afforded by ethical review and approved research protocols. Advocating for the technique based solely on anecdotal experience and personal conviction, without presenting a structured proposal for evaluation or seeking ethical approval, is professionally irresponsible. This approach relies on subjective interpretation rather than objective evidence and fails to acknowledge the need for systematic validation and peer review before widespread adoption, thereby potentially exposing patients to unproven and potentially harmful interventions. Professional Reasoning: Professionals should adopt a decision-making framework that prioritizes patient safety and ethical conduct. This involves a commitment to evidence-based practice, rigorous evaluation of new techniques, and adherence to institutional policies and ethical guidelines. When considering novel interventions, a structured approach involving literature review, ethical review board consultation, development of a clear protocol, robust informed consent, and systematic data collection is essential. This ensures that innovation is pursued responsibly, with the ultimate goal of improving patient care while upholding the highest ethical standards.

This scenario presents a professional challenge due to the critical nature of trauma resuscitation, where rapid and accurate decision-making directly impacts patient outcomes. The need to balance immediate life-saving interventions with comprehensive assessment and adherence to established protocols requires significant clinical judgment. Misapplication of protocols can lead to delayed or inappropriate care, potentially causing irreversible harm. The best professional approach involves a systematic and evidence-based resuscitation strategy that prioritizes immediate life threats while concurrently gathering essential information. This approach begins with a rapid primary survey (Airway, Breathing, Circulation, Disability, Exposure – ABCDE) to identify and manage immediate life-threatening injuries. Concurrently, initiating appropriate fluid resuscitation and blood product transfusion based on clinical signs of shock and haemorrhage is paramount. This is supported by established trauma guidelines, such as those from the Advanced Trauma Life Support (ATLS) program, which emphasize a structured approach to patient assessment and management in the initial critical minutes. Ethical considerations also mandate providing the highest standard of care, which includes following best practices to maximize the chances of survival and recovery. An incorrect approach would be to delay definitive management of circulatory collapse while focusing solely on obtaining detailed patient history or performing extensive diagnostic imaging before addressing obvious signs of shock. This deviates from the urgency required in trauma resuscitation and risks exacerbating hypovolemic shock, potentially leading to organ damage or death. Such a delay would be ethically questionable as it prioritizes less critical information over immediate life-saving interventions. Another incorrect approach would be to administer large volumes of crystalloid fluid without considering the potential for haemodilution and worsening coagulopathy, especially in the context of suspected massive haemorrhage. While fluid resuscitation is crucial, the type and volume must be guided by ongoing assessment and the potential need for blood products, as outlined in modern trauma resuscitation protocols that advocate for early balanced resuscitation. Failure to consider blood products early in significant haemorrhage is a failure to adhere to best practice. Finally, an incorrect approach would be to proceed with invasive procedures or diagnostic tests without a clear indication or without having established basic circulatory support. This could divert valuable resources and time away from addressing the most critical issues, such as haemorrhage control and oxygenation, and may not be justified in the initial resuscitation phase. Professionals should employ a decision-making framework that prioritizes the ABCDE assessment, integrates immediate interventions with ongoing evaluation, and adheres to established trauma resuscitation protocols. This involves continuous reassessment of the patient’s physiological status and a willingness to adapt the management plan based on new information and the patient’s response to treatment.

Scenario Analysis: This scenario is professionally challenging due to the potential for significant patient harm, the need for rapid and accurate decision-making under pressure, and the ethical imperative to act in the patient’s best interest while adhering to established best practices and professional guidelines. Managing a post-operative complication like a deep vein thrombosis (DVT) in a patient who has undergone complex orthopaedic trauma surgery requires a multidisciplinary approach and a thorough understanding of both surgical outcomes and medical management protocols. The urgency of the situation, coupled with the potential for serious sequelae such as pulmonary embolism, necessitates a systematic and evidence-based response. Correct Approach Analysis: The best professional practice involves immediate, comprehensive assessment and prompt initiation of evidence-based anticoagulation therapy. This approach prioritizes patient safety by directly addressing the life-threatening complication. It aligns with established clinical guidelines for DVT management, which emphasize early diagnosis and treatment to prevent further clot propagation and reduce the risk of embolism. Ethically, this approach fulfills the duty of care owed to the patient by acting decisively to mitigate harm. Regulatory frameworks governing medical practice universally support the use of evidence-based treatments for diagnosed conditions. Incorrect Approaches Analysis: Initiating conservative management with elevation and compression without pharmacological intervention fails to address the underlying thrombotic process adequately and carries a significant risk of clot progression and embolism, violating the duty of care. This approach is ethically unsound as it delays necessary treatment for a potentially fatal condition. Consulting with the orthopaedic surgeon for a second opinion before initiating anticoagulation, while collaboration is important, introduces an unnecessary delay in a time-sensitive situation where the diagnosis of DVT is already established. This delay could lead to adverse patient outcomes and is not in line with urgent medical management protocols. Discharging the patient with oral anticoagulation instructions without direct supervision or a clear follow-up plan for monitoring and management is a significant breach of professional responsibility. It fails to ensure adequate patient safety and adherence to treatment, potentially leading to under-treatment or complications from anticoagulation itself. This approach neglects the critical need for ongoing medical oversight in managing a serious condition like DVT. Professional Reasoning: Professionals should adopt a systematic approach to managing post-operative complications. This involves: 1) Rapidly assessing the patient’s clinical status and confirming the diagnosis using appropriate diagnostic tools. 2) Consulting relevant clinical guidelines and evidence-based protocols for the specific complication. 3) Prioritizing immediate, life-saving interventions. 4) Ensuring clear communication and collaboration within the multidisciplinary team. 5) Establishing a robust follow-up plan to monitor treatment efficacy and patient progress. This framework ensures that patient care is both timely and effective, minimizing risks and optimizing outcomes.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for consistent and fair assessment with the practical realities of candidate performance and the integrity of the examination process. The examination board must uphold the rigorous standards of advanced practice in orthopaedic trauma surgery while also providing a transparent and equitable pathway for candidates who may require a second attempt. The weighting and scoring blueprint is the foundation of this assessment, and deviations can undermine its validity. Retake policies, while necessary for candidate progression, must be clearly defined and applied without bias to maintain the credibility of the qualification. Correct Approach Analysis: The best professional practice involves strictly adhering to the established blueprint weighting and scoring criteria for all candidates, including those retaking the examination. This approach ensures that the assessment remains objective, valid, and reliable. The blueprint, developed through expert consensus, defines the relative importance of different domains and competencies, and any deviation would compromise the comparability of results. Retake policies, when clearly communicated and applied consistently, provide a structured and fair opportunity for candidates to demonstrate mastery without compromising the examination’s integrity. This aligns with the principles of fair assessment and professional accountability. Incorrect Approaches Analysis: One incorrect approach involves adjusting the scoring or weighting of specific sections for a retaking candidate based on perceived weaknesses from their previous attempt. This is ethically problematic as it introduces subjectivity and bias into the assessment process, undermining the standardized nature of the examination. It fails to acknowledge that the blueprint represents the agreed-upon standard for all candidates, regardless of prior performance. Another incorrect approach is to allow a retake candidate to bypass certain sections of the examination if they performed well in those areas previously. This violates the principle of comprehensive assessment. The examination is designed to evaluate a candidate’s current competency across all required domains, and a retake signifies a need to demonstrate this competency anew. Ignoring sections would create an incomplete and potentially misleading evaluation. A further incorrect approach is to implement a retake policy that is not clearly defined or communicated to candidates prior to the examination. This lack of transparency is unfair and can lead to confusion and distrust in the examination process. Candidates must understand the conditions under which a retake is permitted, the format of the retake, and how their performance will be evaluated, all of which should be based on the original blueprint. Professional Reasoning: Professionals should approach examination administration with a commitment to fairness, objectivity, and transparency. When faced with decisions regarding scoring, weighting, and retakes, the primary guiding principle should be the integrity and validity of the assessment. This involves: 1) Upholding the established blueprint as the definitive standard for all candidates. 2) Ensuring that retake policies are clearly documented, communicated, and applied consistently and equitably. 3) Prioritizing objective evaluation over subjective judgment. 4) Maintaining open communication with candidates regarding assessment procedures and outcomes.

This scenario presents a common challenge in advanced orthopaedic trauma surgery: balancing the imperative for timely intervention with the need for meticulous, risk-mitigating operative planning. The professional challenge lies in the inherent unpredictability of complex trauma, the potential for catastrophic complications, and the ethical obligation to provide the highest standard of care while managing finite resources and team capacity. Careful judgment is required to ensure that the operative plan is not only technically sound but also ethically defensible and compliant with professional standards. The best professional practice involves a comprehensive, multi-disciplinary pre-operative assessment and planning phase that explicitly identifies and addresses potential risks. This approach prioritizes patient safety by ensuring all relevant stakeholders (surgeons, anaesthetists, nursing staff, allied health professionals) are involved in a structured discussion. It includes a thorough review of imaging, patient comorbidities, and potential intra-operative challenges, leading to the development of contingency plans for anticipated complications. This aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as professional guidelines that mandate thorough preparation and risk assessment for surgical procedures. An approach that relies solely on the senior surgeon’s experience without formal team input or documented risk assessment is professionally unacceptable. This fails to leverage the collective expertise of the surgical team, potentially overlooking critical details or alternative perspectives. It also lacks the transparency and accountability expected in modern healthcare, making it difficult to justify decisions if adverse events occur. Furthermore, it may contravene professional guidelines that emphasize collaborative decision-making and evidence-based practice. Another professionally unacceptable approach is to proceed with surgery based on a preliminary assessment, deferring detailed planning to the intra-operative period. This significantly increases the risk of unexpected complications and delays, potentially compromising patient outcomes. It demonstrates a failure to adequately prepare and anticipate challenges, which is contrary to the principles of prudent surgical practice and patient safety. Such an approach could be seen as a breach of the duty of care owed to the patient. Finally, an approach that prioritizes speed of intervention over thoroughness of planning, assuming that experience will compensate for a lack of detailed preparation, is also professionally unsound. While efficiency is important, it should not come at the expense of patient safety. This approach neglects the systematic identification and mitigation of risks, which is a cornerstone of safe surgical practice. It may also lead to suboptimal outcomes due to unforeseen technical difficulties or complications that could have been anticipated and planned for. Professionals should employ a decision-making framework that begins with a thorough understanding of the patient’s condition and the specific injury. This should be followed by a structured pre-operative planning session involving the entire surgical team, where potential risks are identified, discussed, and mitigation strategies are developed. This process should be documented and communicated to all involved. Contingency plans should be in place for anticipated complications, and the team should be prepared to adapt the plan based on intra-operative findings while maintaining a focus on patient safety and optimal outcomes.

Scenario Analysis: This scenario presents a common challenge for advanced practice professionals preparing for high-stakes examinations like the Applied Global Orthopaedic Trauma Surgery Advanced Practice Examination. The core difficulty lies in balancing comprehensive preparation with efficient resource utilization and a realistic timeline, especially given the demanding nature of advanced surgical practice. Failure to adequately prepare can lead to suboptimal performance, impacting career progression and patient care standards. Conversely, inefficient preparation can detract from clinical duties and personal well-being. Careful judgment is required to select a preparation strategy that is both effective and sustainable. Correct Approach Analysis: The best approach involves a structured, multi-modal preparation strategy that begins well in advance of the examination date. This includes systematically reviewing core orthopaedic trauma principles, engaging with current literature and guidelines relevant to advanced practice, and utilizing practice questions that simulate the examination format and difficulty. A recommended timeline would involve dedicating consistent, focused study blocks over several months, rather than cramming. This approach ensures deep understanding and retention of complex concepts, aligning with the professional expectation of continuous learning and competence in advanced surgical practice. While no specific regulatory body dictates examination preparation timelines, the ethical imperative to maintain and enhance professional competence, as often underscored by professional bodies and revalidation requirements, supports this method. Incorrect Approaches Analysis: Relying solely on informal discussions with colleagues and a last-minute review of lecture notes is professionally inadequate. This approach lacks structure, may perpetuate misinformation, and fails to cover the breadth and depth of knowledge required for an advanced practice examination. It neglects the professional responsibility to engage with evidence-based practice and established learning resources. Focusing exclusively on memorizing answers to past examination questions, if available, without understanding the underlying principles, is also a flawed strategy. This method does not foster true comprehension or the ability to apply knowledge to novel clinical scenarios, which is a hallmark of advanced practice. It bypasses the ethical obligation to develop a robust understanding of the subject matter. Prioritizing clinical duties to the complete exclusion of dedicated examination preparation until the final weeks is unrealistic and potentially detrimental. While clinical experience is invaluable, it is not a substitute for targeted academic preparation. This approach risks burnout and inadequate knowledge acquisition, failing to meet the professional standard of being fully prepared for assessment. Professional Reasoning: Professionals preparing for advanced examinations should adopt a proactive and systematic approach. This involves: 1) Understanding the examination syllabus and format thoroughly. 2) Developing a realistic study schedule that allocates sufficient time for each topic. 3) Employing a variety of high-quality preparation resources, including textbooks, peer-reviewed journals, and reputable online learning platforms. 4) Regularly assessing progress through practice questions and self-testing. 5) Seeking feedback and support from mentors or study groups. This structured methodology ensures comprehensive coverage, deep understanding, and confidence, reflecting the commitment to excellence expected in advanced surgical practice.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the perceived best interests of the patient, especially when the patient’s capacity to make such decisions is in question. Navigating this requires a delicate balance of respecting patient autonomy while upholding the duty of care and adhering to professional ethical guidelines and relevant legislation. The core of the challenge lies in assessing and respecting patient capacity, ensuring informed consent, and acting in the patient’s best interests when capacity is compromised. The best professional approach involves a systematic and documented assessment of the patient’s capacity to make decisions regarding their orthopaedic trauma surgery. This includes clearly explaining the proposed treatment, its risks, benefits, and alternatives in a way the patient can understand, and then assessing their ability to comprehend this information and make a reasoned choice. If capacity is confirmed, their informed consent must be respected, even if it differs from the clinician’s recommendation. This aligns with the fundamental ethical principles of autonomy and beneficence, and is supported by legislation that mandates respect for patient autonomy and the requirement for informed consent for medical interventions. The process must be thoroughly documented to demonstrate due diligence and adherence to professional standards. An approach that proceeds with surgery based solely on the surgeon’s belief that it is in the patient’s best interest, without a formal capacity assessment and informed consent, is ethically and legally unacceptable. This disregards the principle of patient autonomy and the legal requirement for consent. Similarly, proceeding with surgery after a cursory discussion without verifying the patient’s understanding or ability to make a reasoned decision fails to meet the standards of informed consent and capacity assessment, potentially leading to a breach of professional duty. Lastly, deferring the decision entirely to the patient’s family without a robust assessment of the patient’s own capacity and wishes, even if the patient appears to be struggling, is also professionally unsound. While family input is valuable, the primary decision-maker, if capable, is the patient. Failure to engage in a thorough, patient-centred capacity assessment and consent process constitutes a significant ethical and regulatory failure. Professionals should employ a structured decision-making process that prioritizes patient-centred care. This involves: 1) assessing the patient’s capacity to make the specific decision at hand; 2) if capacity is present, ensuring the patient receives comprehensive information to provide informed consent; 3) if capacity is lacking, involving appropriate surrogate decision-makers while still prioritizing the patient’s known wishes and best interests, as determined through available evidence and consultation; and 4) meticulously documenting all assessments, discussions, and decisions.

This scenario presents a professional challenge due to the inherent risks associated with advanced orthopaedic trauma surgery and the critical need for precise anatomical knowledge to ensure patient safety and optimal outcomes. The perioperative period demands meticulous planning and execution, where even minor anatomical misinterpretations can lead to significant complications, including nerve damage, vascular injury, malunion, nonunion, or infection. The surgeon’s responsibility extends beyond the operative field to encompass the entire patient journey, requiring a comprehensive understanding of physiological responses to trauma and surgical intervention. The best professional practice involves a systematic and evidence-based approach to perioperative management, prioritizing patient safety and adherence to established surgical principles. This includes a thorough preoperative assessment, detailed surgical planning that accounts for individual patient anatomy and injury patterns, and the application of advanced imaging and intraoperative navigation techniques where appropriate. Postoperatively, it necessitates vigilant monitoring of physiological parameters, proactive pain management, early mobilization, and diligent wound care, all guided by an understanding of the underlying pathophysiology of trauma and healing. This approach aligns with the ethical obligations of beneficence and non-maleficence, ensuring that all actions taken are in the best interest of the patient and minimize potential harm. It also reflects the professional standard of care expected in advanced orthopaedic trauma surgery. An incorrect approach would be to rely solely on a generalized anatomical understanding without considering the specific variations presented by the patient’s trauma. This could lead to an inadequate surgical plan, increasing the risk of iatrogenic injury or suboptimal fracture reduction. Another unacceptable approach would be to neglect comprehensive perioperative physiological monitoring, potentially missing early signs of complications such as compartment syndrome or systemic inflammatory response syndrome, thereby delaying critical interventions. Furthermore, a failure to document and communicate the surgical findings and postoperative plan effectively to the multidisciplinary team would represent a breach of professional responsibility, hindering coordinated patient care and increasing the likelihood of errors. Professionals should employ a decision-making framework that begins with a comprehensive understanding of the patient’s unique anatomy and physiology in the context of their specific trauma. This should be followed by a detailed review of relevant imaging, consideration of established surgical techniques and their potential complications, and a proactive plan for perioperative care. Continuous reassessment of the patient’s condition and adaptation of the plan based on real-time physiological data and surgical findings are paramount. Ethical considerations, including informed consent and the principle of “do no harm,” must guide every decision.