The scenario presents a professional challenge stemming from a potential conflict between a fellowship candidate’s personal circumstances and the established eligibility criteria for the Critical Latin American Sports and Exercise Medicine Fellowship Exit Examination. Careful judgment is required to ensure fairness, uphold the integrity of the examination process, and adhere to the fellowship’s governing principles. The best professional approach involves a thorough and objective review of the candidate’s situation against the explicitly stated eligibility requirements. This entails gathering all necessary documentation, consulting the fellowship’s official guidelines, and potentially seeking clarification from the examination board or relevant administrative body if ambiguities exist. This approach is correct because it prioritizes adherence to established rules and procedures, ensuring a consistent and equitable application of eligibility criteria for all candidates. It upholds the integrity of the fellowship by preventing arbitrary exceptions and maintaining a clear standard for entry into the exit examination. This aligns with ethical principles of fairness and transparency in professional assessments. An incorrect approach would be to grant an exception based solely on the candidate’s personal narrative without a rigorous assessment of whether their situation genuinely meets the spirit and letter of the eligibility criteria. This could lead to a perception of favoritism and undermine the credibility of the fellowship. Ethically, it fails to treat all candidates equally and could set a precedent for future deviations from established standards. Another incorrect approach would be to dismiss the candidate’s request outright without any form of review or consideration. This demonstrates a lack of empathy and a failure to engage with the candidate’s circumstances, even if ultimately the outcome is that they do not meet the criteria. It risks alienating potential future fellows and could be perceived as an overly rigid and unsupportive administrative stance, potentially violating principles of good governance and professional courtesy. A further incorrect approach would be to delegate the decision-making entirely to a junior administrator without providing clear guidance or oversight. This abdicates responsibility and increases the risk of an inconsistent or improperly justified decision. It fails to ensure that the decision is made with the necessary understanding of the fellowship’s objectives and regulatory framework, potentially leading to errors in judgment and a breach of due diligence. The professional decision-making process for similar situations should involve a structured approach: first, clearly identify the relevant rules and guidelines; second, objectively assess the candidate’s situation against these criteria; third, if necessary, seek clarification or guidance from appropriate authorities; fourth, make a well-reasoned decision based on the evidence and established procedures; and finally, communicate the decision clearly and professionally to the candidate.

Scenario Analysis: This scenario presents a professional challenge due to the inherent uncertainty in interpreting diagnostic imaging, especially when initial findings are equivocal and patient symptoms persist. The physician must balance the need for accurate diagnosis and effective treatment with the ethical imperative to avoid unnecessary procedures and associated risks, costs, and patient anxiety. This requires a systematic approach to diagnostic reasoning and careful consideration of imaging selection and interpretation workflows, adhering to established medical standards and ethical principles. Correct Approach Analysis: The best professional practice involves a systematic, multi-step approach to diagnostic reasoning. This begins with a thorough clinical assessment, including a detailed history and physical examination, to formulate a differential diagnosis. Based on this, the physician selects the most appropriate initial imaging modality, considering its diagnostic yield, cost-effectiveness, and potential risks. If the initial imaging is inconclusive, the next step is to consult with a radiologist or specialist for a second opinion or to discuss further imaging options. This collaborative approach ensures that all available clinical information is integrated with the imaging findings, leading to a more accurate diagnosis and a tailored management plan. This aligns with ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as it prioritizes evidence-based decision-making and minimizes unnecessary interventions. Incorrect Approaches Analysis: Proceeding with a more invasive diagnostic procedure without further imaging consultation or a refined differential diagnosis is ethically problematic. It risks exposing the patient to unnecessary complications, increased costs, and potential delays in definitive treatment if the invasive procedure is not guided by a more precise diagnostic hypothesis. This approach fails to uphold the principle of non-maleficence by potentially causing harm without a clear indication. Ordering a battery of advanced imaging tests without a clear clinical rationale or prior consultation with a radiologist is also professionally unacceptable. This approach can lead to significant financial burdens for the patient and the healthcare system, and may generate incidental findings that cause further anxiety and unnecessary investigations. It demonstrates a lack of efficient diagnostic reasoning and disregards the principle of resource stewardship. Relying solely on the initial imaging report without considering the persistent clinical symptoms or seeking further expert opinion is a failure of due diligence. The physician has a responsibility to integrate all available information, including the patient’s ongoing clinical presentation, with imaging findings. Ignoring persistent symptoms in favor of a potentially incomplete or misinterpreted initial report can lead to misdiagnosis and delayed or inappropriate treatment, violating the principle of beneficence. Professional Reasoning: Professionals should employ a structured diagnostic reasoning process. This involves: 1) Comprehensive data gathering (history, physical exam). 2) Formulation of a broad differential diagnosis. 3) Prioritization of the differential based on likelihood and severity. 4) Selection of appropriate diagnostic tests (imaging, labs) based on the prioritized differential, considering yield, risk, and cost. 5) Critical interpretation of test results in the context of the clinical picture. 6) Consultation with specialists when uncertainty exists. 7) Reassessment and refinement of the diagnosis and treatment plan based on new information.

Scenario Analysis: This scenario presents a professional challenge stemming from a potential conflict of interest and the obligation to maintain patient confidentiality while also ensuring the safety and well-being of the broader sporting community. The physician’s duty to their patient must be balanced against their responsibility to uphold ethical standards and potentially prevent harm to others, especially in a competitive environment where performance can be influenced by undisclosed medical conditions. Careful judgment is required to navigate these competing obligations without compromising professional integrity or patient trust. Correct Approach Analysis: The best professional practice involves a direct, confidential discussion with the patient about the implications of their condition for their participation in the upcoming competition and the potential risks to themselves and others. This approach prioritizes patient autonomy and confidentiality while fulfilling the physician’s duty of care. The physician should clearly explain the medical risks, the ethical considerations of competing with an undisclosed condition, and the potential consequences of not disclosing. This conversation should aim to persuade the patient to withdraw voluntarily or disclose their condition to the relevant authorities. This aligns with the fundamental ethical principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and respect for autonomy. It also adheres to professional guidelines that emphasize open communication and shared decision-making with patients. Incorrect Approaches Analysis: One incorrect approach involves immediately reporting the patient’s condition to the sporting authorities without a prior discussion with the patient. This action breaches patient confidentiality, a cornerstone of the physician-patient relationship, and can erode trust, potentially discouraging patients from seeking medical advice in the future. It bypasses the opportunity for patient education and shared decision-making, undermining their autonomy. Another incorrect approach is to do nothing, assuming the patient will make the right decision or that the condition is not serious enough to warrant intervention. This passive stance fails to uphold the physician’s duty of care to both the patient and the wider sporting community. It ignores the potential for harm that could arise from the patient competing with an undisclosed condition, thereby violating the principle of non-maleficence. A third incorrect approach is to inform the patient’s coach or team management without the patient’s explicit consent. While seemingly aimed at ensuring safety, this also constitutes a breach of confidentiality. The coach or team management are not medical professionals and may not have the appropriate context or understanding to handle the information ethically or effectively, potentially leading to undue pressure on the athlete or discriminatory practices. Professional Reasoning: Professionals facing such dilemmas should first identify the core ethical principles at play: patient confidentiality, beneficence, non-maleficence, and autonomy. The decision-making process should involve a thorough assessment of the risks and benefits of each potential course of action. Prioritizing open and honest communication with the patient, exploring their understanding of the situation, and collaboratively seeking a resolution that respects their rights while safeguarding others is paramount. If the patient remains unwilling to act responsibly, the physician must then consider their professional obligations to report or take other appropriate steps, always aiming to minimize harm and uphold ethical standards.

The assessment process reveals a common yet complex ethical dilemma faced by sports and exercise medicine professionals: balancing patient autonomy, evidence-based practice, and the potential for harm when a patient’s beliefs or preferences diverge from established medical consensus. This scenario is professionally challenging because it requires the clinician to navigate a situation where a patient, who is an athlete, is requesting a treatment that lacks robust scientific evidence for efficacy and may carry potential risks, while simultaneously adhering to ethical principles of informed consent, beneficence, and non-maleficence. Careful judgment is required to ensure the athlete receives appropriate care without compromising their well-being or the integrity of medical practice. The best professional approach involves a thorough, evidence-based discussion with the athlete regarding the proposed treatment. This includes clearly communicating the current scientific understanding of the treatment’s efficacy, detailing the potential benefits and risks based on available evidence (or lack thereof), and exploring alternative, evidence-based treatment options that align with the athlete’s goals. The clinician must empower the athlete to make an informed decision by providing them with all necessary information, respecting their right to choose, even if that choice differs from the clinician’s recommendation, provided it does not lead to significant harm. This aligns with the ethical principle of patient autonomy and the regulatory requirement for informed consent, ensuring the athlete understands the implications of their decision. An approach that involves dismissing the athlete’s request outright without a comprehensive discussion is professionally unacceptable. This fails to respect the athlete’s autonomy and their right to explore treatment options, potentially damaging the patient-clinician relationship. It also neglects the ethical duty of beneficence, as the clinician is not fully exploring the athlete’s concerns or potential avenues for improvement, even if those avenues are unconventional. Another professionally unacceptable approach is to agree to administer the unproven treatment without adequately informing the athlete of its experimental nature and potential risks. This violates the principle of non-maleficence by exposing the athlete to potential harm without their full understanding and consent. It also contravenes ethical guidelines that mandate transparency and honesty in medical practice. Finally, proceeding with the treatment solely based on the athlete’s insistence, without a robust discussion of evidence and alternatives, demonstrates a failure to uphold the clinician’s responsibility to provide evidence-based care. While patient preference is important, it cannot supersede the clinician’s duty to ensure that treatments are grounded in scientific validity and are unlikely to cause harm. The professional reasoning framework for such situations should involve a systematic approach: first, actively listen to and understand the patient’s request and underlying concerns. Second, critically appraise the available evidence for the requested treatment, acknowledging any gaps or limitations. Third, engage in a shared decision-making process, presenting evidence-based options and discussing the pros and cons of each, including the requested treatment. Fourth, document the discussion thoroughly, including the information provided and the patient’s final decision. Finally, continuously reassess the patient’s condition and response to any chosen treatment.

This scenario presents a significant ethical challenge for a sports physician due to the inherent conflict between patient confidentiality, the athlete’s right to privacy, and the potential for harm to the athlete and the integrity of the competition. The physician must navigate these competing interests with utmost care, adhering to professional ethical codes and relevant medical practice guidelines. The best professional approach involves prioritizing the athlete’s immediate well-being and autonomy while seeking to uphold ethical standards. This means engaging in open and honest communication with the athlete about the risks and benefits of their participation, exploring all available treatment options, and documenting the entire process meticulously. The physician should advocate for the athlete’s health, even if it means advising against participation in a high-stakes event, and involve the athlete in the decision-making process. This aligns with the fundamental ethical principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and respect for autonomy. Professional guidelines for sports medicine practitioners emphasize the physician’s primary duty to the athlete’s health and safety above all other considerations, including team or organizational pressures. An approach that involves unilaterally informing the team coach or management about the athlete’s condition without the athlete’s explicit consent would be ethically and regulatorily unsound. This breaches patient confidentiality, a cornerstone of the doctor-patient relationship, and undermines the athlete’s trust. Such an action could also lead to the athlete facing undue pressure or discrimination, violating their rights. Another inappropriate approach would be to dismiss the athlete’s concerns and clear them for participation despite significant medical risks. This directly contravenes the principle of non-maleficence, as it knowingly exposes the athlete to potential harm. It also fails to uphold the physician’s duty of care and could result in severe medical consequences for the athlete, leading to professional repercussions. Finally, an approach that involves delaying a definitive medical opinion or treatment to avoid conflict with the team’s competitive goals is also professionally unacceptable. This demonstrates a failure to act with due diligence and prioritizes external pressures over the athlete’s health. Such inaction can exacerbate the athlete’s condition and lead to long-term health issues, while also compromising the physician’s professional integrity. Professionals should approach such dilemmas by first establishing a clear understanding of the athlete’s condition and the associated risks. They should then engage in a thorough discussion with the athlete, exploring their goals, concerns, and understanding of the situation. The physician’s role is to provide expert medical advice, empowering the athlete to make an informed decision. If the athlete’s decision conflicts with the physician’s medical judgment regarding safety, the physician must clearly articulate the risks and explore all avenues to support the athlete’s health, potentially involving other specialists or seeking ethical consultation if necessary. Documentation of all discussions, assessments, and recommendations is paramount.

When evaluating a fellowship program’s exit examination, particularly concerning blueprint weighting, scoring, and retake policies, a scenario arises where a candidate believes the examination’s structure unfairly disadvantages them due to a perceived imbalance in blueprint weighting for a specific knowledge domain. This situation is professionally challenging because it pits the candidate’s perception of fairness and their career progression against the established policies and the program’s commitment to standardized evaluation. Navigating this requires a delicate balance between upholding academic integrity, ensuring equitable assessment, and providing a supportive yet rigorous environment for fellows. The best approach involves a transparent and structured review process that prioritizes adherence to the established fellowship program’s policies and guidelines. This means the program director or examination committee should first review the official blueprint weighting and scoring rubric that was communicated to candidates prior to the examination. If the candidate’s concern stems from a misunderstanding or misinterpretation of the communicated blueprint, clarification and education are key. If, however, the review reveals a genuine discrepancy or an error in the implementation of the blueprint, the program must have a clear, pre-defined process for addressing such issues, which may include a review of the candidate’s performance against the correct weighting or, in exceptional circumstances, a re-evaluation of the examination’s fairness. This approach upholds the principle of fairness by ensuring that assessments are conducted according to agreed-upon standards and provides a mechanism for rectifying potential errors without compromising the overall integrity of the examination process. It also reinforces the importance of clear communication of policies to candidates. An approach that immediately offers a retake without a thorough review of the blueprint and scoring policies is professionally unsound. This bypasses the fundamental requirement of assessing performance against established criteria and could set a precedent for future challenges based on subjective perceptions rather than objective evaluation. It undermines the validity of the examination process and may not address the root cause of the candidate’s perceived disadvantage. Another professionally unacceptable approach is to dismiss the candidate’s concerns outright without any form of review or explanation. This demonstrates a lack of empathy and a failure to uphold the program’s responsibility to its fellows. It can lead to significant dissatisfaction, damage the program’s reputation, and potentially result in formal grievances. Ethical considerations demand that all concerns, especially those related to assessment fairness, are addressed with due diligence. Finally, an approach that involves altering the scoring or weighting retroactively based solely on the candidate’s complaint, without a pre-existing policy for such adjustments, is also problematic. This compromises the standardization and objectivity of the examination. If the blueprint was indeed flawed, the correction should ideally be applied to all candidates or the examination should be re-administered under corrected conditions, rather than selectively adjusting scores for one individual, which could be perceived as preferential treatment. Professionals should approach such situations by first consulting the program’s official policies and procedures regarding examinations, scoring, and appeals. They should then engage in a fact-finding process, objectively reviewing the examination blueprint, scoring rubric, and the candidate’s performance. Communication should be clear, empathetic, and grounded in the established policies. If an error is identified, the resolution should be consistent with the program’s guidelines and applied equitably.

The analysis reveals a common ethical challenge faced by fellows preparing for high-stakes examinations: balancing the need for comprehensive preparation with the ethical imperative to avoid any form of academic misconduct or unfair advantage. This scenario is professionally challenging because it requires the fellow to navigate the grey areas of collaborative learning and resource utilization while upholding the integrity of the examination process and the standards of the medical profession. The pressure to succeed can lead to temptations to cut corners or engage in ethically questionable practices. Careful judgment is required to ensure that preparation methods are both effective and ethically sound. The best professional approach involves proactive, independent preparation utilizing officially sanctioned or widely accepted, publicly available resources. This includes engaging with peer-reviewed literature, attending reputable review courses, practicing with official mock exams if provided, and forming study groups for discussion and clarification of concepts. This method is correct because it aligns with the principles of academic integrity and fair assessment. It ensures that the fellow’s knowledge and understanding are independently assessed, reflecting their genuine grasp of the subject matter. Relying on such resources demonstrates a commitment to rigorous, self-directed learning, which is a cornerstone of professional development in sports and exercise medicine. Furthermore, it avoids any potential conflicts of interest or breaches of confidentiality that could arise from using unauthorized materials. An ethically unacceptable approach would be to seek out or share leaked examination materials. This is a direct violation of academic integrity and professional ethics. It undermines the fairness of the examination for all candidates and devalues the qualification. Such an action could lead to severe disciplinary consequences, including disqualification from the examination and potential damage to the fellow’s professional reputation and future career prospects. Another professionally unacceptable approach is to rely solely on the notes or summaries provided by a senior colleague who has recently passed the exam, especially if these notes are derived from their personal recollection of specific exam questions or are presented as a shortcut to memorization. While learning from experienced colleagues is valuable, using their recollections of past exam content as a primary study tool can lead to a superficial understanding and an over-reliance on rote memorization rather than deep conceptual comprehension. It also carries the risk of inaccuracies or outdated information, and it bypasses the intended learning process designed by the examination board. This approach can also inadvertently lead to the dissemination of information that, while not explicitly “leaked,” circumvents the spirit of independent assessment. A further professionally unacceptable approach is to purchase study guides or question banks from unofficial or unverified sources that claim to contain actual past exam questions. The authenticity and ethical sourcing of such materials are often questionable. Using these resources can expose the candidate to misinformation, outdated content, or even materials that have been illegally obtained. This not only compromises the integrity of the preparation but also risks reinforcing incorrect knowledge, which can be detrimental during the actual examination. The professional decision-making process for similar situations should involve a clear understanding of the examination’s purpose and the ethical guidelines governing professional conduct. Candidates should prioritize preparation methods that foster genuine learning and understanding, rather than seeking shortcuts. When in doubt about the ethicality of a particular study method or resource, it is always best to err on the side of caution and consult the examination board’s guidelines or seek advice from a trusted mentor or program director. The ultimate goal is to demonstrate competence through fair and honest means.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a physician’s duty to their patient and the potential for financial gain through a referral. The physician must navigate this ethical minefield without compromising patient care or violating professional conduct standards. The core of the challenge lies in ensuring that any recommendation is solely based on the patient’s best interests, not on personal or institutional financial incentives. Correct Approach Analysis: The best professional practice involves transparently disclosing the financial relationship and recusing oneself from the decision-making process if a conflict of interest exists. This approach prioritizes patient autonomy and trust by ensuring the patient receives unbiased information and can make an informed decision free from the physician’s personal financial considerations. This aligns with fundamental ethical principles of beneficence, non-maleficence, and patient autonomy, as well as professional guidelines that mandate disclosure of conflicts of interest and avoidance of self-dealing. Incorrect Approaches Analysis: Recommending the facility without disclosure, despite believing it offers superior care, is ethically flawed because it fails to acknowledge the physician’s financial stake. This omission deprives the patient of crucial information needed to assess the recommendation’s objectivity and violates the principle of informed consent. It also breaches professional conduct codes that require transparency regarding financial relationships that could influence medical advice. Suggesting the facility as a “personal favorite” without mentioning the financial ties is deceptive. While it might seem harmless, it misrepresents the basis of the recommendation and erodes patient trust. The patient is led to believe the recommendation is purely clinical, when in fact, it is influenced by the physician’s financial interest. This constitutes a failure in honesty and integrity. Directly stating that the facility is “better because of the investment” is highly unethical and unprofessional. This approach explicitly prioritizes financial gain over the patient’s well-being and medical needs. It is a clear violation of the physician’s fiduciary duty to the patient and likely contravenes regulations against kickbacks or inducements for referrals. Professional Reasoning: Professionals facing such dilemmas should employ a structured decision-making process. First, identify the potential conflict of interest. Second, consult relevant professional codes of conduct and ethical guidelines. Third, prioritize patient welfare and autonomy above all else. Fourth, practice full transparency with the patient regarding any potential conflicts. Fifth, if a significant conflict exists, recuse oneself from making the recommendation or decision, allowing the patient to seek an independent opinion.

The evaluation methodology shows a need for careful consideration of ethical principles and professional responsibilities when managing patient information and potential conflicts of interest. This scenario is professionally challenging because it pits the physician’s duty to their patient against potential financial incentives and the need for objective medical advice. The physician must navigate the complexities of patient autonomy, informed consent, and the integrity of medical recommendations. The best approach involves prioritizing the patient’s well-being and autonomy above all else. This means clearly disclosing any potential financial relationships with the manufacturer of the recommended device and allowing the patient to make an informed decision based on all available information, including alternatives. The physician should provide objective data on the efficacy and risks of the recommended device, as well as discuss other treatment options, even if they do not offer the same financial benefit. This aligns with the ethical principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and respect for patient autonomy. Regulatory frameworks in sports medicine, particularly those governing professional conduct and medical ethics, emphasize transparency and patient-centered care. An incorrect approach would be to recommend the device without disclosing the financial interest. This violates the principle of transparency and could be seen as a breach of trust, potentially leading the patient to believe the recommendation is solely based on medical merit. Such a failure could have regulatory consequences related to professional misconduct and patient deception. Another incorrect approach would be to recommend the device without thoroughly exploring or presenting alternative treatment options. This limits the patient’s autonomy by not providing a comprehensive understanding of their choices and could lead to a suboptimal treatment decision, potentially causing harm. This neglects the physician’s duty to provide complete and unbiased medical advice. Finally, recommending the device solely based on the potential financial gain, without a thorough assessment of its suitability for the individual patient’s specific condition and needs, is ethically indefensible. This prioritizes personal gain over patient welfare and constitutes a serious breach of professional responsibility and ethical conduct. Professionals should employ a decision-making process that begins with identifying the core ethical principles at play. This is followed by a thorough assessment of the patient’s needs and circumstances. Crucially, any potential conflicts of interest must be identified and disclosed transparently. The physician should then present all viable treatment options objectively, discussing the risks, benefits, and alternatives for each. The final decision must rest with the informed patient.

The efficiency study reveals a critical juncture in the fellowship’s commitment to both patient well-being and the advancement of sports medicine knowledge. This scenario is professionally challenging because it pits the immediate, tangible benefits of a new treatment protocol against the established ethical and regulatory obligations concerning patient autonomy, data integrity, and the potential for bias. The fellowship must navigate the complex interplay between research, clinical practice, and the fundamental principles of ethical medical conduct. Careful judgment is required to ensure that the pursuit of efficiency does not compromise patient safety or the integrity of scientific inquiry. The best professional approach involves prioritizing informed consent and patient autonomy above all else. This means clearly and comprehensively explaining the proposed treatment protocol, including its experimental nature, potential benefits, risks, and alternatives, to each patient. Crucially, it requires obtaining explicit, voluntary consent from each patient before enrolling them in the study or implementing the new protocol. This approach aligns with fundamental ethical principles of respect for persons and beneficence, as well as regulatory frameworks that mandate informed consent for any medical intervention, particularly those involving research or novel treatments. It ensures that patients are active participants in their healthcare decisions and that their rights are protected. An approach that focuses solely on the potential efficiency gains and proceeds with the new protocol without obtaining explicit, individualized informed consent from each patient is ethically and regulatorily unacceptable. This failure to obtain informed consent violates the patient’s right to self-determination and exposes them to potential harm without their full understanding or agreement. It also undermines the scientific validity of the study by introducing selection bias and potentially compromising the data collected. Another unacceptable approach involves selectively enrolling patients who are perceived to be more compliant or likely to benefit, without a transparent and equitable selection process based on clinical need and study criteria. This practice introduces bias into the research, potentially excluding vulnerable populations or those who could benefit from the treatment, and violates principles of justice and fairness in research. Furthermore, it bypasses the ethical imperative of offering all eligible patients the opportunity to participate in research that could advance medical knowledge. Finally, an approach that prioritizes the study’s timeline and the perceived benefits to the broader medical community over the individual patient’s right to refuse participation or to receive standard care is also professionally flawed. While contributing to medical advancement is a noble goal, it cannot be achieved at the expense of individual patient rights and well-being. This approach disregards the ethical principle of non-maleficence and the legal requirements surrounding research ethics. Professionals should employ a decision-making framework that begins with identifying the ethical and regulatory obligations. This involves consulting relevant professional codes of conduct, institutional review board (IRB) guidelines, and applicable laws. The next step is to assess the potential impact of different courses of action on all stakeholders, particularly patients. Prioritizing patient autonomy, beneficence, and non-maleficence should guide the decision-making process. Open communication, transparency, and a commitment to obtaining informed consent are paramount. When faced with conflicting priorities, professionals should err on the side of caution and uphold the highest ethical standards, seeking guidance from ethics committees or senior colleagues when necessary.