This scenario presents a professionally challenging situation due to the inherent risks associated with pediatric surgery, the critical need for precise anatomical knowledge, and the complex physiological responses of young patients. The perioperative period demands meticulous planning and execution to ensure patient safety and optimal outcomes. Careful judgment is required to navigate potential anatomical variations, manage intraoperative physiological instability, and anticipate postoperative complications. The best professional approach involves a comprehensive pre-operative assessment that includes a detailed review of imaging, consultation with relevant specialists (e.g., anesthesiology, radiology), and a thorough discussion of the surgical plan with the pediatric surgical team. This approach prioritizes patient safety by identifying potential anatomical anomalies or physiological risks that might influence the surgical strategy or anesthetic management. It ensures that the surgical team is fully prepared to address any intraoperative challenges and that the perioperative care plan is tailored to the individual child’s needs. This aligns with the ethical principles of beneficence and non-maleficence, as well as the regulatory requirement for thorough pre-operative evaluation and informed consent. An incorrect approach would be to proceed with surgery based solely on standard anatomical knowledge without a detailed review of the specific patient’s imaging. This fails to account for potential anatomical variations common in pediatric populations, increasing the risk of intraoperative injury and adverse events. Ethically, it breaches the duty of care by not taking all reasonable steps to ensure patient safety. Another incorrect approach would be to delegate the entire perioperative management plan to a junior resident without direct senior surgeon oversight. While residents are integral to surgical training, the complexity and potential risks of pediatric surgery necessitate experienced supervision to ensure appropriate decision-making and timely intervention. This approach risks inadequate risk assessment and management, potentially violating guidelines on supervision and patient care standards. A further incorrect approach would be to disregard the anesthesiologist’s concerns regarding the child’s respiratory status, proceeding with surgery as scheduled. The perioperative period is a multidisciplinary effort, and the anesthesiologist plays a crucial role in assessing and managing physiological stability. Ignoring their input can lead to severe intraoperative complications, directly contravening the principles of patient safety and collaborative care. The professional reasoning framework for such situations should emphasize a systematic, multidisciplinary approach. This includes: 1) Thorough pre-operative assessment and risk stratification, incorporating all available diagnostic information. 2) Collaborative planning with all members of the perioperative team, ensuring open communication and shared understanding of the surgical and anesthetic plans. 3) Intraoperative vigilance, with continuous reassessment of the patient’s physiological status and readiness to adapt the surgical approach as needed. 4) Comprehensive post-operative care planning, anticipating potential complications and ensuring appropriate monitoring and management.

Scenario Analysis: This scenario presents a professional challenge because it requires a surgeon to navigate the complex requirements for advanced licensure in a specialized field, specifically pediatric surgery within the Pacific Rim region. The challenge lies in accurately identifying and meeting the eligibility criteria, which are designed to ensure a high standard of care and specialized expertise. Misinterpreting or overlooking these requirements can lead to significant professional setbacks, including denial of licensure, wasted resources, and potential delays in providing specialized care to a vulnerable patient population. Careful judgment is required to meticulously review the examination’s stated purpose and the applicant’s qualifications against these specific criteria. Correct Approach Analysis: The best professional approach involves a thorough and direct examination of the stated purpose and eligibility criteria for the Advanced Pacific Rim Pediatric Surgery Licensure Examination. This entails understanding that the examination is designed to assess advanced competency and specialized knowledge in pediatric surgery relevant to the Pacific Rim region, and that eligibility is contingent upon meeting specific, predefined qualifications such as advanced surgical training, board certification in pediatric surgery, and a demonstrated commitment to practice within the region. This approach is correct because it aligns directly with the regulatory intent of such examinations, which is to ensure that only qualified individuals are licensed to practice at an advanced level, thereby safeguarding patient welfare and upholding professional standards. Adhering strictly to the stated purpose and eligibility requirements ensures compliance with the licensing body’s mandate. Incorrect Approaches Analysis: One incorrect approach involves assuming that general surgical experience, regardless of specialization or geographic relevance, is sufficient for eligibility. This fails to recognize that advanced licensure examinations are typically highly specialized and often have regional considerations. The regulatory framework for such examinations mandates specific training and experience directly relevant to the scope of practice being licensed. Another incorrect approach is to rely on informal advice or anecdotal evidence from colleagues regarding eligibility without verifying against the official examination guidelines. This is professionally unacceptable because it bypasses the established regulatory process and can lead to significant errors in judgment. Licensing bodies establish clear, written criteria for a reason, and deviating from these can result in disqualification. A further incorrect approach is to focus solely on the desire to practice in the Pacific Rim without demonstrating the requisite advanced pediatric surgical qualifications. While intent is important, eligibility for advanced licensure is primarily based on objective qualifications and demonstrated expertise, not solely on geographical preference. The examination’s purpose is to validate advanced skills, not merely to facilitate relocation. Professional Reasoning: Professionals facing this situation should employ a systematic decision-making framework. First, they must clearly identify the specific examination and its governing body. Second, they should locate and meticulously review the official documentation outlining the examination’s purpose, scope, and eligibility requirements. Third, they must objectively assess their own qualifications against each stated criterion. If there are any ambiguities, they should seek clarification directly from the licensing authority. Finally, they should proceed with the application process only after confirming that they meet all documented requirements, ensuring a compliant and professional approach.

The scenario presents a critical ethical and professional challenge common in pediatric surgery: balancing parental autonomy with the best interests of a child when faced with a potentially life-altering surgical decision. The challenge lies in navigating differing opinions on the necessity and risks of a complex procedure, particularly when the child’s long-term well-being is at stake. Careful judgment is required to ensure the child receives optimal care while respecting the family’s role in decision-making. The best professional approach involves a comprehensive, multidisciplinary assessment and a structured, transparent communication process. This includes thoroughly evaluating the child’s condition, exploring all available treatment options with their respective risks and benefits, and engaging in open, empathetic dialogue with the parents. The surgical team should present a clear, evidence-based recommendation, ensuring the parents understand the rationale and potential outcomes. Crucially, this approach prioritizes obtaining informed consent, which requires not just agreement but a deep understanding of the procedure, alternatives, and potential complications. This aligns with the ethical principles of beneficence (acting in the child’s best interest) and respect for autonomy (of the parents, acting on behalf of the child). Regulatory frameworks in pediatric surgery emphasize the importance of parental involvement and informed consent, ensuring that decisions are made collaboratively and with full disclosure. An approach that dismisses parental concerns or pressures them into a decision without adequate explanation is professionally unacceptable. This fails to uphold the principle of shared decision-making and can lead to mistrust and potential legal challenges. It also neglects the ethical imperative to ensure true informed consent, as parental understanding may be compromised by a lack of open communication. Another professionally unacceptable approach is to proceed with surgery based solely on the surgeon’s conviction without ensuring the parents fully comprehend the risks and benefits or have had their questions adequately addressed. This bypasses the essential step of informed consent and can be seen as paternalistic, disregarding the parents’ right to participate in their child’s healthcare decisions. It also fails to acknowledge the potential for unforeseen complications or the parents’ unique insights into their child’s condition and needs. Finally, delaying the decision indefinitely without a clear plan for reassessment or intervention, especially in a situation with potential long-term consequences, is also professionally problematic. While caution is warranted, prolonged indecision can be detrimental to the child’s health and development, failing to act in accordance with the principle of beneficence. A structured decision-making framework is essential, involving clear communication, shared understanding, and a commitment to the child’s best interests, guided by established ethical principles and regulatory requirements for informed consent and parental involvement.

The risk matrix shows a moderate likelihood of intraoperative bleeding during a complex pediatric appendectomy, coupled with a high potential impact on patient outcomes. This scenario is professionally challenging due to the inherent vulnerability of pediatric patients, the need for precise surgical technique, and the critical importance of maintaining hemostasis to prevent complications such as organ damage, prolonged recovery, and increased morbidity. Careful judgment is required to select and safely utilize energy devices, balancing their efficacy in tissue dissection and coagulation with the risk of collateral thermal injury. The best professional practice involves a comprehensive pre-operative assessment and intra-operative management strategy that prioritizes patient safety and minimizes risks associated with energy device use. This includes a thorough review of the patient’s coagulation profile, discussion with the surgical team regarding the specific energy device to be used and its settings, and the availability of appropriate hemostatic adjuncts. During the procedure, the surgeon must employ meticulous technique, utilizing the lowest effective energy setting, maintaining adequate distance between the active electrode and critical structures, and ensuring proper tissue grounding. This approach aligns with the fundamental ethical principles of beneficence and non-maleficence, as well as the regulatory expectation for healthcare providers to utilize best practices and available evidence to ensure patient safety. Utilizing an energy device with excessively high settings without a clear indication of need is professionally unacceptable. This approach disregards the principle of using the minimum effective intervention and significantly increases the risk of thermal injury to adjacent tissues, potentially leading to delayed wound healing, fistulas, or damage to vital organs. This failure to calibrate the device appropriately constitutes a breach of professional duty and may violate guidelines related to safe surgical practice. Employing an energy device without confirming its proper function and calibration before initiating the procedure is also professionally unacceptable. This oversight bypasses a critical safety check, increasing the likelihood of device malfunction or unpredictable energy delivery, which can result in unintended tissue damage or inadequate hemostasis. This demonstrates a lack of due diligence and adherence to established safety protocols for surgical instrumentation. Proceeding with the procedure without ensuring the availability of appropriate hemostatic adjuncts, such as topical agents or sutures, when there is a known moderate risk of bleeding, is professionally unacceptable. This failure to anticipate and prepare for potential complications leaves the surgical team ill-equipped to manage intraoperative bleeding effectively, potentially compromising patient safety and leading to adverse outcomes. This reflects a deficiency in surgical planning and risk management. Professional reasoning in such situations should follow a structured approach: 1. Comprehensive Risk Assessment: Identify potential complications and their likelihood and impact. 2. Evidence-Based Practice: Select instruments and techniques supported by current literature and guidelines. 3. Team Communication: Ensure all team members understand the plan and potential risks. 4. Skillful Application: Execute procedures with precision and adapt as necessary. 5. Continuous Monitoring: Vigilantly assess patient status and device performance throughout the operation.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate need for specialized pediatric surgical care with the stringent requirements for physician licensure and credentialing. The urgency of a patient’s condition can create pressure to bypass established protocols, but failing to do so can have serious legal and ethical repercussions, potentially jeopardizing patient safety and the institution’s standing. Careful judgment is required to navigate this tension, ensuring patient well-being without compromising regulatory compliance. Correct Approach Analysis: The best professional practice involves immediately initiating the process for obtaining a temporary or expedited physician license and ensuring all necessary hospital credentialing and privileging procedures are followed, even under urgent circumstances. This approach is correct because it adheres to the regulatory framework governing medical practice in the Pacific Rim region, which mandates that all physicians providing patient care must be properly licensed and credentialed. The Advanced Pacific Rim Pediatric Surgery Licensure Examination framework emphasizes patient safety and professional accountability, which are directly supported by ensuring all practitioners meet established standards before operating. This proactive engagement with regulatory bodies and hospital administration, even while the patient’s condition is being managed, demonstrates a commitment to both immediate patient care and long-term legal and ethical compliance. Incorrect Approaches Analysis: Initiating surgical procedures without confirming the physician’s licensure and hospital privileges constitutes a significant regulatory and ethical failure. This bypasses the fundamental requirement for a physician to be legally authorized to practice and to have demonstrated competence in the specific procedures they intend to perform. Such an action exposes the physician and the institution to severe legal penalties, professional sanctions, and potential harm to the patient if the physician is not adequately qualified or licensed. Relying solely on the physician’s reputation or assurances from a foreign institution without verifying their credentials through the established Pacific Rim licensing and credentialing pathways is also a failure. While reputation is important, it does not substitute for formal verification of licensure and privileges. This approach neglects the due diligence required by regulatory bodies to protect the public and maintain professional standards. Delaying the licensure and credentialing process until after the patient has been stabilized and discharged is another unacceptable approach. This creates a retroactive justification for practicing without proper authorization, which is a violation of the licensing framework. It undermines the principle of proactive compliance and can lead to the discovery of unqualified practitioners, potentially impacting multiple patients and leading to severe disciplinary actions. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes patient safety and regulatory compliance. This involves a multi-step process: 1. Assess the immediate clinical need and patient stability. 2. Simultaneously, identify and initiate the required regulatory and credentialing processes, even if expedited. 3. Communicate clearly with all relevant parties, including hospital administration, legal counsel, and regulatory bodies, about the situation and the steps being taken. 4. Ensure that any direct patient care provided by the physician during this interim period is within the scope of any provisional approvals or under direct supervision as permitted by the regulatory framework, if applicable. 5. Document all actions taken, communications, and decisions thoroughly.

This scenario is professionally challenging because it requires a surgeon to balance their personal circumstances with the stringent requirements of maintaining licensure for advanced pediatric surgical practice. The core tension lies between the immediate need for personal leave and the obligation to adhere to the examination board’s policies regarding retakes and their impact on licensure status. Careful judgment is required to navigate these competing demands without compromising patient care or professional standing. The best approach involves proactively communicating with the Pacific Rim Pediatric Surgery Licensure Board regarding the necessity of the leave and understanding the specific implications for their examination status. This approach is correct because it prioritizes transparency and adherence to the established regulatory framework. The board’s blueprint weighting, scoring, and retake policies are designed to ensure a consistent and rigorous standard for all candidates. By seeking clarification and understanding the official procedures for extensions or deferrals, the surgeon demonstrates a commitment to fulfilling all licensure requirements ethically and legally. This proactive engagement allows for informed decision-making about the timing of the examination and potential retake scenarios, ensuring compliance with the board’s directives. An incorrect approach would be to assume that a personal leave automatically excuses them from the examination schedule or that a simple notification of absence is sufficient. This fails to acknowledge that licensure examinations are governed by specific policies that dictate how absences, retakes, and deadlines are managed. The regulatory framework of the Pacific Rim Pediatric Surgery Licensure Board likely has defined consequences for missed examinations or failure to adhere to retake timelines, which could include forfeiture of examination fees, a requirement to reapply, or even a lapse in eligibility. Another incorrect approach would be to proceed with the examination despite the personal circumstances, potentially compromising their performance and the integrity of the assessment. This disregards the ethical obligation to be fully present and capable during a high-stakes examination designed to evaluate critical surgical competencies. The blueprint weighting and scoring are designed to assess a surgeon’s knowledge and skills comprehensively, and a compromised performance due to personal distress would not accurately reflect their true abilities, potentially leading to an unfair assessment and licensure outcome. A further incorrect approach would be to delay communication with the board until after the scheduled examination date. This demonstrates a lack of respect for the board’s administrative processes and could lead to more severe consequences. The board’s retake policies are likely structured with specific windows and procedures, and missing these without prior communication can result in a loss of opportunity to retake the examination within the current cycle or under the existing examination blueprint. The professional decision-making process for similar situations should involve: 1) Identifying the conflict between personal needs and professional obligations. 2) Consulting the relevant regulatory body’s policies (in this case, the Pacific Rim Pediatric Surgery Licensure Board’s blueprint, scoring, and retake policies) for clear guidance. 3) Proactively communicating with the regulatory body to understand options and implications. 4) Making decisions based on informed understanding of the regulations and ethical considerations, prioritizing patient safety and professional integrity.

The performance metrics show a concerning trend in postoperative complications for a specific complex pediatric cardiac procedure. This scenario is professionally challenging because it directly impacts patient safety and outcomes, requiring a surgeon to critically evaluate their operative planning and risk mitigation strategies. The pressure to maintain high surgical standards while managing inherent risks in pediatric surgery necessitates a structured and evidence-based approach. The best approach involves a comprehensive pre-operative assessment and multi-disciplinary team discussion to identify and mitigate all potential risks. This includes a detailed review of the patient’s specific anatomy, comorbidities, and the proposed surgical technique. The surgeon should proactively engage with anesthesiologists, intensivists, and other relevant specialists to develop a tailored management plan that addresses potential intraoperative and postoperative challenges. This aligns with ethical principles of beneficence and non-maleficence, ensuring the patient receives the highest standard of care and that all reasonable steps are taken to minimize harm. Furthermore, it reflects a commitment to continuous quality improvement, a core tenet of professional medical practice. An approach that relies solely on the surgeon’s personal experience without formal consultation or structured risk assessment is professionally unacceptable. This overlooks the potential for individual biases or blind spots and fails to leverage the collective expertise of the surgical team. Such a method could lead to missed critical risks and inadequate preparation, violating the duty of care owed to the patient. Another unacceptable approach is to proceed with the surgery without a detailed, documented operative plan that explicitly outlines risk mitigation strategies. This lack of structured planning can result in reactive decision-making during surgery, increasing the likelihood of errors and adverse events. It demonstrates a failure to adhere to best practices in surgical safety and patient care. Finally, an approach that prioritizes speed and efficiency over thorough risk assessment and planning is also professionally unsound. While timely intervention is important, it should never compromise the meticulous preparation required for complex pediatric surgery. Rushing the planning phase can lead to overlooking crucial details, thereby jeopardizing patient safety. Professionals should employ a decision-making framework that emphasizes a systematic, evidence-based, and collaborative approach to operative planning. This involves: 1) thorough patient assessment, 2) identification and quantification of risks, 3) development of specific mitigation strategies, 4) multi-disciplinary team consultation and consensus, and 5) clear, documented operative and post-operative plans. This framework ensures that all potential issues are considered and addressed proactively, leading to improved patient outcomes and adherence to professional standards.

Scenario Analysis: This scenario is professionally challenging because it requires a surgeon to balance the immediate needs of patient care with the long-term commitment to professional development and licensure requirements. The pressure to maintain surgical schedules and meet institutional demands can conflict with the time needed for thorough preparation for a high-stakes examination. Navigating these competing priorities requires careful planning, effective communication, and a strong ethical commitment to patient safety and professional integrity. Correct Approach Analysis: The best professional practice involves proactively integrating dedicated study time into the surgeon’s schedule well in advance of the examination. This approach acknowledges the significant commitment required for comprehensive preparation for the Advanced Pacific Rim Pediatric Surgery Licensure Examination. It prioritizes patient safety by ensuring that the surgeon’s focus during clinical duties remains undivided, and it upholds professional standards by meeting licensure requirements without compromising patient care. This proactive integration aligns with the ethical obligation to maintain competence and the regulatory requirement to hold a valid license, which necessitates successful completion of the examination. Incorrect Approaches Analysis: One incorrect approach involves relying solely on informal learning during clinical rounds and surgical procedures. This method is insufficient for the depth of knowledge required for a specialized licensure examination. It fails to provide structured learning, systematic review of foundational and advanced concepts, or adequate practice with examination-style questions. Ethically, it risks a superficial understanding that could impact patient care and professionally, it is unlikely to lead to successful examination completion, thus jeopardizing licensure. Another incorrect approach is to postpone dedicated study until the final weeks before the examination, assuming that clinical experience will be sufficient. This strategy is highly risky. It creates immense pressure, increases the likelihood of burnout, and may lead to superficial cramming rather than deep comprehension. This approach neglects the regulatory expectation that candidates will be adequately prepared and ethically compromises patient safety by potentially having a surgeon who is not fully confident in their knowledge base during critical decision-making. A further incorrect approach is to delegate study responsibilities to trainees or colleagues, or to rely on them to “quiz” the candidate. While collaboration can be beneficial, the ultimate responsibility for examination preparation rests with the individual candidate. This approach abdicates personal accountability for meeting licensure requirements and demonstrates a lack of commitment to the rigorous standards of the profession. It is ethically questionable as it suggests a lack of personal dedication to maintaining the highest level of competence necessary for pediatric surgical practice. Professional Reasoning: Professionals facing similar situations should adopt a structured, proactive approach to preparation. This involves: 1) Understanding the scope and demands of the examination well in advance. 2) Creating a realistic study schedule that allocates dedicated time for review, practice questions, and simulation, integrating it into existing professional commitments. 3) Prioritizing patient care by ensuring that study time does not detract from clinical responsibilities or lead to fatigue that compromises judgment. 4) Communicating with supervisors and colleagues about study plans to manage expectations and seek support if needed. 5) Recognizing that licensure is a fundamental professional responsibility that requires diligent personal effort.

This scenario presents a significant professional challenge due to the inherent risks associated with pediatric subspecialty surgery, the potential for unexpected complications, and the critical need for timely, evidence-based decision-making under pressure. The surgeon must balance immediate patient needs with long-term outcomes, while adhering to established ethical principles and professional standards of care. The complexity is amplified by the need to communicate effectively with a distressed family and coordinate care within a multidisciplinary team. The correct approach involves immediate, comprehensive assessment of the patient’s hemodynamic stability and neurological status, followed by prompt surgical re-exploration to identify and address the source of bleeding. This is supported by the fundamental ethical principle of beneficence, which mandates acting in the best interest of the patient, and the principle of non-maleficence, requiring the avoidance of harm. Prompt surgical intervention is the most direct and effective means to control hemorrhage and prevent further ischemic damage. This aligns with established surgical best practices for managing intraoperative complications and the implicit duty of care owed to the patient. An incorrect approach would be to delay surgical re-exploration to await further imaging studies, such as a CT scan, without first stabilizing the patient. This fails to address the immediate life threat of active hemorrhage and could lead to irreversible neurological damage due to prolonged hypotension and hypoperfusion. Ethically, this constitutes a failure to act with due diligence and could be seen as a violation of the duty of care. Another incorrect approach would be to manage the bleeding conservatively with blood products and vasopressors without surgical intervention. While supportive measures are important, they are unlikely to resolve active intraoperative bleeding from a surgical site. This approach risks continued blood loss, hemodynamic instability, and potential organ damage, failing to address the root cause of the complication and thus violating the principle of beneficence. A further incorrect approach would be to proceed with the planned closure of the surgical site while continuing to monitor the patient’s vital signs, assuming the bleeding might spontaneously resolve. This is a dangerous gamble that ignores the clear evidence of active hemorrhage and the high probability of catastrophic consequences. It represents a significant departure from accepted surgical standards and a failure to uphold the surgeon’s responsibility to manage complications proactively. Professionals should employ a structured decision-making process that prioritizes patient safety and evidence-based practice. This involves rapid assessment of the situation, identification of the most likely causes of the complication, consideration of immediate interventions, and consultation with colleagues when necessary. A clear understanding of the potential benefits and risks of each management option, guided by ethical principles and professional guidelines, is paramount.

This scenario presents a significant professional challenge due to the inherent instability of a critically injured pediatric patient and the need for rapid, evidence-based decision-making under pressure. The complexity is amplified by the potential for rapid deterioration, the ethical imperative to act in the best interest of the child, and the need to adhere to established trauma and resuscitation protocols. Careful judgment is required to balance immediate life-saving interventions with a thorough diagnostic and management plan, all while ensuring appropriate communication and resource utilization. The best professional approach involves immediate, systematic assessment and management guided by the principles of advanced pediatric life support. This includes rapid primary survey (Airway, Breathing, Circulation, Disability, Exposure) followed by prompt resuscitation measures tailored to the child’s specific injuries and physiological status. This approach prioritizes life-threatening conditions, such as securing the airway, ensuring adequate ventilation and oxygenation, and addressing hemorrhagic shock. It aligns with established international pediatric trauma guidelines and ethical principles that mandate timely and effective intervention to prevent irreversible harm. The systematic nature of this approach ensures that no critical step is missed, and it allows for concurrent resuscitation and diagnostic efforts. An incorrect approach would be to delay definitive airway management in favor of extensive initial imaging before stabilizing the patient. This fails to address the immediate threat to life posed by potential airway compromise, which can lead to rapid hypoxemia and irreversible brain injury. Ethically, this prioritizes diagnostic certainty over immediate life support, violating the principle of beneficence. Another incorrect approach would be to administer large volumes of crystalloid fluid without considering the potential for fluid overload and its adverse effects in pediatric patients, particularly those with head injuries. While fluid resuscitation is crucial in shock, indiscriminate administration can worsen outcomes. This demonstrates a lack of nuanced understanding of pediatric resuscitation physiology and can lead to complications like pulmonary edema, which further compromises oxygenation. Finally, an incorrect approach would be to focus solely on external injuries and neglect the possibility of occult internal injuries, such as intra-abdominal hemorrhage or thoracic trauma, without a systematic secondary survey. This oversight can lead to delayed diagnosis and treatment of life-threatening internal bleeding or organ damage, significantly increasing morbidity and mortality. It represents a failure to conduct a comprehensive assessment as mandated by trauma protocols. The professional decision-making process for similar situations should involve a structured, algorithmic approach to trauma care. This begins with a rapid primary survey to identify and manage immediate life threats. Concurrent with resuscitation, a focused history and physical examination (secondary survey) should be performed to gather further information. Continuous reassessment of the patient’s condition is paramount, allowing for adjustments to the management plan as the patient’s status evolves. Effective communication with the multidisciplinary team and the family, where appropriate, is also a critical component of optimal care.