This scenario is professionally challenging due to the inherent complexity of assessing and monitoring orthopaedic conditions across diverse age groups, each presenting unique physiological, developmental, and psychosocial considerations. Advanced practice nurses must integrate comprehensive assessment skills with diagnostic interpretation and ongoing monitoring to ensure optimal patient outcomes, while navigating potential communication barriers, varying levels of patient comprehension, and the need for tailored interventions. Careful judgment is required to differentiate normal age-related changes from pathological processes and to select appropriate diagnostic tools and monitoring strategies. The best approach involves a systematic, age-appropriate comprehensive assessment that integrates subjective and objective data, followed by the selection of diagnostic investigations based on clinical suspicion and patient presentation. This approach is correct because it aligns with established nursing standards of practice and ethical principles, emphasizing patient-centered care and evidence-based decision-making. Regulatory frameworks for advanced practice nursing universally mandate thorough assessment as the foundation for all subsequent care, ensuring that diagnoses are accurate and interventions are safe and effective. Ethically, this approach prioritizes the patient’s well-being by avoiding unnecessary investigations and focusing on the most relevant diagnostic pathways, thereby respecting patient autonomy and promoting efficient resource utilization. An approach that relies solely on a single diagnostic test without a thorough initial assessment is professionally unacceptable. This fails to meet the regulatory requirement for comprehensive patient evaluation and risks misdiagnosis or delayed diagnosis by overlooking crucial subjective information or other objective findings. Ethically, it can lead to patient harm through inappropriate or missed treatment, violating the principle of non-maleficence. Another professionally unacceptable approach is to apply a standardized diagnostic and monitoring protocol across all age groups without considering developmental or physiological differences. This disregards the regulatory expectation for individualized care plans and fails to acknowledge the unique needs of pediatric, adult, and geriatric populations. Ethically, it can result in suboptimal care, as interventions may be ineffective or even harmful due to a lack of age-specific consideration, violating the principle of beneficence. Finally, an approach that prioritizes diagnostic testing over ongoing monitoring and reassessment is professionally flawed. While diagnostics are crucial, the dynamic nature of orthopaedic conditions, especially across the lifespan, necessitates continuous evaluation of treatment effectiveness, symptom progression, and potential complications. Regulatory guidelines emphasize the importance of ongoing patient assessment and monitoring to adapt care plans as needed. Failure to do so can lead to adverse events and compromised patient outcomes, ethically breaching the duty of care. Professionals should employ a decision-making framework that begins with a thorough, holistic, and age-appropriate patient assessment. This assessment should guide the selection of diagnostic investigations, considering their sensitivity, specificity, and relevance to the suspected condition and patient demographic. Following diagnosis, a robust monitoring plan, incorporating both subjective and objective measures, should be established and regularly reviewed, allowing for timely adjustments to the care plan based on the patient’s evolving clinical status. This iterative process ensures that care remains evidence-based, patient-centered, and ethically sound.

Scenario Analysis: This scenario is professionally challenging because it involves a patient with complex orthopaedic needs and potential for significant pain and functional decline. The advanced practice nurse must balance immediate symptom management with long-term care planning, considering the patient’s autonomy, available resources, and the ethical imperative to provide evidence-based, patient-centred care. The risk assessment requires a holistic view, integrating physical, psychological, and social factors. Correct Approach Analysis: The best professional practice involves a comprehensive, multi-faceted risk assessment that prioritizes patient-reported outcomes and functional goals. This approach involves systematically gathering information about the patient’s pain levels, mobility limitations, daily living activities, psychological well-being, and social support network. It also includes a thorough physical examination and review of diagnostic imaging. This is correct because it aligns with the principles of patient-centred care, emphasizing the patient’s perspective and lived experience, which is a cornerstone of advanced practice nursing ethics. Furthermore, it adheres to best practice guidelines in orthopaedic nursing, which advocate for individualized care plans developed collaboratively with the patient. This approach ensures that interventions are tailored to the patient’s specific needs and aspirations, maximizing the potential for positive outcomes and minimizing risks associated with ineffective or inappropriate treatment. Incorrect Approaches Analysis: One incorrect approach involves solely focusing on objective clinical findings and diagnostic imaging without adequately incorporating the patient’s subjective experience of pain and functional limitations. This fails to acknowledge the patient as the primary source of information regarding their condition and can lead to a care plan that does not address their most pressing concerns or align with their personal goals, potentially causing distress and dissatisfaction. Ethically, this neglects the principle of respect for autonomy and beneficence. Another incorrect approach is to rely heavily on a standardized, one-size-fits-all protocol for pain management and rehabilitation without considering individual patient factors, comorbidities, or psychosocial status. While protocols can provide a useful framework, rigid adherence without adaptation can overlook unique patient needs, leading to suboptimal pain control, delayed recovery, or even iatrogenic harm. This approach risks violating the ethical principle of non-maleficence by not providing care tailored to the individual’s specific risks and benefits. A further incorrect approach is to delegate the primary responsibility for risk assessment and care planning to junior staff without adequate supervision or direct involvement from the advanced practice nurse. While delegation is a necessary skill, the ultimate accountability for the patient’s care rests with the advanced practice nurse. Abdicating this responsibility can lead to gaps in assessment, misinterpretation of findings, and a failure to identify critical risks, thereby compromising patient safety and violating professional standards of care. Professional Reasoning: Professionals should employ a systematic, patient-centred approach to risk assessment. This involves active listening, open-ended questioning, and a willingness to explore the patient’s perspective. The process should be iterative, with ongoing reassessment and adjustment of the care plan as the patient’s condition evolves. Collaboration with the interdisciplinary team, including physicians, physiotherapists, and social workers, is crucial to ensure a holistic and comprehensive approach to care. Professionals must remain vigilant for potential risks, both physical and psychosocial, and proactively implement strategies to mitigate them, always prioritizing patient safety and well-being.

Scenario Analysis: This scenario is professionally challenging because it requires an advanced practice nurse to navigate the specific eligibility criteria for a specialized examination without misinterpreting or overgeneralizing the requirements. The core challenge lies in accurately assessing one’s own qualifications against a defined set of criteria, ensuring that the application is both truthful and compliant, thereby avoiding potential professional repercussions. Careful judgment is required to distinguish between general advanced practice experience and the specific orthopaedic focus mandated by the examination. Correct Approach Analysis: The best professional approach involves a meticulous review of the official examination handbook and any supplementary guidance documents provided by the Mediterranean Orthopaedic Nursing Board. This entails cross-referencing personal qualifications, including educational background, clinical experience in orthopaedic nursing, and any relevant certifications, directly against each stated eligibility criterion. The justification for this approach is rooted in regulatory compliance and professional integrity. Adhering strictly to the published guidelines ensures that the applicant meets the precise, often nuanced, requirements set forth by the examining body. This proactive and detailed self-assessment prevents misrepresentation and demonstrates a commitment to upholding the standards of advanced practice nursing within the specified orthopaedic specialty. Incorrect Approaches Analysis: Relying solely on general advanced practice nursing experience without specific orthopaedic focus fails to meet the specialized nature of the examination. This approach is ethically flawed as it bypasses the explicit requirement for orthopaedic expertise, potentially leading to an unqualified candidate sitting for the exam. Assuming that any advanced practice nursing role inherently qualifies an individual for an orthopaedic specialty examination is a misinterpretation of the eligibility framework. This overlooks the distinct knowledge and skill set required for orthopaedic nursing, leading to a non-compliant application. Seeking informal advice from colleagues without consulting the official examination documentation can lead to inaccurate interpretations of eligibility. While peer advice can be helpful, it cannot substitute for the definitive regulatory guidance provided by the examining body, and reliance on such advice risks misconstruing the precise requirements. Professional Reasoning: Professionals facing such a decision should adopt a systematic approach. First, identify the authoritative source of information regarding examination eligibility. Second, engage in a detailed, point-by-point comparison of personal qualifications against each stated requirement. Third, if any ambiguity exists, proactively seek clarification directly from the examination board or its designated contact. This process prioritizes accuracy, compliance, and ethical conduct, ensuring that all applications are both valid and professionally sound.

This scenario presents a professionally challenging situation due to the inherent complexity of managing chronic pain in a post-operative orthopaedic patient, where subjective reporting of pain intensity must be balanced with objective clinical findings and the potential for opioid-induced side effects. Careful judgment is required to ensure effective pain management while mitigating risks, adhering to best practices in advanced nursing practice, and complying with relevant professional guidelines. The correct approach involves a comprehensive, multi-modal assessment that integrates the patient’s subjective pain report with objective physiological indicators and a thorough review of their medical history and current medication regimen. This approach is correct because it aligns with the principles of evidence-based practice and patient-centred care, emphasizing a holistic understanding of the patient’s condition. Professionally, advanced practitioners are ethically and regulatorily bound to conduct thorough assessments, considering all contributing factors to a patient’s presentation. This includes recognizing that pain is a subjective experience and that objective signs may not always perfectly correlate with the patient’s reported discomfort. Furthermore, a comprehensive review of medications is crucial to identify potential drug interactions or cumulative effects that could be contributing to the patient’s symptoms or masking underlying issues. This systematic evaluation allows for informed clinical decision-making regarding pain management strategies, ensuring patient safety and optimal outcomes. An incorrect approach would be to solely rely on the patient’s subjective report of pain without considering objective findings. This fails to acknowledge the potential for over-reporting or under-reporting of pain due to various psychological or physiological factors, and it neglects the critical responsibility of the advanced practitioner to validate subjective data with objective evidence. Ethically, this could lead to inappropriate treatment decisions, potentially resulting in inadequate pain relief or unnecessary medication side effects. Another incorrect approach would be to dismiss the patient’s pain report based on seemingly normal objective findings, assuming the patient is exaggerating or seeking medication. This demonstrates a lack of empathy and a failure to uphold the professional duty of care. It disregards the patient’s lived experience of pain and can erode the therapeutic relationship, leading to distrust and non-adherence to treatment plans. Professionally, this can be seen as a failure to adequately assess and manage a patient’s presenting complaint. Finally, an incorrect approach would be to immediately escalate medication dosage based solely on the subjective report without a thorough reassessment of the underlying cause of the pain or potential contributing factors. This reactive approach can lead to polypharmacy, increased risk of adverse drug events, and the development of opioid tolerance or dependence without addressing the root cause of the persistent pain. It bypasses the crucial step of differential diagnosis and risk stratification inherent in advanced practice. Professionals should employ a structured decision-making process that begins with a comprehensive assessment, followed by the formulation of differential diagnoses, risk stratification, the development and implementation of a treatment plan, and ongoing evaluation and adjustment. This iterative process ensures that clinical decisions are evidence-based, patient-centred, and ethically sound, always prioritizing patient safety and well-being.

Scenario Analysis: This scenario presents a professional challenge related to the interpretation and application of examination blueprint weighting, scoring, and retake policies within the context of advanced practice nursing. The core difficulty lies in balancing the need for consistent and fair assessment with the individual circumstances of candidates, while strictly adhering to established institutional guidelines. Misinterpreting or misapplying these policies can lead to compromised assessment integrity, candidate dissatisfaction, and potential reputational damage to the examination board. Careful judgment is required to ensure that policy is applied equitably and transparently. Correct Approach Analysis: The best professional approach involves a thorough review of the official examination blueprint and associated policies, specifically focusing on the sections detailing weighting of content areas, scoring methodologies, and retake eligibility criteria. This approach is correct because it directly addresses the established framework governing the examination. Adherence to these documented policies ensures fairness, consistency, and defensibility of the assessment process. It upholds the integrity of the examination by ensuring all candidates are evaluated against the same objective standards. This aligns with ethical principles of fairness and accountability in professional assessment. Incorrect Approaches Analysis: One incorrect approach involves making an ad-hoc decision based on perceived fairness to the individual candidate without consulting the official policy. This is professionally unacceptable because it bypasses the established, transparent rules that are designed to ensure equity for all candidates. Such a deviation undermines the credibility of the examination and can set a precedent for inconsistent application of policies. Another incorrect approach is to rely on informal discussions or past practices that are not officially documented. This is flawed as it introduces subjectivity and potential for misinterpretation, lacking the authoritative basis of written policy. Furthermore, it fails to provide a clear, auditable trail for decision-making. A third incorrect approach is to prioritize the candidate’s personal circumstances over the examination’s stated objectives and policies. While empathy is important, the primary responsibility of an examination board is to assess competence against defined standards, as outlined in the blueprint and policies. Deviating from these standards based on personal circumstances compromises the validity of the assessment. Professional Reasoning: Professionals faced with such situations should employ a systematic decision-making process. First, they must identify the relevant policies and guidelines governing the specific issue (e.g., blueprint weighting, scoring, retakes). Second, they should meticulously review these documents to understand the established procedures and criteria. Third, they must apply these documented policies objectively to the specific case. If ambiguity exists, the appropriate course of action is to consult with the designated policy review committee or senior examination board members for clarification, rather than making an independent, undocumented decision. This ensures that decisions are grounded in established policy and are applied consistently and fairly.

This scenario is professionally challenging because it requires balancing the advanced practice nurse’s commitment to patient care with the ethical and regulatory obligations surrounding professional development and resource allocation. The advanced practice nurse must ensure their preparation for the Applied Mediterranean Orthopaedic Nursing Advanced Practice Examination is both effective and compliant with professional standards, without compromising current patient responsibilities or misrepresenting their qualifications. Careful judgment is required to select resources that are evidence-based, relevant to the examination’s scope, and ethically sourced. The best approach involves a structured, self-directed preparation plan that prioritizes evidence-based resources and allows for flexible scheduling around clinical duties. This includes utilizing reputable professional organizations’ guidelines, peer-reviewed literature, and established textbooks relevant to Mediterranean orthopaedic nursing. A realistic timeline, developed collaboratively with the employer if necessary, ensures adequate study time without neglecting patient care. This approach is correct because it aligns with the professional responsibility to maintain competence, adhere to ethical principles of honesty and integrity in professional development, and respects the employer’s need for consistent clinical service. It demonstrates a proactive and responsible commitment to advancing one’s practice, which is implicitly encouraged by professional bodies and regulatory frameworks that emphasize continuous learning. An approach that relies solely on informal discussions with colleagues without verifying the information’s accuracy or relevance is professionally unacceptable. This fails to meet the standard of evidence-based practice and risks incorporating outdated or incorrect information into one’s knowledge base, potentially impacting patient care and examination performance. It also lacks the rigor expected of advanced practice professionals. Another unacceptable approach is to allocate excessive time to preparation by significantly reducing clinical hours without proper authorization or communication. This not only breaches professional duty to the employer and patients but also raises ethical concerns about misrepresentation of availability and commitment. It undermines the trust placed in advanced practice nurses to manage their time responsibly and maintain patient continuity. Finally, an approach that involves purchasing unverified or potentially plagiarized study materials from unofficial sources is ethically and professionally unsound. This not only risks acquiring inaccurate information but also violates intellectual property rights and professional integrity. It demonstrates a lack of due diligence and a willingness to engage in unethical practices to achieve a professional goal. Professionals should employ a decision-making framework that begins with clearly defining the examination’s scope and required competencies. This should be followed by identifying credible and evidence-based preparation resources, considering their alignment with current professional standards and ethical guidelines. A realistic timeline should then be established, factoring in existing clinical responsibilities and seeking employer input where appropriate. Regular self-assessment and adaptation of the study plan are crucial to ensure progress and address any identified knowledge gaps.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the perceived best interests of their care, complicated by the potential for a significant, irreversible outcome. Advanced practice nurses must navigate complex ethical and legal landscapes, ensuring patient autonomy is respected while also upholding their duty of care and adhering to professional standards. The urgency of the situation and the potential for rapid deterioration necessitate swift, yet carefully considered, decision-making. Correct Approach Analysis: The best professional practice involves a thorough, documented assessment of the patient’s capacity to make decisions regarding their treatment. This includes evaluating their understanding of their condition, the proposed interventions, the risks and benefits, and the alternatives, including the option of no treatment. If capacity is confirmed, the patient’s informed refusal of treatment must be respected, even if it leads to a less desirable outcome from a clinical perspective. This aligns with the fundamental ethical principles of autonomy and beneficence, and is supported by professional nursing codes of conduct that emphasize respecting patient self-determination. The legal framework in most advanced practice jurisdictions supports the right of a competent adult to refuse medical treatment. Incorrect Approaches Analysis: One incorrect approach would be to proceed with the surgical intervention against the patient’s explicit refusal, based solely on the clinical team’s judgment of what is medically necessary. This disregards the principle of patient autonomy and constitutes a violation of the patient’s right to bodily integrity. Ethically and legally, this is considered battery. Another incorrect approach would be to delay the decision-making process by seeking extensive, non-essential consultations without re-evaluating the patient’s capacity or engaging in a structured discussion about their wishes. While consultation can be valuable, an undue delay that compromises the patient’s condition or their ability to make a timely decision, especially when capacity is not in question, can be professionally negligent. A further incorrect approach would be to assume the patient lacks capacity due to their expressed desire to refuse a potentially life-saving procedure. Capacity is not determined by the choice made, but by the ability to make a choice. Without a formal assessment demonstrating a deficit in understanding or reasoning, assuming incapacity is a breach of professional duty and can lead to inappropriate interventions. Professional Reasoning: Professionals should employ a structured decision-making process that prioritizes patient assessment. This involves: 1) assessing the patient’s capacity to make the decision, 2) ensuring the patient has received comprehensive information about their condition, treatment options, risks, benefits, and alternatives, 3) facilitating open communication to understand the patient’s values and preferences, and 4) documenting all assessments, discussions, and decisions meticulously. If capacity is confirmed and the patient refuses treatment, their decision must be respected. If capacity is in doubt, a formal capacity assessment should be undertaken, and if the patient is deemed to lack capacity, decisions should be made in accordance with established legal and ethical guidelines for substitute decision-making.

Scenario Analysis: This scenario presents a professional challenge rooted in the advanced practice nurse’s responsibility for medication safety within a complex orthopaedic setting. The challenge lies in balancing the need for timely and effective pain management for post-operative patients with the imperative to adhere to strict prescribing protocols and ensure patient safety, particularly when encountering potential prescribing errors. The advanced practice nurse must navigate potential conflicts between physician orders, established protocols, and their own clinical judgment, all while upholding their professional and legal obligations. Correct Approach Analysis: The best professional approach involves a systematic and collaborative process. It requires the advanced practice nurse to first verify the suspected error by cross-referencing the physician’s order with the patient’s clinical presentation, medication history, and relevant prescribing guidelines or formularies. If a discrepancy or potential error is confirmed, the next crucial step is to communicate directly and professionally with the prescribing physician to clarify the order. This direct communication allows for immediate correction, prevents potential harm to the patient, and fosters a culture of shared responsibility for medication safety. This approach aligns with ethical principles of beneficence and non-maleficence, as well as regulatory requirements for reporting and addressing medication errors or near misses to ensure patient well-being and continuous quality improvement. Incorrect Approaches Analysis: One incorrect approach involves administering the medication as ordered without further inquiry, despite a strong suspicion of error. This failure to verify and question a potentially erroneous prescription directly violates the advanced practice nurse’s duty of care and professional responsibility to ensure patient safety. It risks patient harm and contravenes regulatory expectations for diligent practice and adherence to medication safety protocols. Another incorrect approach is to unilaterally alter the prescription without consulting the prescribing physician. While the intention might be to correct a perceived error, this action bypasses established communication channels and undermines the collaborative nature of patient care. It could lead to unintended consequences, miscommunication, and potential disciplinary action for exceeding the scope of practice or failing to follow proper reporting procedures. A third incorrect approach is to discuss the suspected error with colleagues or other nursing staff without first attempting to clarify the order with the prescribing physician. While peer consultation can be valuable, it delays the resolution of the immediate prescribing issue and does not directly address the potential error with the source. This can lead to further delays in patient care and does not fulfill the primary responsibility of ensuring the accuracy of the medication order before administration. Professional Reasoning: Professionals facing such a situation should employ a structured decision-making process. This involves: 1. Recognize and identify the potential issue (e.g., suspected prescribing error). 2. Gather relevant information (patient data, guidelines, order details). 3. Assess the risk to the patient. 4. Formulate a plan of action, prioritizing direct, professional communication with the prescriber. 5. Implement the plan and document all actions and communications. 6. Evaluate the outcome and participate in any necessary follow-up or reporting. This systematic approach ensures that patient safety remains paramount while upholding professional standards and regulatory compliance.

This scenario presents a common challenge in advanced practice nursing: balancing the need for efficient patient care with the ethical and legal responsibilities of leadership and delegation. The critical element is ensuring patient safety and quality of care while empowering the nursing team. The advanced practitioner must navigate the complexities of team dynamics, individual competencies, and the specific needs of the patient to make sound decisions regarding task allocation. The best approach involves a comprehensive assessment of the patient’s condition and the skills of the available nursing staff. This includes understanding the scope of practice for each team member, identifying potential risks associated with delegation, and ensuring clear communication of expectations and parameters. By directly engaging with the registered nurse to assess their comfort level and understanding of the delegated task, the advanced practitioner upholds their leadership responsibility to ensure safe and effective care. This aligns with professional nursing standards that emphasize accountability for delegated tasks and the importance of appropriate supervision. Furthermore, it fosters a collaborative environment where team members feel supported and their expertise is valued, which is crucial for effective interprofessional communication and team cohesion. Delegating the task without a direct conversation with the registered nurse, assuming their competence based solely on their role, is professionally unacceptable. This bypasses a crucial step in ensuring the nurse understands the specific requirements and potential complexities of the task for this particular patient. It risks miscommunication and could lead to errors if the nurse is not fully briefed or if they have unexpressed concerns. This approach fails to uphold the advanced practitioner’s duty of care and accountability for the delegated task. Assigning the task to a less experienced nursing assistant without a clear understanding of their training and the specific patient needs is also professionally unacceptable. While delegation to support staff is appropriate, it must be done within the bounds of the assistant’s scope of practice and with adequate supervision. This approach risks patient harm due to the potential lack of necessary skills or knowledge, and it fails to utilize the registered nurse’s expertise appropriately. It also undermines the registered nurse’s role and professional development. Refusing to delegate and performing the task solely as the advanced practitioner, while seemingly prioritizing direct patient care, is professionally suboptimal in this context. While the advanced practitioner is ultimately accountable, effective leadership involves empowering and developing the team. This approach misses an opportunity to mentor the registered nurse, build team capacity, and potentially free up the advanced practitioner’s time for more complex clinical decision-making or patient advocacy. It can also create a bottleneck in care delivery if the advanced practitioner is consistently performing tasks that could be safely delegated. Professionals should employ a decision-making framework that prioritizes patient safety, considers the scope of practice for all team members, assesses individual competencies, and facilitates clear, open communication. This involves a systematic evaluation of the task, the patient’s needs, and the team’s capabilities before delegation occurs.

Scenario Analysis: This scenario presents a professional challenge rooted in the ethical imperative to maintain patient confidentiality while also fulfilling the requirements of a formal educational assessment. Advanced practice nurses are entrusted with sensitive patient information, and any breach of confidentiality can have severe legal and ethical repercussions, eroding patient trust and potentially violating data protection regulations. Balancing the need to demonstrate competence through case study analysis with the duty to protect patient privacy requires careful judgment and adherence to established protocols. Correct Approach Analysis: The best professional practice involves anonymizing patient data to the highest degree possible before its inclusion in any educational material or assessment. This approach upholds the fundamental ethical principle of patient confidentiality and complies with data protection legislation. By removing all direct identifiers such as names, specific dates of birth, addresses, and unique medical record numbers, and by altering or omitting any other potentially identifying details (e.g., rare occupations, specific geographical landmarks within the case), the nurse ensures that the patient cannot be identified, directly or indirectly. This allows for the educational objectives of the assessment to be met without compromising patient privacy. Incorrect Approaches Analysis: Presenting patient information with only minimal or superficial anonymization, such as changing a name but retaining other identifiable details like exact age, specific hospital unit, or precise dates of admission and discharge, fails to adequately protect patient confidentiality. This approach risks indirect identification, especially when combined with other contextual information, and therefore violates ethical duties and potentially data protection laws. Including a blanket statement asserting that all patient information has been anonymized without actually undertaking the rigorous process of de-identification is a serious ethical lapse. This misrepresentation suggests a disregard for the importance of patient privacy and the legal obligations surrounding it. It is a failure to act with due diligence and honesty. Using a hypothetical patient scenario that closely mirrors a real patient’s presentation, even if the name is changed, can still lead to identification by individuals familiar with the real patient’s case. This approach, while seemingly anonymized, carries a significant risk of re-identification and thus breaches the spirit, if not the letter, of confidentiality requirements. Professional Reasoning: Professionals should approach case study presentations for assessment by first identifying all potential direct and indirect identifiers within the patient’s record. The next step is to systematically remove or alter these identifiers to create a truly anonymized record. This process should be guided by institutional policies on data anonymization and relevant data protection legislation. If there is any doubt about whether a piece of information could lead to identification, it should be removed or generalized. The focus should always be on protecting the patient’s privacy while still providing sufficient clinical detail for the assessment to be meaningful.