This scenario is professionally challenging because it requires balancing the imperative to improve wellness coaching and chronic care services with the ethical and regulatory obligations surrounding research and quality improvement initiatives. Professionals must navigate the complexities of data collection, participant consent, and the responsible translation of findings into practice, all while adhering to the principles of evidence-based care and patient well-being. Careful judgment is required to ensure that any simulation, quality improvement, or research activity is conducted ethically, effectively, and in a manner that genuinely benefits patients and the healthcare system. The best approach involves a structured, ethical, and evidence-based methodology for integrating simulation, quality improvement, and research translation. This begins with clearly defining the objectives for improving wellness coaching and chronic care, identifying specific areas for enhancement through a needs assessment. Subsequently, appropriate simulation exercises can be designed to train coaches and healthcare providers on new protocols or skills. Quality improvement initiatives should then be implemented, utilizing data collection methods that respect patient privacy and obtain informed consent where necessary, focusing on measurable outcomes. Finally, findings from both quality improvement efforts and any formal research should be rigorously analyzed and translated into actionable changes in practice, with a clear plan for dissemination and ongoing evaluation. This systematic process ensures that interventions are evidence-based, ethically sound, and contribute to the advancement of chronic care management. An approach that prioritizes immediate implementation of simulation exercises without a prior needs assessment or clear quality improvement goals is professionally unacceptable. This fails to ensure that the simulations are relevant or address actual gaps in care, potentially wasting resources and not leading to meaningful improvements. Furthermore, conducting research or quality improvement activities without explicit informed consent from participants, where applicable, violates fundamental ethical principles of autonomy and privacy, and contravenes regulatory requirements for data handling and research ethics. Another professionally unacceptable approach is to collect extensive data from patient interactions for quality improvement or research purposes without a clear plan for analysis, translation into practice, or dissemination of findings. This can lead to data hoarding, potential breaches of confidentiality, and a failure to realize the potential benefits of the collected information for improving patient care. Professionals should employ a decision-making framework that begins with a thorough understanding of the current landscape and identified needs within wellness coaching and chronic care. This involves consulting relevant literature, stakeholder feedback, and performance data. Next, they should identify potential interventions, considering the ethical implications, regulatory compliance, and feasibility of simulation, quality improvement, and research activities. A critical step is to develop a robust plan for each initiative, including clear objectives, methodologies, data collection strategies with appropriate consent mechanisms, and a pathway for translating findings into practice. Continuous evaluation and adaptation based on outcomes are essential throughout the process.

Scenario Analysis: This scenario presents a professional challenge in balancing the need for consistent quality assurance in wellness coaching with the practicalities of candidate assessment and program integrity. The core tension lies in determining fair and effective retake policies for a competency assessment that is crucial for professional accreditation. Mismanagement of blueprint weighting, scoring, and retake policies can lead to perceptions of unfairness, devalue the certification, and potentially compromise client safety if unqualified individuals are certified. Careful judgment is required to ensure policies are transparent, equitable, and aligned with the assessment’s purpose. Correct Approach Analysis: The best professional practice involves a clearly defined and communicated policy that outlines the blueprint weighting, scoring methodology, and retake conditions. This policy should be established by the assessment body and made accessible to all candidates prior to their assessment. The blueprint weighting should reflect the relative importance of different competency domains, ensuring that the assessment accurately measures the breadth and depth of knowledge and skills required for effective wellness coaching. Scoring should be objective and consistently applied, with clear pass/fail criteria. Retake policies should be fair, allowing for remediation and re-assessment within a reasonable timeframe and potentially with a limit on the number of attempts to maintain the rigor of the certification. This approach ensures transparency, fairness, and upholds the credibility of the certification by setting clear expectations and standards for all candidates. It aligns with ethical principles of fairness and due process in assessment. Incorrect Approaches Analysis: One incorrect approach involves arbitrarily adjusting the blueprint weighting or scoring criteria for individual candidates based on perceived effort or circumstances. This undermines the standardization of the assessment, introduces bias, and creates an uneven playing field. It violates the principle of equitable assessment and can lead to legal challenges and reputational damage for the assessment body. Another incorrect approach is to have vague or uncommunicated retake policies, or to allow an unlimited number of retakes without any requirement for further learning or development. This devalues the certification, as it may not accurately reflect a candidate’s mastery of the required competencies. It also fails to uphold the responsibility of the assessment body to ensure that certified professionals are adequately prepared to serve clients, potentially compromising client safety. A third incorrect approach is to implement punitive retake policies that are overly restrictive or financially burdensome, without providing adequate support or opportunities for candidates to improve. This can disproportionately disadvantage certain candidates and may not serve the ultimate goal of certifying competent professionals. It can also lead to a perception of the assessment body being more interested in revenue generation than in fostering professional development. Professional Reasoning: Professionals should approach the development and implementation of assessment policies with a commitment to fairness, transparency, and the integrity of the certification. This involves establishing clear, objective criteria for blueprint weighting and scoring, and developing retake policies that are supportive of candidate development while maintaining assessment rigor. A decision-making framework should prioritize: 1) Alignment with assessment objectives: Do the policies accurately measure the intended competencies? 2) Fairness and Equity: Are the policies applied consistently to all candidates? 3) Transparency: Are the policies clearly communicated to candidates in advance? 4) Credibility: Do the policies uphold the value and reputation of the certification?

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate needs of a client with the ethical and regulatory obligations of a wellness coach. The coach must navigate potential conflicts of interest, maintain professional boundaries, and ensure the client’s well-being is prioritized without overstepping the scope of practice for allied health professionals. The reliance on a client’s personal network for professional referrals introduces a risk of compromised objectivity and potential breaches of confidentiality if not managed with extreme care. Correct Approach Analysis: The best professional practice involves a structured, ethical, and transparent approach to referral. This entails the wellness coach first assessing the client’s needs against their own scope of practice and identifying areas where specialized allied health support is genuinely required. Subsequently, the coach should provide the client with a curated list of qualified and reputable allied health professionals, ideally those with whom the coach has a professional, non-financial relationship or who are recognized by professional bodies. The coach should clearly explain the rationale for each referral and empower the client to make their own informed choice, ensuring the client understands the coach’s role is supportive and not directive in the selection process. This approach upholds client autonomy, maintains professional integrity, and adheres to ethical guidelines that prohibit self-referral for personal gain and mandate appropriate scope of practice. Incorrect Approaches Analysis: Referring the client to a personal friend who is an allied health professional, without disclosing the personal relationship and without exploring other options, is ethically problematic. This creates a significant conflict of interest, potentially compromising the objectivity of both the referral and the subsequent care. It also fails to ensure the referred professional is the most suitable for the client’s specific needs, potentially violating the duty of care. Suggesting that the client consult a specific allied health professional based solely on the coach’s personal positive experience, without a formal assessment of the client’s needs or consideration of other qualified professionals, is also inappropriate. This approach prioritizes personal anecdote over professional due diligence and client-centered care, potentially leading to a suboptimal referral. Directing the client to a specific allied health clinic that offers a reciprocal referral agreement with the wellness coach’s practice, without informing the client of this arrangement or exploring alternative providers, constitutes a clear breach of ethical conduct and potentially regulatory guidelines concerning kickbacks or undue influence in healthcare referrals. This prioritizes financial or professional gain over the client’s best interests. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes client well-being, ethical conduct, and regulatory compliance. This involves: 1) Self-assessment of scope of practice and identification of needs beyond that scope. 2) Research and identification of appropriate, qualified professionals or services. 3) Transparent communication with the client regarding needs and referral options. 4) Empowering the client to make informed choices. 5) Maintaining professional boundaries and avoiding conflicts of interest. 6) Documenting the referral process and rationale.

Scenario Analysis: This scenario is professionally challenging because it requires a wellness coach to balance the client’s immediate desire for rapid progress with the ethical and regulatory imperative to ensure adequate preparation and realistic expectations. The pressure to demonstrate quick results can lead to shortcuts that compromise the integrity of the coaching process and potentially harm the client’s long-term well-being. Careful judgment is required to navigate these competing demands, prioritizing client safety and sustainable progress over superficial gains. Correct Approach Analysis: The best professional practice involves a structured, phased approach to candidate preparation, emphasizing foundational knowledge and skill development before intensive application. This includes recommending a comprehensive review of core wellness coaching principles, relevant Indo-Pacific health and cultural nuances, and chronic care management strategies. It also necessitates a realistic timeline that allows for deliberate practice, self-reflection, and integration of learning, rather than rushing through material. This approach aligns with ethical guidelines that mandate competence and client welfare, ensuring the coach is adequately prepared to provide effective and safe support. It also respects the spirit of a competency assessment, which is designed to evaluate mastery, not just superficial familiarity. Incorrect Approaches Analysis: Recommending a superficial overview of key topics without delving into practical application or cultural context is ethically problematic. This approach risks creating a coach who can recite information but lacks the nuanced understanding and practical skills to effectively support clients in the Indo-Pacific region, potentially leading to misinterpretations of cultural practices or ineffective interventions. Suggesting an overly compressed timeline that prioritizes speed over thorough understanding is also a failure. This can result in a coach who is not truly competent, potentially leading to client harm due to inadequate knowledge or skill. Furthermore, focusing solely on memorization of assessment content without understanding the underlying principles of wellness coaching and chronic care management undermines the purpose of the assessment and the profession itself. This approach can lead to a coach who can pass the test but is ill-equipped to handle the complexities of real-world client situations. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes client well-being and ethical practice. This involves: 1) Understanding the assessment’s purpose: Is it to test rote memorization or applied competency? 2) Identifying core competencies: What knowledge and skills are essential for effective practice in the specified context? 3) Evaluating preparation resources: Do they foster deep understanding and practical application? 4) Establishing realistic timelines: Does the proposed schedule allow for mastery and integration? 5) Consulting ethical guidelines: Do the preparation recommendations align with professional standards of competence and client welfare?

This scenario presents a professional challenge because it requires balancing the client’s immediate desire for a specific intervention with the coach’s ethical and professional responsibility to ensure the intervention is evidence-based, appropriate for the client’s condition, and aligned with established wellness coaching protocols. The coach must navigate potential client pressure while upholding standards of care and client safety. Careful judgment is required to avoid premature or inappropriate interventions that could be ineffective or even harmful. The best professional approach involves a comprehensive assessment of the client’s chronic condition, including their current symptoms, medical history, and previous treatment responses, before recommending or implementing any therapeutic intervention. This assessment should inform the selection of evidence-based protocols that are recognized within the wellness coaching framework for managing the specific chronic condition. The coach must then collaboratively develop a personalized plan with the client, clearly outlining the chosen intervention, its expected outcomes, and the methods for measuring progress. This approach is correct because it prioritizes client well-being by ensuring interventions are tailored, evidence-informed, and delivered within a structured, ethical framework. It aligns with the principles of responsible wellness coaching, which mandate a thorough understanding of the client’s needs and the application of appropriate, validated therapeutic strategies. An incorrect approach would be to immediately implement the client’s requested intervention without a thorough assessment. This fails to uphold the coach’s duty of care, as the requested intervention may not be suitable or effective for the client’s specific chronic condition. It bypasses the crucial step of evidence-based protocol selection and personalized planning, potentially leading to ineffective treatment or adverse outcomes. Another incorrect approach would be to rely solely on anecdotal evidence or popular trends when selecting a therapeutic intervention, disregarding established wellness coaching protocols and outcome measures. This demonstrates a lack of professional rigor and an abdication of the responsibility to use validated methods. It risks offering unproven or potentially harmful interventions, undermining client trust and the credibility of the coaching profession. A further incorrect approach would be to proceed with an intervention without establishing clear, measurable outcome indicators. This makes it impossible to objectively assess the effectiveness of the intervention, hindering the ability to adapt the plan as needed and demonstrate progress to the client. It represents a failure to engage in systematic evaluation, a cornerstone of effective chronic care management. The professional decision-making process for similar situations should involve a systematic, client-centered approach. This begins with a comprehensive needs assessment, followed by the identification of relevant, evidence-based protocols. The coach should then collaboratively develop a personalized intervention plan with the client, clearly defining goals and measurable outcomes. Ongoing monitoring and evaluation are crucial, allowing for adjustments to the plan based on the client’s progress and feedback. This iterative process ensures that interventions remain appropriate, effective, and aligned with the client’s evolving needs and the established standards of wellness coaching.

This scenario is professionally challenging because it requires a wellness coach to balance client-centred care with the ethical imperative to avoid overstepping professional boundaries and providing advice outside their scope of practice, particularly when dealing with potential medical conditions. The coach must recognise the limitations of their expertise and the importance of referring clients to qualified medical professionals for diagnosis and treatment. The best professional approach involves a thorough understanding of the client’s current health status, acknowledging their symptoms, and then clearly and empathetically guiding them towards appropriate medical assessment. This approach prioritises client safety by ensuring that any underlying medical issues are addressed by a qualified healthcare provider. It aligns with ethical guidelines for wellness coaching, which typically mandate that coaches do not diagnose or treat medical conditions. The coach’s role is to support lifestyle changes and general well-being, not to act as a substitute for medical professionals. An incorrect approach would be to attempt to diagnose the cause of the client’s joint pain based on the described biomechanical issues. This constitutes practising medicine without a license and violates ethical codes that prohibit coaches from diagnosing or treating medical conditions. It places the client at risk of delayed or incorrect medical intervention. Another incorrect approach would be to dismiss the client’s symptoms as minor and unrelated to any significant health concern, advising them to simply “push through the pain” or rely solely on general stretching exercises. This fails to acknowledge the potential seriousness of the client’s discomfort and neglects the coach’s responsibility to encourage appropriate medical consultation when symptoms suggest a potential underlying issue. It could lead to the exacerbation of an undiagnosed condition. A further incorrect approach would be to recommend specific over-the-counter pain relief or topical treatments without a medical diagnosis. This crosses the line into providing medical advice and treatment, which is outside the scope of a wellness coach’s practice and could interfere with a proper medical evaluation. The professional reasoning framework for such situations involves: 1. Active listening and empathetic acknowledgement of the client’s concerns. 2. Self-assessment of the coach’s scope of practice and expertise regarding the presented symptoms. 3. Prioritisation of client safety and well-being, which includes recognising when medical expertise is required. 4. Clear, direct, and supportive referral to a qualified healthcare professional for diagnosis and treatment. 5. Documentation of the conversation and referral made.

This scenario presents a professional challenge because a wellness coach, while not a medical practitioner, is tasked with interpreting information that could influence a client’s health decisions. The core difficulty lies in navigating the boundary between providing supportive wellness guidance and engaging in diagnostic activities or offering interpretations of medical imaging that fall outside their scope of practice and regulatory purview. Careful judgment is required to ensure the client receives appropriate care without the coach overstepping professional boundaries or providing potentially misleading information. The best professional approach involves recognizing the limitations of the wellness coach’s role and prioritizing the client’s safety and access to qualified medical professionals. This means acknowledging the client’s report of imaging results and immediately advising them to discuss these findings with their treating physician or a qualified healthcare provider. The coach should offer support in understanding the importance of this medical consultation and assist the client in preparing questions for their doctor, rather than attempting to interpret the images or results themselves. This approach aligns with ethical principles of non-maleficence (do no harm) and beneficence (act in the client’s best interest) by ensuring the client receives expert medical interpretation and guidance. It also respects the regulatory framework that defines the scope of practice for wellness coaches, which typically excludes medical diagnosis and interpretation of diagnostic tests. An incorrect approach would be to attempt to interpret the imaging report or provide a personal opinion on the findings. This is ethically problematic as it constitutes practicing outside the scope of a wellness coach’s training and licensure, potentially leading to misinterpretation, undue anxiety for the client, or delayed appropriate medical intervention. Such an action could also violate regulations governing healthcare professionals and allied health services, which strictly define who is authorized to interpret diagnostic imaging. Another incorrect approach would be to dismiss the client’s concerns about the imaging results or to suggest that the results are not significant without any medical basis. This is ethically unsound as it fails to acknowledge the client’s health concerns and could lead to the client neglecting important medical follow-up. It also demonstrates a lack of professional responsibility in guiding the client towards appropriate healthcare resources. A further incorrect approach would be to recommend specific treatments or lifestyle changes based on a presumed interpretation of the imaging results, without consulting a medical professional. This is dangerous as it bypasses the diagnostic process and could lead to ineffective or even harmful interventions. It also directly infringes upon the domain of licensed medical practitioners. Professionals should employ a decision-making framework that prioritizes client safety and adheres strictly to their defined scope of practice. This involves: 1. Identifying the core issue: The client has received medical diagnostic information. 2. Recognizing professional boundaries: As a wellness coach, interpreting medical imaging is outside the scope of practice. 3. Prioritizing client well-being: The client needs accurate medical interpretation and guidance. 4. Seeking appropriate resources: Directing the client to qualified medical professionals is paramount. 5. Offering support within scope: Providing emotional support and assistance in navigating the healthcare system (e.g., scheduling appointments, preparing questions) is appropriate.

This scenario presents a professional challenge due to the inherent conflict between a client’s expressed desire and the wellness coach’s ethical and professional boundaries, particularly concerning the scope of practice. The wellness coach must navigate the client’s request for advice that extends beyond their certified expertise into medical diagnosis and treatment, which falls under the purview of licensed healthcare professionals. Careful judgment is required to maintain client trust while upholding professional integrity and adhering to regulatory guidelines. The best professional approach involves clearly and empathetically communicating the limitations of the wellness coach’s scope of practice. This approach prioritizes client safety and well-being by ensuring that medical concerns are addressed by qualified practitioners. Specifically, the coach should acknowledge the client’s concerns, express understanding, and then gently redirect the client to seek appropriate medical evaluation from their physician or a specialist. This aligns with the ethical principles of beneficence (acting in the client’s best interest) and non-maleficence (avoiding harm), as well as the governance of scope-of-practice, which mandates that coaches operate within their defined competencies and refer clients to other professionals when their needs exceed those competencies. This also upholds the principle of professional integrity by being transparent about one’s qualifications and limitations. An incorrect approach involves agreeing to provide advice on the client’s medical condition without the necessary qualifications. This directly violates the scope-of-practice governance, as it constitutes practicing outside of one’s certified expertise. Ethically, this action could lead to harm if the advice given is inaccurate or inappropriate, thereby breaching the duty of care and the principle of non-maleficence. It also undermines professional integrity and client trust. Another incorrect approach is to dismiss the client’s concerns outright without offering any guidance or referral. While it avoids practicing outside the scope, it fails to demonstrate empathy and support, potentially damaging the client relationship and neglecting the ethical principle of beneficence by not facilitating access to appropriate care. This approach can be perceived as unsupportive and unprofessional. A further incorrect approach is to provide general wellness advice that indirectly touches upon the medical condition without explicitly addressing it, hoping the client will connect the dots. This is ethically ambiguous and professionally risky. It can be seen as an attempt to skirt the boundaries of the scope of practice without being fully transparent, potentially misleading the client and still failing to ensure they receive the necessary medical attention. It lacks the clarity and directness required for effective and ethical client care. Professionals should employ a decision-making framework that begins with active listening to understand the client’s needs and concerns. This is followed by an assessment of whether the client’s request falls within the professional’s scope of practice and ethical guidelines. If it does not, the next step is to clearly and compassionately communicate these limitations, explain the rationale (referencing professional standards), and provide a clear referral to an appropriate qualified professional. Maintaining professional boundaries, prioritizing client safety, and fostering trust through transparency are paramount.

This scenario presents a professional challenge because it requires a wellness coach to interpret complex data from a client’s wearable device and electronic health record (EHR) to inform chronic care management. The coach must balance the client’s autonomy and privacy with the need to provide effective, evidence-based support, all while operating within the ethical and regulatory landscape governing health information and coaching practice. The potential for misinterpretation of data or overstepping professional boundaries necessitates a rigorous decision-making framework. The best approach involves a systematic, client-centered process that prioritizes data validation and collaborative decision-making. This begins with the coach independently reviewing the aggregated data from the wearable device and EHR, cross-referencing it for consistency and identifying trends or anomalies that may indicate a need for clinical intervention or adjustment to the wellness plan. Crucially, this initial interpretation is then presented to the client in a clear, understandable manner, facilitating a discussion about their understanding of the data and their personal health goals. The coach then collaborates with the client to co-develop or refine the wellness plan, ensuring it is aligned with their preferences and capabilities, and importantly, seeking explicit consent for any communication with healthcare providers. This approach respects client autonomy, promotes shared decision-making, and adheres to principles of informed consent and data privacy, which are foundational in ethical health coaching and align with general principles of patient-centered care and data protection regulations that emphasize transparency and client involvement. An incorrect approach would be to immediately implement changes to the client’s wellness plan based solely on the data without discussing it with the client. This fails to respect the client’s autonomy and right to self-determination in their healthcare journey. It also bypasses the essential step of validating the client’s understanding and acceptance of the data’s implications, potentially leading to a plan that is not sustainable or desirable for the client. Furthermore, it risks overstepping the coach’s scope of practice by making unilateral clinical decisions without proper consultation or client agreement. Another incorrect approach involves sharing the interpreted data and proposed plan directly with the client’s primary care physician without first obtaining explicit, informed consent from the client. This constitutes a breach of client confidentiality and data privacy. Regulations and ethical guidelines universally mandate that sensitive health information can only be shared with third parties, including healthcare providers, with the client’s express permission. This failure undermines trust and can have legal repercussions. A further incorrect approach is to dismiss any data that appears contradictory to the client’s stated goals without further investigation or discussion. This demonstrates a lack of thoroughness in data interpretation and a failure to address potential underlying issues that the data might be highlighting. A responsible coach must explore all data points, even those that seem inconvenient, to provide comprehensive support and ensure the wellness plan is truly addressing the client’s holistic needs. The professional decision-making process for similar situations should involve a structured approach: 1. Data Aggregation and Initial Review: Collect and review all relevant data from client-provided sources and authorized EHR access. 2. Data Interpretation and Trend Analysis: Analyze the data for patterns, anomalies, and potential implications for the client’s wellness goals. 3. Client-Centered Discussion and Validation: Present findings to the client in an accessible format, encouraging their interpretation and feedback. 4. Collaborative Plan Development: Work with the client to co-create or adjust the wellness plan based on the data and their goals. 5. Informed Consent for External Communication: Obtain explicit consent before sharing any information with other healthcare professionals. 6. Ongoing Monitoring and Adjustment: Regularly review progress and adapt the plan as needed.

The assessment process reveals a critical juncture in ensuring client safety and maintaining high standards of care within a wellness coaching practice. The scenario is professionally challenging because it requires balancing immediate client needs with the imperative to uphold established safety protocols and quality control measures. A failure in this area can lead to adverse health outcomes for clients, damage to professional reputation, and regulatory sanctions. Careful judgment is required to navigate situations where a client’s perceived urgency might conflict with the systematic processes designed to prevent harm and ensure efficacy. The best professional approach involves a systematic, evidence-based response that prioritizes client well-being while adhering to established safety and quality frameworks. This includes promptly documenting the observed issue, consulting relevant internal protocols or external guidelines (such as those from the World Health Organization’s guidelines on infection prevention and control or national health service quality standards), and initiating a review process. This approach ensures that the issue is addressed comprehensively, potential risks are mitigated, and lessons learned are integrated to improve future practice. It aligns with the ethical duty of care and the regulatory expectation for continuous quality improvement in healthcare services. An incorrect approach would be to dismiss the observation as minor or to address it solely based on the client’s immediate request without a proper assessment of underlying risks or systemic implications. This could involve overlooking the potential for broader issues that might affect other clients or the overall service quality. Such an approach fails to meet the standards of due diligence and proactive risk management expected of wellness professionals. Another unacceptable approach is to implement a solution without consulting established protocols or seeking expert advice. This can lead to the adoption of ineffective or even harmful practices, bypassing the quality control mechanisms designed to ensure client safety and the efficacy of interventions. It demonstrates a lack of commitment to evidence-based practice and regulatory compliance. Furthermore, delaying or avoiding the formal documentation and review of the observed issue is professionally unsound. This hinders accountability, prevents learning from the experience, and leaves the practice vulnerable to recurring problems. It undermines the principles of transparency and continuous improvement essential for maintaining high standards of care. The professional decision-making framework for similar situations should involve: 1. Observation and Identification: Clearly identify and document the observed issue. 2. Risk Assessment: Evaluate the potential risks to client safety and service quality. 3. Protocol Consultation: Refer to established organizational policies, professional guidelines, and relevant regulatory standards. 4. Expert Consultation: Seek advice from supervisors, peers, or subject matter experts if necessary. 5. Action Planning: Develop a plan to address the issue, including immediate interventions and long-term improvements. 6. Documentation and Review: Thoroughly document all actions taken and outcomes, and participate in any review processes to facilitate learning and enhance future practice.