Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the potential for harm based on evolving clinical pharmacology knowledge. The pharmacist must balance patient autonomy with their ethical and professional responsibility to ensure safe and effective medication use, especially when dealing with a medication that has known pharmacokinetic variability and potential for adverse drug reactions. The integration of clinical pharmacology, pharmacokinetics, and medicinal chemistry is crucial for understanding the underlying mechanisms of the patient’s condition and the drug’s action, but applying this knowledge ethically requires careful consideration of patient context. Correct Approach Analysis: The best professional approach involves a thorough, patient-centered discussion that educates the patient about the rationale for the proposed medication change, drawing upon the principles of clinical pharmacology and pharmacokinetics. This includes explaining how the new medication’s pharmacokinetic profile (absorption, distribution, metabolism, excretion) and its medicinal chemistry (how it interacts with biological targets) are expected to offer a more favorable therapeutic outcome and potentially reduce the risk of adverse effects compared to their current regimen. The pharmacist should actively listen to the patient’s concerns, address their misconceptions, and collaboratively develop a plan that respects their autonomy while prioritizing their well-being. This approach aligns with ethical principles of beneficence, non-maleficence, and respect for autonomy, and is supported by professional guidelines emphasizing patient education and shared decision-making. Incorrect Approaches Analysis: One incorrect approach involves overriding the patient’s wishes and unilaterally changing the prescription without adequate discussion or consent. This disregards patient autonomy and can erode trust, potentially leading to non-adherence. It fails to acknowledge the patient’s right to be informed and to participate in their healthcare decisions. Another incorrect approach is to simply dismiss the patient’s concerns as unfounded without providing a clear, evidence-based explanation. This demonstrates a lack of empathy and fails to leverage the pharmacist’s expertise in clinical pharmacology and pharmacokinetics to address the patient’s specific anxieties. It neglects the pharmacist’s duty to educate and empower patients. Finally, an incorrect approach would be to agree to the patient’s request to continue the current medication despite knowing it is suboptimal, solely to avoid confrontation. This violates the principle of beneficence and potentially non-maleficence, as the pharmacist would be knowingly allowing the patient to be exposed to a less effective or potentially more harmful treatment regimen. Professional Reasoning: Professionals should approach such situations by first understanding the patient’s perspective and concerns. Then, they should utilize their knowledge of clinical pharmacology, pharmacokinetics, and medicinal chemistry to formulate an evidence-based recommendation. This recommendation should be communicated clearly and empathetically to the patient, explaining the scientific rationale and potential benefits and risks of different treatment options. The decision-making process should be collaborative, respecting patient autonomy while ensuring the best possible health outcome.

This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and the pharmacist’s ethical and professional obligation to ensure patient safety and well-being, particularly when dealing with vulnerable populations. The pharmacist must navigate the complexities of patient autonomy, beneficence, and non-maleficence within the specific regulatory framework governing pharmaceutical practice in Latin America, which emphasizes patient-centered care and adherence to evidence-based guidelines. Careful judgment is required to balance these competing principles. The best approach involves a thorough and empathetic conversation with the patient to understand the underlying reasons for their request, while simultaneously consulting available clinical guidelines and, if necessary, seeking input from the prescribing physician. This approach prioritizes open communication, patient education, and collaborative decision-making. It aligns with ethical principles of informed consent and shared decision-making, ensuring the patient’s request is understood in its full context. Furthermore, it adheres to professional standards that mandate pharmacists to act in the best interest of the patient, which includes verifying the appropriateness of medication regimens and intervening when potential harm is identified. This method respects patient autonomy while upholding the pharmacist’s responsibility to ensure safe and effective medication use, as often stipulated in national pharmaceutical practice acts and ethical codes across Latin American countries. An incorrect approach would be to immediately refuse the patient’s request without further investigation. This fails to acknowledge the patient’s autonomy and the importance of understanding their perspective. It could lead to a breakdown in the patient-pharmacist relationship and may cause the patient to seek medication from less reputable sources, potentially compromising their safety. Another incorrect approach would be to fulfill the request without any attempt to verify its appropriateness or discuss potential risks with the patient. This directly violates the pharmacist’s duty of care and professional responsibility to ensure medication safety and efficacy. It disregards the potential for adverse drug reactions, drug interactions, or the inappropriateness of the dosage for the patient’s condition, which are core tenets of pharmaceutical practice in the region. Finally, an incorrect approach would be to immediately involve the physician without first attempting to engage the patient in a dialogue. While physician consultation is often necessary, bypassing direct communication with the patient can be perceived as dismissive of their concerns and may hinder the pharmacist’s ability to gather crucial information directly from the patient. Professionals should employ a decision-making framework that begins with active listening and empathetic engagement with the patient. This should be followed by a critical assessment of the request against established clinical guidelines and pharmacological knowledge. If uncertainties or concerns arise, collaborative consultation with the prescribing physician is a crucial step. Throughout this process, maintaining patient confidentiality and respecting their dignity are paramount.

The control framework reveals a scenario that is professionally challenging due to the inherent conflict between patient autonomy and the pharmacist’s duty of care, compounded by potential resource limitations within a public health setting. The pharmacist must navigate the ethical imperative to respect a patient’s informed decision while also ensuring that decision is truly informed and not influenced by misinformation or undue pressure, especially when it pertains to public health outcomes. Careful judgment is required to balance these competing principles. The approach that represents best professional practice involves a thorough, non-judgmental exploration of the patient’s reasoning, coupled with the provision of accurate, evidence-based information and a clear explanation of the potential consequences of their decision. This approach prioritizes patient education and empowerment, allowing the patient to make a truly informed choice. It aligns with ethical principles of beneficence (acting in the patient’s best interest by providing accurate information) and autonomy (respecting the patient’s right to self-determination), while also upholding professional responsibility to ensure understanding of public health implications. This method facilitates shared decision-making and maintains trust. An approach that involves immediately deferring to the patient’s stated refusal without further inquiry fails to uphold the pharmacist’s duty of care. While respecting autonomy is crucial, it assumes the patient’s decision is fully informed. In a public health context, where individual choices can impact community well-being, a pharmacist has a responsibility to ensure the patient understands the broader implications and has not been misled. This approach risks allowing a decision based on incomplete or incorrect information, potentially leading to negative health outcomes for the individual and the community. Another incorrect approach is to attempt to coerce or guilt the patient into compliance. This violates the principle of autonomy and can damage the patient-pharmacist relationship. Ethical practice demands respect for the patient’s right to refuse treatment or intervention, even if the pharmacist disagrees with the decision. Persuasion should be based on education and reasoned argument, not emotional manipulation or pressure. Finally, an approach that involves immediately reporting the patient to public health authorities without attempting to understand their concerns or provide further information is premature and potentially damaging. While reporting might be necessary in certain extreme circumstances, it should be a last resort after all attempts at patient education and engagement have been exhausted. Such an action can erode trust and discourage future engagement with healthcare services. Professionals should employ a decision-making framework that begins with active listening and empathy to understand the patient’s perspective. This is followed by a clear, objective assessment of the patient’s understanding of the situation and the potential consequences of their choices. The pharmacist should then provide accurate, unbiased information, addressing any misconceptions and explaining the rationale behind recommended public health interventions. The goal is to facilitate an informed decision, respecting the patient’s autonomy while fulfilling the professional duty of care.

The risk matrix shows a high likelihood of medication errors due to a lack of standardized electronic prescribing across different healthcare facilities within a Latin American country. This scenario is professionally challenging because it directly impacts patient safety, requires navigating complex regulatory landscapes that may vary by region or institution, and necessitates a proactive approach to process optimization to mitigate identified risks. Careful judgment is required to balance immediate patient care needs with long-term systemic improvements. The best approach involves developing and implementing a unified electronic prescribing system that adheres to national health informatics standards and data privacy regulations. This unified system should incorporate features for drug interaction checking, allergy alerts, and dose verification, thereby directly addressing the identified risk of medication errors. Regulatory justification stems from the fundamental ethical obligation to provide safe and effective patient care, which is supported by national health regulations promoting the adoption of health information technology to improve patient outcomes and reduce preventable harm. Such systems are often mandated or strongly encouraged by national health ministries to enhance interoperability and data security. An incorrect approach would be to rely solely on manual cross-referencing of patient medication histories between facilities. This fails to address the root cause of the problem, which is the lack of a standardized electronic system, and remains highly susceptible to human error, potentially leading to continued medication discrepancies and adverse events. Ethically and regulatorily, this passive approach does not meet the standard of care expected when a known systemic risk exists. Another incorrect approach would be to implement separate, proprietary electronic prescribing systems within each healthcare facility without ensuring interoperability or adherence to common national standards. While this might offer some localized benefits, it exacerbates data fragmentation, hinders seamless patient care transitions, and creates significant challenges for national health data aggregation and oversight, potentially violating data sharing and interoperability mandates. A further incorrect approach would be to focus solely on staff training for existing manual processes without addressing the underlying systemic issue of non-standardized prescribing. While training is important, it cannot compensate for a fundamentally flawed or absent technological infrastructure designed to prevent errors. This approach neglects the opportunity to leverage informatics for robust safety checks and fails to comply with regulatory expectations for adopting modern, evidence-based medication safety practices. Professionals should employ a decision-making framework that prioritizes risk assessment, evidence-based practice, and regulatory compliance. This involves identifying systemic vulnerabilities, evaluating potential solutions against established safety standards and regulatory requirements, and selecting the most effective and sustainable approach. A proactive, technology-driven strategy that fosters interoperability and adheres to national informatics guidelines is paramount for achieving optimal medication safety and regulatory adherence in this context.

Scenario Analysis: This scenario is professionally challenging because it requires a pharmacist to navigate the specific purpose and eligibility criteria for a specialized competency assessment without overstepping the defined scope or misinterpreting the assessment’s intent. Misunderstanding these foundational aspects can lead to inefficient resource allocation, inappropriate referrals, and a failure to meet the needs of the target population. Careful judgment is required to ensure the assessment serves its intended function within the Latin American population health context. Correct Approach Analysis: The best professional practice involves accurately identifying the primary purpose of the Comprehensive Latin American Population Health Pharmacy Competency Assessment as enhancing the health outcomes of Latin American populations through specialized pharmacy services and ensuring that only pharmacists meeting the defined eligibility criteria, typically related to their practice focus, experience, or commitment to serving this demographic, are directed towards it. This approach aligns with the assessment’s design to address specific health disparities and improve care for this group, ensuring that resources are utilized effectively and that the assessment genuinely contributes to its stated goals. This is ethically sound as it prioritizes targeted interventions and professional development for those best positioned to benefit and contribute to the population’s health. Incorrect Approaches Analysis: One incorrect approach is to assume the assessment is a general professional development tool applicable to any pharmacist regardless of their practice area or patient population. This fails to recognize the specific “Latin American Population Health” focus, potentially diverting pharmacists who do not serve this demographic away from more relevant training and misallocating assessment resources. Another incorrect approach is to interpret eligibility solely based on a pharmacist’s desire to work with Latin American populations in the future, without considering their current practice or demonstrated commitment. This broadens the eligibility beyond the assessment’s intended scope and may include individuals whose immediate impact on the target population’s health is uncertain, undermining the assessment’s purpose of addressing current needs. A further incorrect approach is to consider the assessment as a mandatory requirement for all pharmacists practicing in regions with a significant Latin American population, irrespective of their specific patient interactions or the assessment’s stated purpose. This misinterprets the assessment as a universal mandate rather than a targeted opportunity for specialized competency enhancement, potentially creating unnecessary administrative burdens and diluting the impact of the assessment. Professional Reasoning: Professionals should approach competency assessments by thoroughly understanding their stated purpose, target audience, and eligibility requirements as outlined by the governing body or assessment developers. This involves consulting official documentation, seeking clarification from assessment administrators if necessary, and critically evaluating how an individual’s current practice and professional goals align with the assessment’s objectives. The decision-making process should prioritize the efficient and effective application of resources to achieve the intended health outcomes for the specified population.

Scenario Analysis: This scenario presents a common challenge in sterile compounding where a deviation from a validated process is identified. The professional challenge lies in balancing the immediate need for product availability with the paramount importance of patient safety and product integrity. A hasty decision without proper investigation could lead to the administration of sub-potent, super-potent, or contaminated products, with severe consequences for patients. Conversely, an overly cautious approach that halts all production without clear justification could lead to critical drug shortages. Therefore, careful judgment, adherence to established protocols, and thorough investigation are essential. Correct Approach Analysis: The best professional practice involves immediately halting the compounding of the affected batch and initiating a comprehensive investigation. This approach is correct because it prioritizes patient safety by preventing the potential distribution of compromised medication. Regulatory frameworks, such as those governing pharmaceutical quality control and sterile product manufacturing, mandate that any deviation from established, validated processes must be thoroughly investigated to determine the root cause and assess the impact on product quality. This investigation should involve reviewing all relevant documentation, including compounding records, environmental monitoring data, equipment calibration logs, and personnel training records. The goal is to identify the source of the discrepancy and implement corrective and preventive actions (CAPA) before resuming production. This aligns with the principles of Good Manufacturing Practices (GMP) and Good Pharmacy Practice (GPP), which emphasize a proactive approach to quality assurance and risk management. Incorrect Approaches Analysis: One incorrect approach involves proceeding with the compounding of the remaining doses from the same batch while initiating a separate, less urgent investigation. This is professionally unacceptable because it risks exposing more patients to a potentially compromised product. The immediate priority is to contain the issue and prevent further risk, not to continue production under uncertain conditions. This violates the principle of “do no harm” and disregards the potential for widespread patient harm if the deviation impacts multiple doses. Another incorrect approach is to simply discard the entire batch and resume compounding without a thorough investigation. While discarding a potentially compromised batch is a reasonable step, failing to investigate the root cause means the underlying issue will likely recur, leading to repeated waste and continued risk. This approach is reactive rather than proactive and fails to address systemic weaknesses in the quality control system. It also represents a missed opportunity to improve processes and prevent future deviations. A further incorrect approach is to assume the deviation is minor and proceed with compounding after a brief visual inspection, without any formal investigation or documentation. This is highly unprofessional and ethically unsound. Visual inspection alone is insufficient to detect many types of contamination or potency issues. Regulatory bodies require documented evidence of investigation and resolution for any deviation from validated processes. This approach demonstrates a disregard for established quality standards and patient safety protocols, potentially leading to severe patient harm and regulatory sanctions. Professional Reasoning: Professionals should adopt a systematic, risk-based approach to quality control deviations. When a discrepancy is identified, the immediate steps should be to: 1) Contain the issue by halting production of the affected batch. 2) Initiate a formal, documented investigation to identify the root cause. 3) Assess the impact of the deviation on product quality and patient safety. 4) Implement appropriate corrective and preventive actions. 5) Document all findings and actions taken. This structured process ensures that decisions are evidence-based, patient safety is prioritized, and regulatory compliance is maintained.

Scenario Analysis: This scenario is professionally challenging because it requires a pharmacist to bridge care transitions for a patient with complex medication needs, ensuring continuity and safety across different healthcare settings. The risk of medication errors, duplication of therapy, or omission of critical medications is high during these transitions. Effective communication and collaboration among healthcare providers, as well as patient engagement, are paramount to prevent adverse events and optimize therapeutic outcomes. Correct Approach Analysis: The best approach involves a proactive, interdisciplinary strategy focused on comprehensive medication reconciliation and patient education. This entails the pharmacist actively engaging with the patient and their caregivers, reviewing all current medications (including over-the-counter and herbal supplements), identifying potential drug-related problems, and communicating these findings and recommendations clearly to the discharging physician and the receiving care provider. This aligns with principles of patient-centered care and the ethical imperative to ensure patient safety and optimal medication use, as emphasized in professional pharmacy practice standards that promote collaborative care and medication management across the continuum of care. Incorrect Approaches Analysis: One incorrect approach would be to rely solely on the patient to report their medication list to the new provider. This is professionally unacceptable as it places an undue burden on a potentially vulnerable patient and significantly increases the risk of incomplete or inaccurate information, leading to medication errors. It fails to uphold the pharmacist’s responsibility in ensuring safe medication use. Another incorrect approach would be to only communicate with the discharging physician without directly involving the patient or the receiving care provider in the medication review process. This limits the opportunity to identify patient-specific adherence issues, understanding, or concerns, and may result in a disconnect in care continuity. It neglects the collaborative nature of modern healthcare and the importance of a holistic patient assessment. A further incorrect approach would be to assume that the electronic health record accurately reflects the patient’s complete medication regimen without independent verification. While electronic records are valuable tools, they can contain errors, omissions, or outdated information. A pharmacist’s professional duty requires independent verification and critical evaluation of all medication data to ensure accuracy and safety. Professional Reasoning: Professionals should adopt a systematic process for medication therapy management during care transitions. This involves initiating medication reconciliation early, actively seeking information from all available sources (patient, caregivers, previous providers, electronic records), identifying and resolving drug-related problems, and facilitating clear communication with all involved parties. Prioritizing patient safety and understanding their medication experience should guide all decision-making.

This scenario presents a professional challenge because it requires balancing the need for consistent competency assessment with the practical realities of candidate performance and the integrity of the assessment process. Determining appropriate blueprint weighting, scoring, and retake policies necessitates a nuanced understanding of how these elements impact the validity and reliability of the Comprehensive Latin American Population Health Pharmacy Competency Assessment. Careful judgment is required to ensure that policies are fair, equitable, and uphold the standards expected of competent pharmacy professionals in the region. The best professional approach involves a systematic and data-driven review of the assessment blueprint and scoring mechanisms. This includes analyzing candidate performance data to identify areas where the weighting or scoring might be disproportionately affecting outcomes, and evaluating the effectiveness of the current retake policy in ensuring competency without creating undue barriers. Recommendations for adjustments should be based on evidence of improved assessment validity and reliability, and should be clearly communicated to stakeholders. This approach aligns with ethical principles of fairness and professional accountability, ensuring that the assessment accurately reflects the knowledge and skills required for safe and effective practice. It also adheres to the spirit of continuous improvement in professional development and assessment. An incorrect approach would be to arbitrarily change blueprint weighting or scoring without empirical justification. This could lead to an assessment that no longer accurately measures essential competencies, potentially allowing less qualified individuals to pass or unfairly penalizing well-prepared candidates. Such a change, driven by anecdotal evidence or pressure rather than data, would undermine the credibility of the assessment and could have negative implications for public health and patient safety. Another incorrect approach would be to implement a punitive retake policy that imposes excessive financial or time burdens on candidates who fail. While retakes are necessary to ensure competency, overly restrictive policies can discourage qualified individuals from pursuing or continuing in the profession, and do not necessarily guarantee improved performance on subsequent attempts. This approach fails to consider the underlying reasons for failure and can be seen as inequitable. Finally, an incorrect approach would be to solely focus on increasing the difficulty of the assessment without a corresponding review of the blueprint or scoring. This might lead to a higher failure rate but would not necessarily improve the assessment’s ability to differentiate between competent and incompetent candidates. It could also indicate a flaw in the assessment design rather than a lack of candidate preparedness. Professionals should employ a decision-making framework that prioritizes evidence-based practice, ethical considerations, and stakeholder engagement. This involves regularly reviewing assessment data, consulting with subject matter experts, and considering the impact of policies on candidates and the profession. Transparency in policy development and communication is also crucial.

Scenario Analysis: This scenario is professionally challenging because it requires the pharmacist to balance patient privacy with the need to ensure appropriate medication use and public health. The pharmacist must navigate the ethical obligation of confidentiality against the potential for harm if a patient is not adhering to their treatment or if there are safety concerns. This requires careful judgment, empathy, and a thorough understanding of professional responsibilities. Correct Approach Analysis: The best professional approach involves directly and empathetically engaging with the patient to understand the reasons for non-adherence or potential misuse. This approach prioritizes patient-centered care and respects their autonomy while seeking to identify and address the underlying issues. By initiating a private conversation, the pharmacist can explore barriers to adherence, such as cost, side effects, or misunderstanding of the medication’s purpose, and offer appropriate support, education, or referral. This aligns with ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as professional guidelines that emphasize open communication and patient empowerment. It also respects the patient’s right to privacy by not disclosing information to third parties without consent or a clear legal/ethical imperative. Incorrect Approaches Analysis: Disclosing the patient’s medication information to their family member without the patient’s explicit consent is a significant breach of patient confidentiality. This violates privacy regulations and ethical codes that mandate the protection of patient health information. Such an action erodes trust and can have severe legal and professional repercussions. Reporting the patient’s perceived non-adherence to their physician without first attempting to discuss it with the patient or understanding the context is premature and potentially damaging. While physician communication is important, it should be based on a comprehensive understanding of the patient’s situation, not on assumptions or incomplete information. This approach bypasses the opportunity for direct patient intervention and support. Ignoring the family member’s concern and refusing to engage in any discussion about the patient’s medication is professionally negligent. While patient privacy is paramount, a complete refusal to acknowledge a concerned party’s inquiry can be perceived as a lack of professional responsibility, especially if there are genuine safety concerns. A more nuanced approach that acknowledges the concern while upholding privacy is necessary. Professional Reasoning: Professionals should employ a patient-centered decision-making framework. This involves: 1) Actively listening to and acknowledging concerns raised by all parties involved, while prioritizing the patient’s rights. 2) Assessing the situation for immediate risks to the patient or others. 3) If direct patient engagement is possible, initiating a private, empathetic conversation to understand the patient’s perspective and identify barriers. 4) Offering education, support, and problem-solving strategies. 5) If patient consent is obtained or if there is a clear and imminent risk that cannot be mitigated otherwise, then considering appropriate disclosure to other healthcare professionals or, in extreme cases, relevant authorities, always in accordance with legal and ethical guidelines.

Scenario Analysis: This scenario is professionally challenging because it requires a pharmacist to balance the immediate need for comprehensive preparation with the practical constraints of time and available resources, all while ensuring the preparation is aligned with the specific competency requirements of the Comprehensive Latin American Population Health Pharmacy Competency Assessment. Misjudging the timeline or the effectiveness of preparation resources can lead to under-preparedness, impacting the candidate’s performance and potentially their career progression within the Latin American healthcare system. The assessment’s focus on population health pharmacy competencies necessitates a strategic approach to learning, rather than a superficial one. Correct Approach Analysis: The best approach involves a structured, phased preparation plan that begins with a thorough review of the assessment’s official syllabus and competency framework. This initial step is crucial for identifying key knowledge areas and skill domains. Following this, the candidate should allocate dedicated time slots for studying each identified competency, prioritizing areas where they have less experience or knowledge. Integrating practice questions and case studies relevant to Latin American population health pharmacy issues, and seeking feedback from peers or mentors who have experience with similar assessments, are vital components. This method ensures that preparation is targeted, efficient, and directly addresses the assessment’s objectives, aligning with the ethical imperative to demonstrate competence and the professional responsibility to be adequately prepared for assessment. Incorrect Approaches Analysis: One incorrect approach is to solely rely on general pharmacy textbooks and online resources without consulting the specific assessment guidelines. This fails to acknowledge that the assessment has a defined scope and emphasis, potentially leading to wasted effort on irrelevant material and a lack of focus on critical population health pharmacy competencies specific to the Latin American context. This approach also risks overlooking the unique regulatory and public health challenges prevalent in the region, which are likely to be central to the assessment. Another incorrect approach is to cram all preparation into the final week before the assessment. This method is highly likely to result in superficial learning, poor retention, and increased stress, significantly hindering the candidate’s ability to demonstrate deep understanding and application of complex population health pharmacy principles. It neglects the principle of continuous learning and mastery, which is essential for developing robust professional competencies. A third incorrect approach is to focus exclusively on theoretical knowledge without engaging in practical application through case studies or simulated scenarios. Population health pharmacy requires the ability to translate knowledge into actionable strategies for improving health outcomes at a population level. Without this practical component, the candidate may struggle to apply their learning to real-world situations, which is a core expectation of the assessment. Professional Reasoning: Professionals facing similar assessment preparation challenges should adopt a systematic and evidence-based approach. This involves: 1) Deconstructing the assessment requirements: Thoroughly understanding the syllabus, learning outcomes, and assessment format. 2) Self-assessment: Identifying personal strengths and weaknesses relative to the required competencies. 3) Resource identification and curation: Selecting high-quality, relevant resources, prioritizing those directly aligned with the assessment’s scope and jurisdiction. 4) Strategic planning: Developing a realistic study schedule that allows for in-depth learning, practice, and revision. 5) Active learning and application: Engaging with the material through practice questions, case studies, and discussions to solidify understanding and develop practical skills. 6) Seeking feedback: Utilizing mentors, peers, or study groups to gain insights and identify areas for improvement. This structured process ensures preparation is comprehensive, efficient, and directly addresses the professional standards expected.