This scenario is professionally challenging because it requires balancing the need for rigorous competency assessment with fairness and support for surgeons seeking to advance their skills in a highly specialized field. The Elite Pan-Asia Gynecologic Oncology Surgery Competency Assessment’s blueprint weighting, scoring, and retake policies directly impact a surgeon’s career progression and patient safety. Careful judgment is required to ensure these policies are applied equitably and effectively, reflecting both the demands of the specialty and the principles of professional development. The best approach involves a transparent and consistently applied policy that clearly outlines the weighting of different assessment components, the scoring thresholds for successful completion, and the conditions under which a retake is permitted. This approach is correct because it aligns with principles of fairness and due process, ensuring all candidates understand the expectations and have a clear pathway for demonstrating competency. Regulatory frameworks and ethical guidelines in professional assessments emphasize clarity, consistency, and objective evaluation. A well-defined policy minimizes ambiguity, reduces the potential for bias, and provides a predictable framework for candidates. This fosters trust in the assessment process and upholds the integrity of the competency standards for gynecologic oncology surgery. An approach that allows for subjective adjustments to scoring based on individual circumstances, without a pre-defined policy, fails to meet regulatory and ethical standards. This introduces an unacceptable level of arbitrariness and potential for bias, undermining the objectivity of the assessment. It also creates an uneven playing field for candidates, as the criteria for success become unpredictable. Another incorrect approach is to have overly punitive retake policies that offer limited opportunities or impose significant barriers to re-assessment. This can stifle professional development and discourage highly capable surgeons from pursuing advanced certification, potentially impacting the availability of skilled practitioners. Such a policy may not align with the ethical imperative to support continuous learning and skill enhancement within the medical profession. Finally, an approach where the blueprint weighting is not clearly communicated to candidates prior to the assessment is ethically problematic. This lack of transparency prevents candidates from adequately preparing and understanding how their performance will be evaluated, violating principles of informed consent and fair assessment practices. Professionals should use a decision-making process that prioritizes transparency, fairness, and adherence to established assessment principles. This involves clearly defining and communicating all policies related to blueprint weighting, scoring, and retakes before candidates begin the assessment process. Regular review and potential revision of these policies should be undertaken to ensure they remain relevant, equitable, and aligned with best practices in professional competency evaluation.

The control framework reveals the critical importance of understanding the purpose and eligibility criteria for specialized competency assessments like the Elite Pan-Asia Gynecologic Oncology Surgery Competency Assessment. This scenario is professionally challenging because it requires a nuanced understanding of how such assessments are designed to uphold patient safety and advance surgical standards within a specific regional context, while also balancing the professional aspirations of surgeons. Misinterpreting the purpose or eligibility can lead to wasted resources, professional frustration, and potentially, a delay in recognizing highly skilled surgeons who could contribute to improved patient outcomes. The best approach involves recognizing that the assessment is designed to identify and credential surgeons who have demonstrated a high level of proficiency and expertise in gynecologic oncology surgery, specifically within the Pan-Asian region. This includes understanding that eligibility is likely tied to a combination of documented surgical experience, specialized training, and potentially, peer recognition or specific procedural volume, all aimed at ensuring that those who pass are truly at the elite level. The regulatory and ethical justification for this approach lies in the fundamental principle of patient welfare. Competency assessments are a cornerstone of professional regulation, ensuring that only qualified individuals are permitted to perform complex procedures. For a Pan-Asian assessment, this means ensuring that the standards reflect the specific challenges and best practices prevalent in that region, thereby enhancing the quality and safety of care for patients across Asia. An incorrect approach would be to assume the assessment is a general surgical credentialing process without considering its specialized nature and regional focus. This failure overlooks the specific intent to benchmark elite performance in a particular subspecialty and geographic area. Another incorrect approach would be to believe that simply having a medical license and some experience in gynecologic oncology is sufficient for eligibility, without acknowledging the likely requirement for advanced, specialized training and a significant volume of complex cases. This disregards the “elite” aspect of the assessment and its purpose of identifying top-tier surgeons. Finally, assuming the assessment is primarily a pathway for career advancement or a means to gain international recognition without meeting stringent, predefined criteria would be a flawed perspective. This misunderstands that such assessments are driven by patient safety and quality assurance, not solely by individual career goals. Professional reasoning in such situations requires a systematic approach: first, thoroughly research and understand the stated purpose and eligibility criteria of the specific assessment. Second, honestly evaluate one’s own qualifications against these criteria, seeking clarification from the assessment body if necessary. Third, consider the ethical imperative to only participate in assessments for which one is genuinely qualified, thereby respecting the integrity of the process and the standards it aims to uphold.

The evaluation methodology shows that assessing competency in elite pan-Asian gynecologic oncology surgery requires a nuanced approach that balances technical skill with patient-centered care and adherence to evolving best practices. This scenario is professionally challenging because it demands not only a surgeon’s mastery of complex procedures but also their ability to navigate diverse patient needs, cultural considerations, and the ethical imperative of continuous learning within a highly specialized field. Careful judgment is required to ensure that assessment methods are comprehensive, fair, and ultimately serve to improve patient outcomes. The best approach involves a multi-faceted assessment that integrates direct observation of surgical performance by experienced peers, a thorough review of operative reports and patient outcomes, and a structured discussion of complex case management, including ethical dilemmas and adherence to the latest evidence-based guidelines. This method is correct because it provides a holistic view of the surgeon’s capabilities, directly evaluating their technical proficiency in a real-world setting, their ability to document and learn from their practice, and their critical thinking skills in managing challenging clinical situations. It aligns with the principles of competency-based assessment, emphasizing both what a surgeon can do and how they apply that knowledge and skill ethically and effectively, reflecting the standards expected in elite surgical practice. An approach that relies solely on the surgeon’s self-assessment and a review of published literature is professionally unacceptable. This fails to provide objective evidence of surgical skill and decision-making in practice. It overlooks the critical element of direct observation and peer feedback, which are essential for identifying subtle technical nuances or potential areas for improvement that a surgeon might not recognize themselves. Furthermore, it does not adequately assess the surgeon’s ability to apply knowledge to individual patient circumstances or to manage intraoperative complications. Another unacceptable approach is one that focuses exclusively on the number of procedures performed without considering the complexity, outcomes, or the surgeon’s role in each case. While volume can be an indicator of experience, it does not guarantee competency or quality. This method risks overlooking surgeons who may have high volumes but suboptimal outcomes or who are not performing the most challenging procedures independently. It fails to capture the depth of expertise required for elite practice. Finally, an approach that prioritizes theoretical knowledge through written examinations alone, without practical or case-based components, is insufficient. While theoretical knowledge is foundational, it does not directly translate to surgical competence. The ability to perform surgery safely and effectively requires psychomotor skills, judgment under pressure, and the capacity to adapt to unforeseen circumstances, none of which are fully assessed by written tests. Professionals should employ a decision-making process that prioritizes comprehensive evaluation. This involves defining clear competency standards, utilizing a variety of assessment tools that capture different facets of performance (technical, cognitive, and behavioral), ensuring assessments are conducted by qualified and unbiased evaluators, and providing constructive feedback for continuous professional development. The ultimate goal is to ensure patient safety and optimize surgical outcomes through rigorous and fair evaluation.

The evaluation methodology shows that managing operative principles, instrumentation, and energy device safety in gynecologic oncology surgery requires a meticulous and proactive approach, especially given the complexity and potential risks involved. This scenario is professionally challenging due to the critical nature of oncologic surgery, where precision, patient safety, and adherence to best practices are paramount. Surgeons must balance the need for effective tumor removal with minimizing damage to surrounding healthy tissues and preventing complications such as unintended thermal injury. The rapid evolution of surgical technology, including advanced energy devices, necessitates continuous learning and strict adherence to safety protocols. The best approach involves a comprehensive pre-operative assessment of instrumentation and energy device functionality, coupled with a clear understanding of the specific device’s limitations and intended use in the context of the planned oncologic resection. This includes verifying that all instruments are sterile, functional, and appropriate for the surgical task, and that the chosen energy device settings are optimized for tissue type and surgical objective, with a clear plan for managing potential complications like smoke plume and unintended thermal spread. This aligns with ethical principles of beneficence and non-maleficence, ensuring the patient receives the highest standard of care while minimizing harm. Regulatory guidelines, such as those promoted by surgical professional bodies and hospital accreditation standards, emphasize the importance of a safe surgical environment, proper equipment maintenance, and surgeon competency in using advanced technologies. An incorrect approach would be to assume that all instruments and energy devices are functioning optimally without specific verification, relying solely on prior experience. This overlooks the potential for equipment malfunction or subtle degradation that could compromise surgical precision or patient safety, violating the principle of non-maleficence and potentially contravening hospital policies on equipment checks. Another incorrect approach is to use an energy device at settings that are not specifically validated for the tissue type being manipulated or for the specific surgical maneuver, without considering the potential for collateral thermal damage or charring. This demonstrates a lack of adherence to established best practices for energy device use, which are designed to maximize efficacy while minimizing iatrogenic injury, and could lead to increased post-operative complications, thereby failing the duty of care. A further incorrect approach is to neglect the management of surgical smoke, which can contain hazardous byproducts and obscure the surgical field. Failure to implement appropriate smoke evacuation strategies not only poses a risk to the surgical team’s health but also compromises the surgeon’s ability to visualize critical structures, increasing the risk of operative errors and patient harm. This disregards established safety protocols and ethical considerations for both patient and staff well-being. Professionals should adopt a decision-making process that prioritizes patient safety through rigorous pre-operative preparation, continuous intra-operative vigilance, and a commitment to evidence-based practices. This involves a systematic review of surgical plans, equipment checks, and a thorough understanding of the risks and benefits associated with each surgical step and technological tool employed.

Scenario Analysis: This scenario is professionally challenging due to the immediate life-threatening nature of gynecologic oncology emergencies, the need for rapid, coordinated intervention, and the potential for significant patient harm if protocols are not followed. The complexity arises from integrating surgical expertise with critical care principles, requiring swift decision-making under pressure, effective interdisciplinary communication, and adherence to established resuscitation guidelines to optimize patient outcomes. Correct Approach Analysis: The best professional practice involves immediate activation of the hospital’s established trauma and critical care resuscitation protocols, tailored to the specific gynecologic oncology emergency. This approach is correct because it ensures a systematic, evidence-based response that prioritizes life support, addresses hemodynamic instability, and facilitates timely surgical intervention. Adherence to these protocols aligns with professional ethical obligations to provide competent care and minimize patient harm, as well as regulatory requirements for standardized emergency management. It ensures that all necessary steps, from airway management to fluid resuscitation and blood product administration, are considered and implemented efficiently by a multidisciplinary team. Incorrect Approaches Analysis: Initiating immediate surgical exploration without a structured resuscitation phase is professionally unacceptable. This approach fails to address potential underlying physiological derangements such as hypovolemia or coagulopathy, which can significantly increase surgical risks and mortality. It bypasses critical steps mandated by trauma and critical care protocols designed to stabilize the patient before invasive procedures. Delaying surgical intervention to conduct an exhaustive diagnostic workup beyond initial bedside assessments is also professionally unacceptable. While diagnostics are important, in a critical emergency, prolonged delays in definitive surgical management when indicated can lead to irreversible organ damage and increased morbidity or mortality. This approach neglects the urgency dictated by the patient’s unstable condition. Relying solely on the surgical team’s experience without engaging the critical care team and established resuscitation protocols is professionally unacceptable. This siloed approach can lead to fragmented care, missed opportunities for optimal physiological support, and a failure to leverage specialized expertise in managing critically ill patients. It deviates from the collaborative, protocol-driven care essential in complex emergencies. Professional Reasoning: Professionals should employ a structured decision-making process that begins with rapid assessment of the patient’s hemodynamic status and airway. This should be followed by immediate activation of appropriate emergency response systems and protocols. Effective communication among the surgical, critical care, and nursing teams is paramount. The decision to proceed with surgery should be based on a clear indication of surgical pathology requiring intervention, coupled with adequate physiological resuscitation to optimize the patient for the procedure. Continuous reassessment of the patient’s response to interventions is crucial throughout the management process.

This scenario is professionally challenging due to the inherent risks associated with complex gynecologic oncology surgery and the critical need for timely, accurate management of unexpected intraoperative complications. The surgeon must balance the immediate need for patient safety with the long-term implications of surgical decisions, all while adhering to established best practices and ethical obligations. The pressure of a live surgical environment, potential for unforeseen anatomical variations, and the patient’s underlying oncologic condition necessitate a structured and evidence-based approach to complication management. The best approach involves immediate, clear communication with the surgical team, including the anaesthetist and nursing staff, to assess the nature and extent of the complication. This is followed by a rapid, evidence-based decision-making process to implement the most appropriate corrective action, prioritizing patient haemodynamic stability and anatomical integrity. This approach aligns with the fundamental ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm). It also reflects the professional responsibility to maintain competence and act within the scope of one’s expertise, seeking consultation if necessary. Regulatory frameworks emphasize patient safety as paramount and require surgeons to manage complications competently and ethically. An incorrect approach would be to proceed with the planned dissection without adequately addressing the identified vascular injury. This fails to uphold the principle of non-maleficence, as it knowingly risks further haemorrhage and potential organ ischaemia, leading to significant patient harm. Ethically, it represents a dereliction of duty to manage an emergent situation proactively. Another incorrect approach would be to abruptly terminate the procedure without attempting to control the bleeding or stabilize the patient, and then immediately delegate the management to another surgeon without a proper handover or clear rationale. This demonstrates a failure to act decisively in a critical situation and could be seen as abandoning the patient’s immediate care, potentially violating professional conduct guidelines that expect surgeons to manage complications within their purview or seek appropriate assistance in a structured manner. A further incorrect approach would be to delay definitive management of the vascular injury while attempting to complete the oncologic resection, assuming the bleeding can be managed with less invasive measures later. This prioritizes the oncologic goal over immediate patient safety, which is a misapplication of clinical judgment and violates the principle of immediate harm avoidance. It also fails to acknowledge the potential for the complication to escalate rapidly and compromise the entire surgical field. Professionals should employ a structured decision-making process when faced with intraoperative complications. This involves: 1. Rapid assessment of the situation and its immediate impact on the patient’s stability. 2. Identification of potential causes and immediate corrective actions based on established surgical principles and evidence. 3. Clear and concise communication with the entire surgical team to ensure coordinated action. 4. Implementation of the chosen corrective strategy with continuous reassessment of the patient’s response. 5. Consideration of further consultation or escalation of care if the complication is beyond the surgeon’s immediate expertise or if patient stability is compromised. This systematic approach ensures that patient safety remains the absolute priority while addressing the underlying surgical issue.

The assessment process reveals a common challenge in complex surgical specialties: balancing the need for comprehensive pre-operative planning with the dynamic nature of operative execution. In gynecologic oncology, where patient anatomy can be significantly altered by disease and prior treatments, structured operative planning is paramount. The professional challenge lies in anticipating potential intraoperative complications and developing robust mitigation strategies without becoming overly rigid, which could hinder necessary adaptations. Careful judgment is required to ensure patient safety and optimize oncologic outcomes while respecting the surgeon’s autonomy and clinical expertise. The best approach involves a systematic pre-operative assessment that includes detailed imaging review, multidisciplinary team consultation, and the development of a tiered operative plan. This plan should outline primary, secondary, and even tertiary strategies for managing anticipated challenges, such as extensive adhesions, unexpected tumor involvement, or the need for complex reconstructive techniques. Crucially, this planning phase must also incorporate a thorough risk assessment, identifying potential complications and outlining specific measures to prevent or manage them, such as the availability of specialized equipment or the presence of consultants with specific expertise. This aligns with ethical principles of beneficence and non-maleficence, ensuring that all reasonable steps are taken to maximize patient benefit and minimize harm. It also reflects best practice in surgical quality improvement, emphasizing proactive problem-solving. An approach that focuses solely on the most straightforward surgical pathway, without adequately considering alternative scenarios or potential complications, is professionally unacceptable. This failure to anticipate and plan for contingencies increases the risk of intraoperative decision-making under pressure, potentially leading to suboptimal outcomes or preventable complications. It neglects the ethical duty to prepare thoroughly for all foreseeable eventualities. Another professionally unacceptable approach is to delegate the entire risk mitigation strategy to junior team members without adequate senior oversight or integration into the primary operative plan. While junior input is valuable, the ultimate responsibility for comprehensive planning and risk assessment rests with the senior surgeon. This approach risks overlooking critical aspects or failing to adequately resource the mitigation strategies. Finally, an approach that prioritizes speed and efficiency over thorough planning, assuming that intraoperative problem-solving will suffice, is also professionally unsound. While surgical efficiency is desirable, it should not come at the expense of meticulous pre-operative preparation. This can lead to rushed decisions, increased operative time due to unforeseen difficulties, and a higher likelihood of adverse events. Professionals should employ a decision-making framework that begins with a comprehensive understanding of the patient’s specific pathology and anatomy. This should be followed by a collaborative planning session involving the entire surgical team and relevant specialists. The process should include a structured risk assessment, the development of contingency plans, and clear communication of these plans to all team members. Regular review and refinement of the plan based on evolving information are also essential components of professional surgical practice.

The scenario is professionally challenging because it requires a surgeon to balance the demands of advanced surgical training with the ethical imperative of patient safety and the efficient allocation of limited training resources. The pressure to master complex techniques within a defined timeframe, while also ensuring adequate preparation, necessitates careful planning and resource management. Misjudging the preparation timeline or relying on suboptimal resources can lead to compromised surgical performance, potentially impacting patient outcomes and the surgeon’s professional development. The best approach involves a structured, proactive, and evidence-based preparation strategy. This includes meticulously reviewing the specific competency assessment requirements, identifying knowledge and skill gaps through self-assessment and peer feedback, and then systematically addressing these gaps using a combination of high-fidelity simulation, cadaveric labs, and focused didactic learning. The timeline should be realistic, allowing ample time for deliberate practice and consolidation of learning, ideally commencing several months in advance of the assessment. This approach aligns with ethical principles of competence and due care, ensuring the surgeon is adequately prepared to perform safely and effectively. It also reflects best practice in professional development, emphasizing continuous learning and skill refinement. An approach that relies solely on reviewing surgical videos in the weeks leading up to the assessment is professionally unacceptable. While video review can be a supplementary tool, it lacks the hands-on practice and feedback necessary to develop surgical proficiency. This method fails to address the practical, psychomotor skills required for complex gynecologic oncology surgery and neglects the ethical obligation to ensure demonstrable competence through active skill acquisition. Another professionally unacceptable approach is to assume prior experience in similar procedures is sufficient without dedicated preparation for the specific assessment criteria. This overlooks the nuances and specific demands of the competency assessment, potentially leading to a false sense of security. It violates the principle of due diligence, as it fails to proactively identify and address any unique requirements or standards of the assessment, thereby risking underperformance. Finally, an approach that prioritizes attending numerous unrelated surgical conferences over focused, targeted preparation for the assessment is also professionally unsound. While broad exposure to surgical advancements is valuable, it does not substitute for the specific, deliberate practice needed to master the competencies being evaluated. This strategy represents a misallocation of time and resources, failing to directly address the assessment’s objectives and potentially leaving critical skill gaps unaddressed. Professionals should adopt a decision-making framework that begins with a thorough understanding of the assessment’s objectives and requirements. This should be followed by an honest self-assessment of current capabilities, identifying specific areas for improvement. Subsequently, a personalized, evidence-based learning plan should be developed, incorporating a variety of learning modalities and realistic timelines. Regular self-evaluation and seeking feedback from mentors or peers are crucial throughout the preparation process to ensure progress and adapt the plan as needed.

The evaluation methodology shows a commitment to assessing core knowledge domains in elite Pan-Asia gynecologic oncology surgery. This scenario is professionally challenging because it requires balancing the need for rigorous, standardized assessment with the diverse cultural contexts and existing training frameworks across Pan-Asia. Ensuring that the assessment accurately reflects competency without imposing a single, potentially inappropriate, standard is paramount. Careful judgment is required to design an evaluation that is both effective and culturally sensitive. The best approach involves developing a competency framework that is informed by a consensus of leading Pan-Asian gynecologic oncologists, incorporating both universally accepted surgical principles and region-specific best practices. This framework should then guide the creation of assessment tools that are validated across different sub-regions within Pan-Asia. This approach is correct because it prioritizes a collaborative, evidence-based methodology that respects regional expertise and ensures the assessment’s relevance and applicability. It aligns with ethical principles of fairness and equity in professional development, ensuring that the assessment is a true measure of competency across the diverse Pan-Asian landscape. An approach that solely relies on adapting existing Western assessment models without significant Pan-Asian input is professionally unacceptable. This fails to acknowledge the unique challenges, patient populations, and healthcare systems present in Pan-Asia, potentially leading to an assessment that is not reflective of actual clinical practice or competency in the region. It risks imposing standards that may be unattainable or irrelevant, undermining the purpose of the assessment. Another professionally unacceptable approach would be to delegate the entire assessment design to a single institution or country within Pan-Asia. This lacks the breadth of perspective necessary for a Pan-Asia assessment, potentially embedding the biases and specific training paradigms of that single entity. It would fail to achieve the goal of a truly Pan-Asian competency assessment, leading to a skewed and unrepresentative evaluation. Finally, an approach that prioritizes speed of implementation over thorough validation and stakeholder consultation is also professionally unsound. While efficiency is desirable, rushing the development of a high-stakes competency assessment without adequate input and validation can lead to flawed instruments that do not accurately measure the intended competencies, potentially disadvantaging capable surgeons and failing to uphold the standards of elite practice. Professionals should employ a decision-making framework that begins with clearly defining the assessment’s objectives and scope. This should be followed by extensive stakeholder engagement, including surgeons, educators, and regulatory bodies from across Pan-Asia, to gather input on core competencies and assessment methodologies. A phased approach to development, including pilot testing and iterative refinement based on feedback and validation data, is crucial. Ethical considerations, such as fairness, equity, and cultural sensitivity, must be integrated into every stage of the design and implementation process.

Scenario Analysis: This scenario is professionally challenging because it requires a surgeon to balance immediate patient needs with the long-term implications of surgical intervention, particularly in the context of potential oncological recurrence and the need for precise anatomical knowledge. The surgeon must consider not only the immediate surgical goal but also the impact on subsequent diagnostic imaging and treatment planning, all while adhering to ethical principles of patient care and informed consent. Careful judgment is required to select the approach that maximizes diagnostic accuracy and therapeutic efficacy without compromising patient safety or future management options. Correct Approach Analysis: The best professional practice involves meticulously identifying and documenting the precise location of the primary tumor and any suspicious lymph nodes using intraoperative imaging guidance and palpation, and then performing a targeted excision of the primary tumor and relevant lymph nodes. This approach is correct because it directly addresses the immediate oncological concern while preserving adjacent anatomical structures that are crucial for accurate staging and potential future interventions. It aligns with the ethical principle of beneficence by aiming for the most effective treatment while minimizing harm. Furthermore, it respects the principle of non-maleficence by avoiding unnecessary dissection that could compromise future diagnostic capabilities or lead to complications. This method ensures that the specimen is optimally prepared for pathological analysis, providing the most accurate information for subsequent treatment decisions. Incorrect Approaches Analysis: One incorrect approach involves a broad, en bloc resection of a large area encompassing the primary tumor and surrounding tissues without precise identification of the tumor margins or suspicious nodal stations. This is professionally unacceptable because it risks unnecessary removal of healthy tissue, potentially leading to increased morbidity and functional deficits. It also compromises the accuracy of pathological staging by including uninvolved tissues, which can lead to over- or under-treatment. Another incorrect approach is to perform a partial excision of the primary tumor, leaving significant residual disease, with the intention of relying solely on adjuvant therapy. This is professionally unacceptable as it fails to achieve the primary surgical goal of complete tumor removal, thereby increasing the risk of local recurrence and metastasis. It also demonstrates a failure to adhere to the principle of providing the most effective treatment available at the time of surgery. A third incorrect approach is to proceed with surgery without adequate intraoperative imaging or palpation to precisely delineate the tumor and suspicious lymph nodes, relying solely on anatomical landmarks. This is professionally unacceptable because it significantly increases the risk of incomplete resection, damage to vital structures, and inadequate sampling of nodal basins, all of which can have severe consequences for patient outcomes and future management. It represents a failure to utilize available tools to ensure surgical precision and patient safety. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with a thorough understanding of the patient’s specific pathology and relevant anatomy. This involves pre-operative planning, including reviewing imaging and considering potential anatomical variations. During surgery, the surgeon must continuously assess the situation, utilizing all available diagnostic tools (e.g., intraoperative ultrasound, palpation) to precisely identify the target lesion and surrounding critical structures. The decision-making process should prioritize achieving oncological goals (complete resection, accurate staging) while simultaneously minimizing iatrogenic harm and preserving function. This requires a commitment to evidence-based practice and adherence to ethical principles of patient care.