This scenario is professionally challenging because it requires balancing the urgent need to establish competency assessment for Long COVID and post-viral conditions within Caribbean healthcare systems against the complexities of resource limitations, diverse healthcare infrastructures, and varying levels of existing regulatory frameworks across different islands. Careful judgment is required to ensure that any assessment process is not only effective in identifying competent practitioners but also equitable, accessible, and sustainable within the regional context. The best approach involves a phased, collaborative development process that prioritizes the establishment of a regional steering committee. This committee, composed of representatives from national health ministries, professional medical associations, and patient advocacy groups across the Caribbean, would be tasked with developing a standardized competency framework. This framework would then inform the creation of assessment tools and training modules tailored to the specific needs and resources of the region. This approach is correct because it fosters buy-in, ensures cultural relevance, and promotes resource sharing, thereby enhancing operational readiness and sustainability. It aligns with principles of good governance and collaborative healthcare development, which are implicitly encouraged by regional health organizations aiming for standardized quality of care. An incorrect approach would be to adopt a competency assessment model from a highly resourced, developed nation without adaptation. This fails to acknowledge the unique economic and infrastructural realities of Caribbean nations, potentially leading to an assessment process that is prohibitively expensive, technically complex, or culturally inappropriate, rendering it operationally unfeasible and inequitable. Another incorrect approach would be to delegate the entire responsibility for developing and implementing competency assessments to individual island nations without any regional coordination. This would likely result in a fragmented and inconsistent approach, with significant disparities in the quality and rigor of assessments across the Caribbean. It would also miss opportunities for shared learning and resource optimization, hindering overall operational readiness. Finally, an incorrect approach would be to prioritize speed of implementation over thoroughness by using pre-existing, generic assessment tools without validation or adaptation. This risks assessing competencies that are not relevant to the specific challenges of Long COVID and post-viral care in the Caribbean context, or conversely, failing to assess critical regional needs. It undermines the integrity of the assessment process and its ability to genuinely measure operational readiness. Professionals should employ a decision-making framework that begins with a thorough needs assessment, considering the specific context of Long COVID and post-viral care within the Caribbean. This should be followed by stakeholder engagement to ensure buy-in and relevance. A phased implementation strategy, starting with pilot programs and iterative refinement, is crucial. Collaboration and knowledge sharing among Caribbean nations should be actively encouraged to leverage collective expertise and resources. Finally, continuous evaluation and adaptation of the assessment process are necessary to ensure its ongoing effectiveness and relevance.

The investigation demonstrates a scenario where a healthcare professional is seeking to understand their eligibility for a specialized competency assessment. This situation is professionally challenging because it requires navigating the specific criteria and purpose of the Premier Caribbean Long COVID and Post-Viral Medicine Competency Assessment, ensuring alignment with the individual’s professional background and the assessment’s stated objectives. Misinterpreting eligibility can lead to wasted resources, professional frustration, and a delay in obtaining necessary credentials. Careful judgment is required to accurately assess whether one’s experience and qualifications meet the defined standards for this niche assessment. The correct approach involves a thorough review of the official documentation outlining the purpose and eligibility requirements for the Premier Caribbean Long COVID and Post-Viral Medicine Competency Assessment. This includes understanding the specific patient populations, clinical conditions, and skill sets the assessment is designed to evaluate. By cross-referencing one’s professional experience, training, and current practice against these explicit criteria, an individual can make an informed decision about their suitability. This aligns with ethical professional conduct by ensuring that individuals pursue assessments that are relevant to their practice and that they meet the established standards for competence in the designated field. Regulatory frameworks in healthcare competency assessments typically emphasize transparency and clear criteria to ensure the validity and reliability of the evaluation process. An incorrect approach would be to assume eligibility based on a general understanding of post-viral conditions or a broad desire to work in the field without consulting the specific assessment guidelines. This could lead to applying for an assessment for which one is not qualified, potentially misrepresenting one’s expertise. Another incorrect approach is to rely solely on anecdotal evidence or the experiences of colleagues who may have different backgrounds or have undergone different assessment processes. This bypasses the official channels for determining eligibility and can lead to significant misunderstandings about the assessment’s scope and requirements. A further incorrect approach is to focus on the perceived prestige or career advancement opportunities of the assessment without verifying if the individual’s practice directly aligns with the specialized competencies being assessed. This prioritizes personal gain over ensuring genuine competence in the specific area. Professionals should adopt a systematic decision-making process when considering specialized competency assessments. This process should begin with identifying the assessment and its stated purpose. Next, a detailed review of the official eligibility criteria, including any prerequisites, experience requirements, and scope of practice, is essential. This should be followed by an honest self-assessment of one’s own qualifications and experience against these criteria. If there is any ambiguity, seeking clarification directly from the assessment body is a crucial step. This methodical approach ensures that decisions are based on accurate information and align with professional standards and ethical considerations.

Regulatory review indicates that managing patients with Long COVID and post-viral syndromes presents significant professional challenges due to the evolving understanding of these conditions, the potential for symptom overlap with other diagnoses, and the ethical imperative to provide evidence-based care while acknowledging patient experiences. Careful judgment is required to balance diagnostic uncertainty with the need for timely and appropriate interventions. The correct approach involves a comprehensive, multidisciplinary assessment that integrates the patient’s subjective experience with objective clinical findings and current scientific literature. This approach prioritizes establishing a clear diagnostic pathway, ruling out other potential causes for the patient’s symptoms, and developing a personalized management plan. It aligns with ethical principles of beneficence and non-maleficence by ensuring that care is tailored to the individual’s needs and based on the best available evidence, while also respecting patient autonomy through shared decision-making. This method also adheres to professional guidelines that advocate for holistic patient care and continuous learning in emerging medical fields. An incorrect approach would be to dismiss the patient’s symptoms as purely psychological without a thorough medical workup. This fails to acknowledge the biological underpinnings of Long COVID and post-viral syndromes, potentially leading to delayed or inappropriate treatment, and can erode patient trust, violating the principle of respect for persons. Another incorrect approach is to rely solely on anecdotal evidence or unproven therapies without critical evaluation. This risks exposing the patient to ineffective or harmful treatments, contravening the principle of non-maleficence and potentially violating regulations concerning the promotion of unproven medical interventions. Finally, adopting a purely symptomatic treatment approach without investigating underlying mechanisms or potential contributing factors neglects the complexity of these conditions and may lead to suboptimal long-term outcomes, failing to meet the standard of comprehensive medical care. Professionals should employ a decision-making framework that begins with active listening and empathetic engagement with the patient’s narrative. This should be followed by a systematic diagnostic process, utilizing available clinical tools and evidence-based guidelines. When faced with uncertainty, consultation with specialists and engagement in ongoing professional development are crucial. The process should always prioritize patient safety and well-being, ensuring that all interventions are ethically sound and professionally justifiable.

Scenario Analysis: This scenario presents a professional challenge due to the inherent complexity of Long COVID and post-viral syndromes, which often involve multifaceted symptoms and a lack of standardized diagnostic criteria or universally accepted treatment protocols. Professionals must navigate patient expectations, evolving scientific understanding, and the ethical imperative to provide evidence-based care while acknowledging the limitations of current knowledge. The pressure to offer definitive solutions can be high, making it crucial to maintain professional integrity and avoid premature or unsubstantiated claims. Correct Approach Analysis: The best professional approach involves a comprehensive, individualized assessment that integrates the patient’s reported symptoms, medical history, and relevant diagnostic findings. This approach prioritizes a thorough understanding of the patient’s unique presentation and potential contributing factors. It aligns with ethical principles of patient-centered care and the professional obligation to practice within the scope of evidence-based medicine. Specifically, it adheres to the principles of good medical practice by ensuring that any diagnostic or therapeutic interventions are guided by the best available scientific evidence and clinical judgment, while also acknowledging uncertainties and the need for ongoing monitoring and adaptation of care plans. This approach respects the patient’s experience while maintaining scientific rigor. Incorrect Approaches Analysis: Adopting a treatment protocol based solely on anecdotal evidence or emerging, unverified theories without rigorous scientific validation poses a significant ethical and professional risk. This approach fails to uphold the standard of care by potentially exposing patients to ineffective or even harmful interventions. It disregards the importance of evidence-based practice, which is a cornerstone of medical ethics and professional responsibility. Implementing a one-size-fits-all diagnostic pathway or treatment regimen without considering the individual patient’s specific symptom profile and medical history is also professionally unacceptable. This approach neglects the principle of individualized care, which is essential for effective management of complex conditions like Long COVID. It can lead to misdiagnosis, delayed appropriate treatment, and patient dissatisfaction, violating the duty of care owed to the patient. Relying exclusively on patient self-reported symptom severity to dictate the urgency and type of intervention, without objective clinical assessment or diagnostic corroboration, is another flawed approach. While patient experience is vital, it must be integrated with clinical expertise and objective data to form a comprehensive picture. This approach risks over- or under-treating conditions based on subjective reporting alone, potentially leading to inappropriate resource allocation or missed opportunities for effective intervention. Professional Reasoning: Professionals should adopt a decision-making framework that begins with a thorough and individualized patient assessment. This involves active listening to the patient’s narrative, a comprehensive review of their medical history, and the application of appropriate clinical examination and diagnostic tools. The next step is to critically evaluate the available scientific literature and clinical guidelines relevant to Long COVID and post-viral syndromes, prioritizing evidence-based interventions. Where evidence is limited, a cautious and adaptive approach is necessary, involving close monitoring of patient response and a willingness to adjust the treatment plan as new information emerges or the patient’s condition evolves. Open and honest communication with the patient about the uncertainties and the rationale behind proposed interventions is paramount.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for consistent competency assessment with the practical realities of candidate performance and the institution’s commitment to fair evaluation. Misinterpreting or misapplying the blueprint weighting, scoring, and retake policies can lead to unfair assessments, damage the institution’s reputation, and potentially compromise patient safety if unqualified individuals are certified. Careful judgment is required to ensure policies are applied equitably and transparently. Correct Approach Analysis: The best professional practice involves a thorough review of the official Premier Caribbean Long COVID and Post-Viral Medicine Competency Assessment blueprint, specifically examining the stated weighting of each domain, the defined passing score, and the explicit retake policy. This approach ensures that all assessments are conducted in strict adherence to the established standards, providing a consistent and objective measure of competency. The justification lies in the fundamental principle of fair assessment and regulatory compliance. The blueprint’s weighting dictates the relative importance of different knowledge and skill areas, ensuring that the assessment accurately reflects the breadth and depth of expertise required for competent practice. The passing score defines the minimum acceptable level of performance, and the retake policy outlines the process for candidates who do not initially meet this standard, offering a structured pathway for improvement and re-evaluation without compromising the integrity of the certification. Adhering to these documented policies is paramount for maintaining the credibility and validity of the assessment. Incorrect Approaches Analysis: One incorrect approach involves prioritizing a candidate’s perceived effort or personal circumstances over the established scoring rubric. This failure to apply the defined passing score objectively undermines the assessment’s validity and fairness. It suggests a deviation from the regulatory framework that mandates standardized evaluation, potentially leading to the certification of individuals who have not demonstrated the required level of competency. Another incorrect approach is to arbitrarily adjust the weighting of assessment domains based on the perceived difficulty of specific questions or the candidate’s performance in certain areas. This violates the blueprint’s established weighting, which is designed to reflect the relative importance of different competencies. Such an adjustment introduces bias and compromises the assessment’s ability to accurately measure overall proficiency according to the intended standards. A third incorrect approach is to deviate from the outlined retake policy by offering unlimited retakes without a structured remediation process or by imposing additional, unannounced requirements for re-assessment. This undermines the policy’s purpose, which is to provide a fair opportunity for candidates to demonstrate competency after initial failure while maintaining assessment rigor. It can lead to inconsistent application of standards and questions the integrity of the certification process. Professional Reasoning: Professionals should approach competency assessment by first thoroughly understanding and internalizing the official assessment blueprint, including its weighting, scoring, and retake policies. When faced with a candidate’s performance, the decision-making process should be guided by these established criteria. If a candidate does not meet the passing score, the next step is to consult the defined retake policy and implement it consistently. Any proposed deviations or exceptions should be carefully considered against the potential impact on the assessment’s validity, fairness, and regulatory compliance, and should ideally involve consultation with assessment oversight bodies if permitted by policy. The primary focus must always be on upholding the integrity and fairness of the assessment process as defined by the governing framework.

Scenario Analysis: This scenario is professionally challenging because it requires a healthcare professional to balance the need for comprehensive preparation with the practical constraints of time and resource availability. The rapidly evolving nature of Long COVID and post-viral medicine, coupled with the specific competency assessment requirements, necessitates a strategic approach to learning. Misjudging the preparation timeline or relying on suboptimal resources can lead to an unsuccessful assessment, potentially impacting patient care and professional standing. Careful judgment is required to identify the most efficient and effective learning pathways. Correct Approach Analysis: The best professional practice involves a structured, multi-modal preparation strategy that prioritizes official assessment guidelines and reputable, evidence-based resources. This approach begins with a thorough review of the Premier Caribbean Long COVID and Post-Viral Medicine Competency Assessment’s official syllabus and recommended reading list. Subsequently, candidates should allocate dedicated time slots for studying these materials, integrating them with practical application through case studies or simulated scenarios. This method ensures direct alignment with assessment objectives and builds a robust understanding of the subject matter, supported by credible information. This approach is correct because it directly addresses the assessment’s requirements and leverages authoritative sources, minimizing the risk of misinformation or irrelevant study. It also promotes a deeper, more integrated learning experience rather than superficial coverage. Incorrect Approaches Analysis: One incorrect approach involves relying solely on informal online forums and anecdotal evidence for preparation. This is professionally unacceptable because such sources often lack scientific rigor, may contain outdated or inaccurate information, and do not align with the structured learning required for a formal competency assessment. There is no regulatory or ethical justification for basing professional competency on unverified information. Another incorrect approach is to dedicate an insufficient amount of time to preparation, assuming prior general medical knowledge will suffice. This is professionally unacceptable as it underestimates the specialized knowledge and skills required for Long COVID and post-viral medicine, and the specific demands of the competency assessment. It fails to meet the implicit ethical obligation to be adequately prepared to demonstrate competence, potentially leading to a failure in the assessment and a risk to patient safety. A further incorrect approach is to focus exclusively on a single type of resource, such as only reading textbooks without engaging with practical application or official guidance. This is professionally unacceptable because it creates a theoretical understanding without the necessary practical skills or the specific context of the assessment. It fails to develop a holistic competency, which is often a requirement for professional assessments that aim to evaluate both knowledge and application. Professional Reasoning: Professionals should adopt a systematic decision-making process for preparation. This involves: 1) Identifying the specific requirements and objectives of the competency assessment. 2) Researching and prioritizing official and evidence-based resources recommended by the assessment body. 3) Developing a realistic study timeline that allocates sufficient time for each topic, including review and practice. 4) Integrating theoretical learning with practical application through case studies or simulations. 5) Regularly self-assessing progress and adjusting the study plan as needed. This structured approach ensures comprehensive preparation and maximizes the likelihood of success.

Scenario Analysis: This scenario is professionally challenging because it requires a clinician to navigate the complexities of diagnosing and managing a condition with a variable presentation, where definitive diagnostic markers may be elusive and treatment pathways are still evolving. The pressure to provide timely and accurate diagnostic information for patient care and potential future research, while adhering to ethical and regulatory standards for medical imaging, necessitates careful consideration of multiple factors. The potential for patient anxiety and the need for clear communication further amplify the challenge. Correct Approach Analysis: The best professional practice involves a systematic, evidence-based approach that prioritizes non-invasive and readily available imaging modalities first, escalating to more advanced or invasive techniques only when indicated by clinical suspicion or the failure of initial investigations to yield a diagnosis. This approach aligns with the principles of judicious resource utilization, minimizing patient exposure to radiation and contrast agents where possible, and adhering to established diagnostic pathways for post-viral syndromes. It reflects a commitment to patient safety and cost-effectiveness, which are implicitly supported by ethical medical practice and regulatory guidelines that encourage appropriate and necessary investigations. Incorrect Approaches Analysis: One incorrect approach involves immediately proceeding to advanced imaging modalities like functional MRI or PET scans without first exploring less invasive options. This fails to adhere to the principle of diagnostic stewardship, potentially exposing the patient to unnecessary risks, costs, and delays in diagnosis if simpler methods could have been sufficient. It also disregards the evidence base for initial investigations in post-viral conditions. Another incorrect approach is to rely solely on subjective patient reporting without any objective imaging confirmation, even when symptoms suggest potential underlying physiological changes. This neglects the diagnostic role of imaging in identifying or excluding specific pathologies that may contribute to persistent symptoms, potentially leading to delayed or missed diagnoses and suboptimal patient management. It also fails to meet the standard of care for thorough medical investigation. A third incorrect approach is to order a broad, unfocused panel of imaging studies without a clear diagnostic hypothesis. This is inefficient, costly, and can lead to incidental findings that complicate the diagnostic process and may not be relevant to the patient’s primary concerns. It demonstrates a lack of structured diagnostic reasoning and fails to optimize the use of diagnostic resources. Professional Reasoning: Professionals should employ a structured diagnostic reasoning process. This begins with a comprehensive clinical assessment, including detailed history and physical examination, to formulate differential diagnoses. Based on these differentials, the clinician should then select the most appropriate initial imaging investigations, considering their diagnostic yield, safety profile, and cost-effectiveness. If initial investigations are inconclusive or suggest a specific pathology, the diagnostic pathway can be escalated to more advanced imaging modalities, always guided by the evolving clinical picture and evidence-based guidelines. Clear communication with the patient regarding the rationale for each investigation and the interpretation of results is paramount.

Scenario Analysis: This scenario is professionally challenging because it requires the clinician to integrate complex, evolving scientific understanding of Long COVID’s pathophysiology with established clinical diagnostic and management principles, all while navigating the ethical imperative of providing evidence-based care to a patient presenting with a constellation of non-specific symptoms. The novelty of Long COVID means that definitive diagnostic markers and universally accepted treatment protocols are still under development, necessitating careful consideration of differential diagnoses and a patient-centered approach. Correct Approach Analysis: The best professional practice involves a systematic, evidence-informed approach that prioritizes ruling out other established medical conditions that could explain the patient’s symptoms before attributing them solely to Long COVID. This begins with a thorough history and physical examination, followed by judicious use of diagnostic investigations guided by the patient’s specific presentation and potential differential diagnoses. This approach aligns with the fundamental principles of medical ethics, particularly beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), by ensuring that treatable conditions are not missed and that management is tailored to the individual. It also reflects the professional responsibility to stay abreast of emerging medical knowledge while grounding practice in established diagnostic paradigms. Incorrect Approaches Analysis: Attributing all symptoms directly to Long COVID without a comprehensive differential diagnosis risks misdiagnosis and delayed treatment of other potentially serious conditions. This fails the ethical principle of beneficence by not thoroughly investigating the patient’s well-being and could lead to harm if an underlying, treatable condition is overlooked. Initiating a broad, unselected battery of advanced diagnostic tests without a clear clinical rationale based on the initial assessment is inefficient, potentially costly, and could lead to incidental findings that cause patient anxiety or unnecessary further investigations. This approach deviates from the principle of judicious resource utilization and can be considered ethically questionable if not directly serving the patient’s diagnostic needs. Focusing solely on symptom management without a structured diagnostic workup to confirm or refute Long COVID as the primary cause is premature. While symptom relief is important, it should be guided by an understanding of the underlying pathophysiology, which requires a diagnostic foundation. This approach risks treating symptoms without addressing the root cause, potentially leading to suboptimal outcomes and failing to meet the standard of comprehensive medical care. Professional Reasoning: Professionals should employ a structured diagnostic framework. This involves: 1. Comprehensive history and physical examination to gather all relevant information. 2. Development of a differential diagnosis list based on the initial assessment. 3. Prioritization of investigations to systematically rule out or confirm potential diagnoses, starting with common and serious conditions. 4. Consideration of emerging evidence for conditions like Long COVID once other diagnoses are less likely or have been addressed. 5. Patient-centered shared decision-making regarding investigations and management plans.

This scenario presents a professional challenge due to the inherent complexities of managing Long COVID, where evidence is evolving, and patient experiences can be highly individualized. The physician must balance the need for timely and effective care with the ethical imperative of ensuring patients fully understand their treatment options and potential outcomes. Health systems science principles are crucial here, emphasizing the interconnectedness of patient care, research, and system-level resources. Careful judgment is required to navigate patient expectations, resource limitations, and the evolving scientific understanding of Long COVID. The correct approach involves a comprehensive and collaborative discussion with the patient, clearly outlining the current understanding of Long COVID, the available treatment modalities (including their evidence base, potential benefits, risks, and uncertainties), and the patient’s role in shared decision-making. This approach prioritizes patient autonomy and informed consent by ensuring the patient has sufficient information to make a decision aligned with their values and goals. It also acknowledges the limitations of current knowledge and the need for ongoing monitoring and adaptation of the treatment plan. This aligns with fundamental ethical principles of beneficence, non-maleficence, and respect for autonomy, as well as professional guidelines emphasizing clear communication and patient-centered care. An incorrect approach would be to unilaterally decide on a treatment plan without thorough patient engagement. This fails to uphold the principle of informed consent, as the patient is not given the opportunity to understand the rationale, risks, and benefits of the proposed treatment, nor are their preferences considered. This can lead to patient dissatisfaction, mistrust, and potentially suboptimal adherence. Another incorrect approach would be to dismiss the patient’s concerns or symptoms due to a lack of definitive diagnostic markers or established treatment protocols for all aspects of Long COVID. This demonstrates a failure in empathy and a disregard for the patient’s lived experience, potentially violating the ethical duty of care and leading to feelings of abandonment. It also overlooks the principles of health systems science, which advocate for a holistic approach to patient well-being that extends beyond purely biomedical interventions. A further incorrect approach would be to overpromise or guarantee specific outcomes without a clear evidence base. This is ethically problematic as it misrepresents the current state of medical knowledge and can create unrealistic expectations, leading to disappointment and erosion of trust when those outcomes are not achieved. It also fails to respect the inherent uncertainties in managing a complex and evolving condition. Professionals should employ a decision-making process that begins with active listening to the patient’s concerns and experiences. This should be followed by a clear and honest explanation of the current medical understanding of their condition, including what is known and what remains uncertain. Treatment options should be presented with a balanced discussion of potential benefits, risks, and alternatives, emphasizing shared decision-making. The professional should then collaboratively develop a treatment plan that respects the patient’s values and preferences, with a commitment to ongoing monitoring and adjustment.

Scenario Analysis: This scenario is professionally challenging due to the complexity of Long COVID, which involves a multi-systemic and often fluctuating presentation. Clinicians must navigate diagnostic uncertainty, the lack of universally standardized treatment protocols, and the potential for significant patient distress and functional impairment. The need to integrate evidence-based practices with individualized patient care, while adhering to ethical principles of beneficence and non-maleficence, requires careful judgment. Furthermore, the evolving nature of research in this field necessitates continuous learning and adaptation. Correct Approach Analysis: The best professional practice involves a comprehensive, individualized assessment that prioritizes evidence-based interventions while acknowledging the limitations of current knowledge. This approach begins with a thorough history and physical examination, followed by targeted investigations to rule out other conditions and identify specific organ system involvement. Management then focuses on symptom-based treatments, rehabilitation strategies (e.g., graded exercise therapy, cognitive rehabilitation), and patient education, all tailored to the individual’s needs and capabilities. This aligns with the principles of patient-centered care and the ethical imperative to provide the most effective and least harmful interventions based on the best available evidence. It also respects the patient’s autonomy by involving them in shared decision-making regarding their care plan. Incorrect Approaches Analysis: One incorrect approach is to rely solely on anecdotal evidence or unproven therapies. This fails to adhere to the ethical obligation to provide care based on robust scientific evidence, potentially exposing the patient to ineffective or harmful treatments. It disregards the principles of evidence-based medicine, which are foundational to competent healthcare practice. Another incorrect approach is to dismiss the patient’s symptoms as psychosomatic or purely psychological without a thorough medical workup. This can lead to delayed or missed diagnoses of underlying physical conditions, violating the principle of non-maleficence and potentially causing significant harm. It also undermines the patient’s experience and trust in the healthcare system. A third incorrect approach is to adopt a “wait and see” attitude without offering any active management or support. While some Long COVID symptoms may resolve spontaneously, prolonged inactivity or lack of appropriate rehabilitation can lead to deconditioning, functional decline, and worsening psychological distress. This passive approach fails to meet the ethical duty to provide timely and beneficial care. Professional Reasoning: Professionals should approach Long COVID management by first establishing a strong therapeutic alliance with the patient, characterized by empathy and active listening. The diagnostic process should be systematic, aiming to identify treatable co-morbidities or specific organ dysfunction. Treatment planning should be collaborative, integrating evidence-based strategies for symptom management and rehabilitation with the patient’s goals and preferences. This involves a multidisciplinary approach where appropriate, and a commitment to ongoing assessment and adjustment of the care plan as the patient’s condition evolves and new evidence emerges.