Professionalism, Ethics, and Interprofessional Collaboration
What this domain tests
This domain tests ethical reasoning and team behavior in EBP. Items ask you to apply principles, identify when consent or IRB review is needed, manage conflicts of interest, and collaborate across professions.
Core rules
- Core principles: beneficence, nonmaleficence, autonomy, and justice. The Belmont Report adds respect for persons, beneficence, and justice; it underpins informed consent, risk-benefit assessment, and fair subject selection.
- Informed consent requires capacity, disclosure, understanding, voluntariness, and documentation. Vulnerable populations, including children, prisoners, cognitively impaired adults, pregnant women, and economically disadvantaged groups, need extra safeguards.
- IRB review is required for human-subjects research, not routine QI; when QI is published or tests a novel intervention, seek review. Clinical equipoise exists when there is genuine uncertainty about which treatment is better.
- Conflicts of interest: disclose financial and nonfinancial interests and manage them, not just deny them. Research misconduct includes fabrication, falsification, and plagiarism; questionable practices include selective reporting and ghost authorship.
- Privacy: HIPAA and institutional rules govern protected health information; de-identification is not risk-free.
- Interprofessional collaboration: IPEC competencies cover values and ethics, roles and responsibilities, communication, and teams and teamwork. Use structured communication such as SBAR, shared decision-making, and psychological safety so all team members can speak up.
Worked example
A nurse wants to implement a new skin-care bundle. The vendor offers free product and a conference trip. The team should disclose the gift, check institutional conflict-of-interest policy, and ensure the appraisal and decision are independent of the vendor. If the project is QI, IRB may not be needed, but patient consent for photographs or publication still applies. The team includes wound care, nursing assistants, pharmacy, and patients; a huddle identifies that night shift cannot access supplies, so the implementation plan changes.
Traps that cost marks
- Assuming QI never needs ethics review.
- Treating informed consent as a signature rather than a process.
- Ignoring nonfinancial conflicts such as career gain or institutional pressure.
- Allowing hierarchy to silence concerns.
- Confusing cultural competence with cultural humility; the latter involves lifelong self-reflection and power sharing.