Wouter Leclercq

Chapter 7 118 Whereas SDM scores were generally good, quality of SIC recording as observed by evaluation of the EPD was poor. Previous studies also showed a low quality of SIC recording in general surgery. A number of items were not, or inadequately noted. Improved recording is required as surgeons are at risk for legal issues. This is even more true once patient satisfaction is altered when postoperative complications occur. The present pilot study has limitations including a limited number of participants. Patient selection was at random whereas the SIC score was not validated. SDM-Q-9 and SDM- Q-Doc scores were higher as expected reducing their discriminative ability. SDM may be improved if surgeons receive adequate training. A pilot study by Geessink in which surgeons were trained in implementation of SDM and difficult conversations, showed an enhancement of their level of SDM in consultations with older cancer patients. 9 One method of improving both SDM and SIC is the implementation of standard SIC modules in the EPD, addressing items that are considered essential in SDM and SIC. In this pilot study, the EPD could not be used as an adequate checklist for neither SDM nor SIC as only a restricted number of items were recorded. A standard, extensive SDM/SIC checklist may help surgeons and patients to improve the quality of their consultation. If this checklist is made available as a leaflet with personalised perioperative information and contact details for future questions, a patient may be optimally prepared prior to the surgical procedure. In conclusion, focus on optimizing SDM and SIC may help patient and surgeons in their preoperative process. However, The potential use of SDM-Q-9 and SDM-Q-doc questionnaires seems limited as baseline scores are very high whereas a correlation with SIC scores was absent.