Wouter Leclercq

Chapter 3 48 In case of complex interventions, the surgeon is legally expected to check whether the patient comprehended the information. The repeat back method (RB) is considered gold standard. 16 However, this method was only used by 14% of the respondents whereas the vast majority (86%) relied on less reliable methods including asking ‘if everything was understood’ or ‘are there any questions’, or judged on the basis of their own intuition (Table 3.2). 3. Stage of consent The use of IC forms is not obligatory in the Netherlands. However, a minority (26%) of the respondents used these forms whereas 65% made notes in the surgical record; 9% made no report of SIC at all (Question 6). Nearly half (46%) routinely checked if a SIC was obtained before starting a surgical procedure (Table 3.2). SIC support tools Tools to support patient education were used more frequently by surgeons compared to residents (Table 3.3). Leaflets (97%) were popular in contrast to websites (S 37%, R 24%, P=0.008) or movies (S 16%, R 8%, P=0.019). Almost half of all respondents also relied on other staff members for patient information (48%). 76% were interested in using SIC software (S 79%, R 71%, P=0.038). Medicolegal consequence of SIC The majority of the respondents (94%) judged a proper SIC important for themselves (Question 19). Interestingly, just 73% thought that their patients also considered a sound SIC important (Question 20). Some 17% of the surgeons faced an officially filed complaint regarding improper SIC in the previous five years compared to 3% of the residents (P<0.001, Question 21). Non-university hospital surgeons were significantly more at risk for these complaints compared to university hospitals colleagues (21% vs. 7%, P=0.004).