title: Challenging the knowledge base and skillset for providing surgical consent by orthopedic and plastic surgeons in the Netherlands: an identified area of improvement in patient safety.
abstract: BACKGROUND
  Successfully completing a surgical informed consent process is an important element of the preoperative consult. A previous study of Dutch general surgeons demonstrated that the implementation of SIC did not meet acceptable standards. However, the quality of the SIC process in the orthopedic surgical or plastic surgical arena is unknown.
  
  
  METHODS
  Following ethical approval, an online survey investigating specifics of surgical informed consent was performed among members of the Dutch Scientific Association of Orthopedic Surgeons and the Dutch Society for Plastic Surgery.
  
  
  RESULTS
  A total of 335 responses from a majority of departments of orthopedic (86 %) and plastic surgery (78 %) were eligible for analysis. Scores on knowledge were poor as only 50 % recognized the three basic elements of surgical informed consent (competence, exchange of information and consent). The orthopedic group used more tools in the surgical informed consent process, such as instruction movies and websites or specialized nursing staff, compared to plastic surgery (orthopedic: 31-50 % vs. plastic: 6-30 %,p= 0.05- < 0.001). In contrast, surgical informed consent forms were used more frequently by the plastic surgical group (orthopedic 21 % vs. plastic:42 %p< 0.001). Control of the efficacy of the surgical informed consent process was low, 36 % in both groups. One in every seven orthopedic or plastic surgeons was faced with an official surgical informed consent-related complaint in the previous five years.
  
  
  CONCLUSIONS
  Similar to general surgeons, Dutch orthopedic and plastic surgeons demonstrate poor knowledge and skills regarding surgical informed consent. Increased awareness, better training and use of modern tools including standard forms and online software programs will improve the SIC process and will optimize patient care.
authors: Department of Surgery, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands.
authors: Wouter K G
authors: WK
authors: Leclercq
authors: Department of Surgery, UMCG, Groningen, The Netherlands.
authors: Sarah
authors: S
authors: Sloot
authors: Department of Plastic Surgery, Bernhoven Hospital, Uden, The Netherlands.
authors: Bram J
authors: BJ
authors: Keulers
authors: Department of Education and Research, Catharina Hospital, Eindhoven, The Netherlands.
authors: Saskia
authors: S
authors: Houterman
authors: Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors: Johan
authors: J
authors: Legemaate
authors: Department of plastic Surgery, Isala Hospital, Zwolle, The Netherlands.
authors: Margot
authors: M
authors: Veerman
authors: School of Information, University of South Florida, Tampa, USA.
authors: Leslie
authors: L
authors: Thomas
authors: Department of Surgery, Máxima Medical Centre, De Run 4600, 5504 DB Veldhoven, The Netherlands.
authors: Marc R
authors: MR
authors: Scheltinga
keywords: Informed consent; Orthopedic surgery; Plastic surgery; Preoperative care; Surgery