Enhancing medical student skills in dispute prevention through objective structured clinical examinations: insights...

In the complex and dynamic landscape of healthcare, preventing medical disputes has become a critical aspect of medical practice. Medical disputes often arise from miscommunication, medical errors, or unmet patient expectations, leading to a breakdown in the doctor-patient relationship and potentially resulting in litigation. Despite the growing recognition of the importance of dispute prevention, current medical education often lacks comprehensive training in communication and conflict resolution. This study aims to explore the feasibility and preliminary educational effects of integrating Objective Structured Clinical Examinations (OSCE) into medical education to enhance medical students' ability to prevent and manage medical disputes.

This quasi-experimental pilot study involved 24 sixth-year medical students from Chang Gung University, divided into two groups: one received traditional classroom instruction on medical dispute prevention, while the other participated in formative OSCE-based simulation sessions. Both groups later underwent a summative OSCE. Group allocation was based on existing timetable assignments; no randomisation was performed. Data were collected through MCQ assessments, OSCE performance scores, and a semi-structured group interview conducted by an independent researcher, recorded and transcribed verbatim. Quantitative data were analysed using descriptive statistics, paired t-tests, and ANOVA; qualitative data were analysed using thematic analysis.

The results suggested preliminary improvements in students' ability to manage and prevent medical disputes following simulation-based familiarisation. The simulation group demonstrated higher scores across all five OSCE communication domains: rapport building (18.4 ± 1.3 vs. 16.2 ± 1.8, p = 0.004), issue identification (17.9 ± 1.2 vs. 15.7 ± 1.9, p = 0.007), active listening (17.5 ± 1.5 vs. 14.8 ± 2.2, p = 0.002), patient-centred language (17.8 ± 1.6 vs. 15.6 ± 2.0, p = 0.006), and respectful discussion of sensitive topics (17.7 ± 1.4 vs. 15.2 ± 2.3, p = 0.003). MCQ scores showed greater gains in the simulation group (pre = 72.5 ± 6.4; post = 85.3 ± 5.8) than in the traditional instruction group (pre = 73.1 ± 7.2; post = 79.4 ± 6.6). Qualitative findings revealed three themes: learning effectiveness, course evaluation, and confidence levels. Students in the simulation group perceived OSCE-based training as more realistic and described increased confidence in handling disputes.

This pilot study provides preliminary evidence that simulation-based familiarisation using formative OSCEs may support the development of medico-legal communication and dispute prevention competencies in senior medical students. As a pilot study with a non-randomised design and small sample size, these findings should be interpreted as exploratory and hypothesis-generating. A key limitation is that the simulation group practised in the identical format as the summative assessment, which may confer a rehearsal advantage independent of genuine learning. Larger randomised studies are needed before broader curricular implementation can be recommended.