Refining a Mature Dental Medico-Legal Curriculum Through ADDIE: Courtroom Immersion Under High-Baseline Evaluation

Dental medico-legal education should connect legal knowledge with responsibility, communication and dispute contexts. This study examined how Analysis, Design, Development, Implementation and Evaluation (ADDIE) can support quality improvement in a mature dental medico-legal curriculum through courtroom immersion.

This curriculum quality-improvement study used a quasi-experimental, non-equivalent-group, post-test-only design comparing two cohorts of fourth-year dental students at a Taiwanese dental school. The 2024 baseline cohort completed the established curriculum; its post-course questionnaire and open-ended feedback informed the next refinement cycle. The 2025 ADDIE-refined cohort completed a revised curriculum incorporating courtroom immersion, judge-facilitated teaching and a restructured mock trial. Quantitative data were analysed using independent-samples t-test, one-sample t-test against 4 and Cohen's d; qualitative responses were analysed inductively.

Valid questionnaires were obtained from 37 baseline and 41 ADDIE-refined participants. Internal consistency of the 13-item scale was high (Cronbach's alpha = 0.94). Ratings were high in both cohorts. The ADDIE-refined cohort reported greater motivation to learn medico-legal content (4.32 vs. 3.41, p < 0.001, d = 1.400), whereas ratings for lawyer feedback and discussion were lower than in the baseline cohort (4.46 vs. 4.76, p = 0.037, d = -0.482). No other between-cohort differences were significant. Baseline feedback requested courthouse visits and real-hearing observation; the refined cohort described courtroom immersion as authentic and complementary to mock trials.

ADDIE identified improvement opportunities in a highly rated curriculum. Courtroom immersion complemented mock trials by strengthening procedural authenticity, professional links, motivation and perceived authenticity.