Effect of a Conflict Management Workshop With Simulated Mediation and Mock Court Proceedings: A Mixed-Methods Study

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To address this issue, we implemented a novel pedagogical approach incorporating simulated mediation and mock court proceedings into a medical course to enhance medicolegal competency among medical students. Methods This study was conducted in August 2022 that recruited medical students preparing for clinical rotations. Students completed a 4-part 150-minute workshop that covered simulated mediation, mock court, debriefing, and reflection sessions. During the simulated mediation session, the participants watched expert-recorded videos of different medical mediation perspectives, followed by small-group discussions with real-time feedback. During the mock court session, a judge-led multidisciplinary expert group demonstrated actual litigation process. Data were collected by using an online questionnaire, including structured and semi-structured items. Results For quantitative analysis, 157 valid responses were analyzed and the questionnaire had satisfactory internal consistency. Quantitative analysis revealed significant improvements in medicolegal knowledge, empathy, and physician–patient communication, with postworkshop mean scores being significantly higher than preworkshop scores. Participant feedback indicated high satisfaction levels, with 66.9% of participants endorsing the effectiveness of simulations for learning. Qualitative analysis of 113 student reflections identified 3 themes: medicolegal competencies, mutual engagement in communication, and legal and professional reflections. Conclusions This brief conflict management workshop using simulated mediation and mock court proceedings effectively enhanced medical students' perceived medicolegal knowledge, empathy, and dispute resolution skills. However, students' unfamiliarity with legal terminology highlighted learning barriers that require interdisciplinary collaboration with legal professionals. Integrating such simulations with legal expert involvement in future medicolegal education is recommended. Conflict management simulated mediation mock court proceedings medicolegal competencies empathy physician-patient communication Figures Figure 1 Background Mediation has become an indispensable component of contemporary healthcare dispute resolution, representing a paradigm shift from adversarial litigation toward collaborative problem-solving approaches [ 1 , 2 ]. This alternative dispute resolution method addresses the inherent limitations of traditional legal proceedings, which often exacerbate tensions between healthcare providers and patients while failing to address the underlying causes of conflict [ 3 ]. Through structured dialogue facilitated by neutral mediators, this process enables meaningful communication between parties. This approach fosters mutual understanding and preserves the physician-patient relationship, which is fundamental to healthcare quality [ 4 ]. While mediation offers clear advantages, understanding actual litigation scenarios remains essential for healthcare professionals, as it prepares them for the legal realities they may encounter in clinical practice [ 5 ]. Exposure to real-world court proceedings enables healthcare professionals to comprehend malpractice case complexities, including expected standards of care and evidence scrutinized during litigation [ 6 ]. Nevertheless, most modern medical curricula prioritize clinical skill development, with limited structured training in the legal aspects of health care [ 7 , 8 ]. This gap in education not only contributes to physician anxiety and defensive medicine but also underscores the need for a more integrated approach to medicolegal training in medical education [ 7 , 9 , 10 ]. Adopting structured medicolegal education can enhance physicians’ confidence in handling legal disputes and increase their overall preparedness for medical litigation [ 7 , 8 , 11 ]. Traditional legal education is often embedded within medical ethics courses, with these approaches typically adopting a didactic format, limiting opportunities for experiential learning [ 3 , 7 , 12 ]. Court visits can be incorporated into undergraduate medical curricula. Students engaging in court visits can gain a practical understanding of courtroom proceedings [ 13 ]. Nonetheless, court visits present major logistical and financial challenges, necessitate adherence to judicial protocols, and limit students’ ability to select cases that closely align with their specific educational goals. Additionally, court visits cannot be combined with mediation, which is an essential alternative to litigation in resolving medical disputes, thereby limiting students’ ability to learn about conflict management processes in clinical settings. To enhance medical students’ understanding of medical mediation and litigation, this study developed a workshop-based educational program, incorporating simulated mediation and mock court proceedings. To the best of our knowledge, this is the first study to combine simulated mediation with mock court proceedings in medical education. This study aims to evaluate the effectiveness of this innovative educational intervention in improving medical students' medicolegal knowledge, attitudes toward dispute resolution, and confidence in handling medicolegal challenges. Method Course design and learning objectives The workshop was developed on the basis of an established framework [ 8 , 14 ] and was grounded in situated learning theory [ 15 , 16 ]. The workshop was designed around real medical dispute cases to provide authentic learning experiences, enabling students to understand how physicians and patients engage in dialogue and negotiation to resolve conflicts. Additionally, the workshop incorporated expert-led discussions featuring professionals from interdisciplinary legal and healthcare fields. Overall, the workshop was developed with 3 primary learning objectives. First, the workshop aimed to enhance students’ understanding of the medicolegal principles underlying medical dispute resolution. Second, the workshop aimed to cultivate empathy by familiarizing students with the perspectives of diverse stakeholders involved in medical litigation and mediation. Third, the workshop aimed to enhance students’ dispute resolution skills to effectively navigate complex physician–patient interactions in legally and ethically challenging contexts. Study design and participants This study employed a convergent, parallel, mixed-methods design, integrating quantitative and qualitative approaches to evaluate the educational intervention. The study was conducted in August 2022 at a medical school in northern Taiwan. Convenience sampling was used to recruit fourth-year medical students from the National Defense Medical Center (NDMC). Students at this institution are required to complete a one-credit compulsory course on medical ethics and medical law as part of their curriculum. The workshop served as an instructional session within this course. Intervention The structured framework of the simulation-based workshop is shown in Fig. 1. The workshop spanned a total of 150 minutes and comprised 4 sequential sessions. The introductory session was led by the course director, who provided an overview on medical mediation, medical litigation, and a brief introduction to the case scenario, followed by a preworkshop questionnaire to evaluate the students’ baseline understanding of medicolegal concepts. A simulated mediation session was then conducted, involving prerecorded, expert-led video presentations depicting diverse stakeholder perspectives in medical mediation, including patients, physicians, and mediators. Following these video presentations, the students engaged in small-group discussions while faculty members and legal experts observed and provided real-time feedback. A mock court session was then conducted. This session was designed to simulate a stressful civil litigation proceeding guided by a presiding judge to enhance the students’ understanding of legal procedures while fostering their ability to communicate under challenging conditions. The mock court session was joined by a multidisciplinary panel comprising a district court judge, senior representatives from the Taiwan Drug Relief Foundation, and the head of the legal affairs department at a major medical center. The workshop concluded with a debriefing and reflection session. During this session, faculty members and guest experts provided constructive feedback on student performance and addressed misconceptions. Overall, this workshop design emphasizes the development of the 7 core competencies of the NDMC, which strategically align with the 6 core competencies of the Accreditation Council for Graduate Medical Education [ 17 ] (Supplement Table 1 and 2 ). Table 1 Medicolegal professionalism scale ( n = 157). Item Preworkshop Postworkshop t P Mean Standard deviation Mean Standard deviation Part 1: Medicolegal knowledge 1. I understand the legal responsibilities associated with medical disputes. 3.80 1.02 4.48 0.73 9.89 < 0.001 2. I understand the prelitigation mediation mechanisms for resolving medical disputes. 3.81 1.07 4.46 0.72 8.53 < 0.001 3. I understand the litigation procedures following the occurrence of a medical dispute. 3.86 1.07 4.51 0.69 8.93 < 0.001 4. I understand the differences between judicial mediation and litigation in medical dispute resolution. 3.85 1.08 4.50 0.68 8.75 < 0.001 Part 2: Empathy 5. During physician–patient communication, I recognize the importance of actively listening to patients. 4.29 0.71 4.67 0.51 7.12 < 0.001 6. During physician–patient communication, I understand the importance of effectively using body language. 4.21 0.81 4.63 0.54 6.83 < 0.001 7. During physician–patient communication, I appreciate the value of empathy and perspectives from patients. 4.25 0.79 4.66 0.55 7.67 < 0.001 8. During physician–patient communication, I understand the factors contributing to differences in perception between physicians and patients. 4.25 0.77 4.61 0.61 5.98 < 0.001 Part 3: Dispute resolution skills 9. I understand the potential psychological effects of medical disputes. 4.16 0.80 4.62 0.55 7.71 < 0.001 10. I understand the underlying causes of medical disputes. 4.10 0.97 4.54 0.65 7.52 < 0.001 11. I recognize the dynamic nature and challenges of physician–patient communication during medical disputes. 4.25 0.75 4.61 0.56 6.59 < 0.001 12. I know how to resolve medical disputes. 4.07 0.85 4.57 0.67 7.82 < 0.001 Table 2 Learning satisfaction scale ( n = 157). Item Strongly disagree (1) Disagree (2) Neutral (3) Agree (4) Strongly agree (5) Mean Standard deviation N (%) 1. The goal of this learning activity (videos and scenario simulations) helps me understand how to identify and classify the features of the target learning objects. 0 (0) 0 (0) 5 (3.2) 47 (29.9) 105 (66.9) 4.64 0.545 2. I have endeavored to observe the differences between the target learning objects in this learning activity. 0 (0) 0 (0) 7 (4.5) 50 (31.8) 100 (63.7) 4.59 0.58 3. This learning activity was simple to understand yet difficult to successfully complete. 0 (0) 1 (0.6) 7 (4.5) 50 (31.8) 99 (63.1) 4.57 0.61 4. Learning with simulated mediation and mock court proceedings is more challenging or interesting than learning with the traditional approach. 0 (0) 0 (0) 7 (4.5) 46 (29.3) 104 (66.2) 4.62 0.57 5. I acquired new knowledge regarding the target learning objects because I used simulated mediation and mock court proceedings to learn in an actual environment. 0 (0) 0 (0) 8 (5.1) 46 (29.3) 103 (65.6) 4.61 0.59 6. I have attempted new methods or thinking styles to learn with simulated mediation and mock court proceedings. 0 (0) 0 (0) 14 (8.9) 41 (26.1) 102 (65.0) 4.56 0.65 7. The guidance provided by simulated mediation and mock court proceedings helped me learn how to identify the features of the target learning objects. 0 (0) 0 (0) 10 (6.4) 45 (28.7) 102 (65.0) 4.59 0.61 8. The guidance provided by simulated mediation and mock court proceedings helped me observe the differences within the target learning objects. 0 (0) 0 (0) 7 (4.5) 47 (29.9) 103 (65.6) 4.61 0.57 Data collection and instruments Data were collected using an online questionnaire that had the following 4 sections: medicolegal professionalism (Table 1 ), learning satisfaction (Table 2 ) [ 18 ], and reflective feedback. 1. Medicolegal professionalism Medicolegal professionalism was measured using 12 items designed to evaluate the effectiveness of a workshop in achieving 3 key learning objectives: (1) medicolegal knowledge, (2) empathy, and (3) competency in resolving medical disputes. Each item was rated on a 5-point Likert scale, with endpoints ranging from 1 ( strongly disagree ) to 5 ( strongly agree ). Multidisciplinary experts were consulted in the development of this section of the questionnaire to ensure content validity. To evaluate internal consistency, we conducted a reliability analysis, which yielded an overall Cronbach’s α coefficient of 0.96, indicating excellent reliability. The reliability coefficients for each subscale were as follows: medicolegal knowledge (Cronbach’s α = 0.96), empathy (Cronbach’s α = 0.94), and physician–patient communication skills (Cronbach’s α = 0.89). 2. Learning satisfaction Learning satisfaction was measured using 8 structured items, each rated on a 5-point Likert scale, with endpoints ranging from 1 ( strongly disagree ) to 5 ( strongly agree ). This section of the questionnaire was adapted from a validated scale and has been demonstrated to exhibit strong content validity and construct validity for measuring student satisfaction in situated simulation and case-based learning environments [ 18 ]. To further establish reliability, we conducted a Cronbach’s α analysis, which yielded a coefficient of 0.96, confirming its excellent internal consistency. 3. Reflective narrative Reflective narrative was obtained using a semi structured instrument designed to elicit students’ reflections on their learning experiences. The instrument consists of a single open-ended prompt inviting students to articulate their insights. The prompt was, “What aspect of this workshop had the greatest effect on you? What did you learn from it?” By enabling students to provide an unstructured, qualitative response, this instrument provides in-depth insights into students’ learning experiences and the perceived applicability of the workshop content to clinical practice. Data analysis Quantitative analysis Descriptive statistical analysis, reliability analysis, and paired-samples t tests were conducted using IBM SPSS Statistics version 25.0 (IBM, Armonk, NY, USA). Cronbach’s α coefficients were used to evaluate the reliability of the questionnaire, with a threshold of 0.7 indicating acceptable internal consistency. Paired-samples t tests were used to compare preworkshop and postworkshop mean scores, with statistical significance set at P < .05. Qualitative analysis A social constructivist framework was adopted and a thematic analysis approach was employed to explore the qualitative data. All data were deidentified to ensure the anonymity of the students. The first three authors (Z.-Y.C., T.-W.C., and F.-C.P.) initially conducted open coding of the reflective narratives, identifying concepts that informed the development of a preliminary codebook, which was then revised through iterative review. The finalized version of the codebook was subsequently applied to code the entire dataset. Seven authors (Z.-Y.C., T.-W.C., F.-C.P., H.-Y.L., S.-Y.C., Daphne Yih Ng, and W.-C.C.) conducted an inductive and iterative analysis of the data, consistently revisiting the reflective texts and coded segments to develop an initial set of thematic drafts. This process continued until thematic saturation was reached (i.e., no new themes emerged). Throughout the qualitative research process, we employed deliberately designed reflexivity strategies to continuously examine and challenge our own assumptions about students’ learning experiences. To enhance the rigor of the qualitative analysis, this study was prepared in accordance with the standards for reporting qualitative research [ 19 ]. Additionally, to ensure clarity and linguistic precision, this report was professionally translated by an academic specialist to guarantee that the English version accurately conveyed the original meaning. Mixed-methods results integration The integration approach used in this study aligns with the concurrent triangulation design described by Creswell and Clark, as both quantitative and qualitative data were collected and analyzed simultaneously to corroborate and complement each other's findings [ 20 ]. Results Quantitative analysis results A total of 169 fourth-year medical students were recruited. Of these students, 157 provided valid responses to the questionnaire (response rate, 91%) (Table 1 ). Preworkshop scores for medicolegal knowledge ranged from 3.80 to 3.86, with an overall mean of 3.83 (SD, 1.06). Postworkshop scores were significantly higher, ranging from 4.47 to 4.52, with an overall mean of 4.49 (SD, 0.71; all P < .001). Preworkshop scores for empathy ranged from 4.21 to 4.29, with an overall mean of 4.24 (SD, 0.77). Postworkshop scores were significantly higher, ranging from 4.61 to 4.67, with an overall mean of 4.64 (SD, 0.55; all P < .001). Preworkshop scores for assessment of competency in resolving medical disputes ranged from 4.07 to 4.25, with an overall mean of 4.15 (SD, 0.84). Postworkshop scores were significantly higher, ranging from 4.54 to 4.62, with an overall mean of 4.58 (SD, 0.61; all P < .001). In the learning satisfaction assessment, mean scores ranged from 4.56 to 4.64 (Table 2 ), with an overall mean of 4.59 (SD, 0.57). Qualitative analysis results A total of 113 student reflections were collected. The reflections were primarily in paragraph form. Thematic analysis identified 3 themes and 9 subthemes (Table 3 ). The following section provides a detailed description of each theme. Table 3 Thematic analysis of student feedback ( n = 113). Theme Subtheme Frequency Percentage (%) Medicolegal competencies Physicians’ legal accountability 68 60.2% Empathic judicial mediation 83 73.5% Legal procedural insight 52 46.0% Mutual engagement in communication Medical humanistic concerns 73 64.6% Collaborative decision-making 45 39.8% Addressing common misunderstandings 51 45.1% Legal and professional reflections Legal terminology challenges 41 36.3% Confidence in managing disputes 76 67.3% Proactive risk management 63 55.8% Theme 1: Medicolegal competencies 1.1 Physicians’ legal accountability The students initially viewed comprehensive documentation as proof of professional adherence. Their reflections revealed that legal accountability also included informed consent. One student noted the following: “ I was shocked to learn that without proper documentation, a full verbal risk disclosure may still be deemed inadequate, resulting in legal liability. ” (Student 036) The students’ reflections also underscored how a physician’s duty extends beyond proper documentation. One student was particularly shocked by the potential criminal consequences: “ I never realized that a physician could face involuntary manslaughter charges and imprisonment if a patient dies—an alarming reality for those dedicated to patient care. ” (Student 055) The students recognized that legal accountability extends beyond clinical competence, with noncompliance posing civil and criminal risks. 1.2 Empathic judicial mediation Initially viewed as a rigid, compensation-driven process, mediation emerged from the students’ reflections as a structured yet empathetic dialog, fostering trust and mitigating litigation burdens. Some students reflected on this shift in perspective: “ Simulated mediation revealed that patients and families seek acknowledgment of their suffering more than financial compensation. ” (Student 021), “ Sincere physician empathy and regret can soften patient and family attitudes, often diffusing tension and reducing blame. ” (Student 042) These reflections highlight physicians’ attitudes as pivotal in mediation, wherein empathy reduces tension and facilitates constructive dialog. 1.3 Legal procedural insight Initially, students perceived legal procedures as cumbersome but later recognized their role in ensuring due process and judicial integrity: “ I once thought legal procedures were overly complex, but I now see that each step safeguards fairness and prevents rights from being lost due to procedural gaps. ” (Student 005) The students also came to realize that understanding legal procedures increases argument clarity and enhances critical thinking and rebuttal skills: “ I used to rely on intuition, but now I construct arguments systematically, following legal logic for greater structure and persuasiveness. ” (Student 031) These reflections confirm that legal procedures are not mere technicalities but rather essential protective mechanisms for fairness and justice. Theme 2: Mutual engagement in communication 2.1 Medical humanistic concerns The students recognized the need to adhere to legal regulations to mitigate risks while also fearing that excessive defensive practices can diminish physician–patient trust: “ Physicians must protect themselves legally. Simultaneously, patients need to feel that their doctor genuinely cares. ” (Student 014) Some of the students worried that prioritizing legal safeguards may make patients feel unheard: “ Focusing only on lab results while neglecting emotional well-being makes building trust difficult. ” (Student 072) These reflections underscore the need for patient-centered care that balances legal and clinical standards with empathy to ensure that medicine remains both scientifically rigorous and humanistically compassionate. 2.2 Collaborative decision-making By engaging in real-world case discussions, the students recognized that clear explanations and shared decision-making increased treatment acceptance and reduced the risk of disputes: “ I realized that treatment decisions involve not only medical factors but also quality of life, financial concerns, and personal beliefs. ” (Student 068) This realization indicated a shift from a physician-centered decision-making approach to a patient-inclusive approach. The students observed that active patient involvement not only enhanced adherence and adaptability but also addressed challenges in practice: “ Some patients seek clear guidance; others prefer full autonomy. I am learning to balance professional advice without overwhelming them. ” (Student 070) These reflections indicate that treatment decisions extend beyond medical factors. Instead, they require physicians to integrate their expertise with an understanding of patient concerns to align care with individual needs. 2.3 Addressing common misunderstandings Initially, students assumed that medical disputes originated from poor outcomes. Student reflections revealed that the students came to realize that communication failures were often the actual root cause of such disputes: “ I thought patients questioned physicians only when dissatisfied with outcomes, but I now see that misunderstandings often arise from unclear treatment explanations or unrealistic expectations. ” (Student 038) Some of the students believed that providing complete medical information was sufficient for informed decision-making. Simulations revealed the difficulty faced by patients in processing complex information as a result of jargon, stress, or misconceptions: “ Patients may nod in agreement but still misunderstand risks and alternatives. I’ve learned to verify comprehension rather than assume it. ” (Student 081) These reflections illustrate a shift from a one-way information delivery model to an interactive, verification-based approach. Theme 3: Legal and professional reflections 3.1 Legal terminology challenges Students perceived legal terminology as challenging and believed legal terminology limited their ability to understand medical disputes and communicate effectively in legal contexts: “ Many of the professional terms used by the judge and other experts during the mock court were unfamiliar to me. ” (Student 058) They recognized that legal terms were abstract and context-dependent: “ I was surprised to learn that the same legal term could carry different definitions across civil, criminal, and administrative law. ” (Student 077) These reflections indicate that mastering legal terminology requires more than memorization; it necessitates a deep understanding of legal principles. 3.2 Confidence in managing disputes Before the workshop, students had concerns regarding litigation and felt unprepared for medical disputes. Structured learning helped them develop legal awareness and confidence: “ I now understand medical law principles and know which steps to take and whom to consult for support. This gives me newfound confidence. ” (Student 112) The students also recognized the psychological effects of disputes and the need for emotional resilience: “ Medical disputes are sometimes inevitable; the key is to stay calm and respond rationally. ” (Student 075) These reflections suggest a shift from fear to preparedness, which enables students to approach disputes with greater confidence and professionalism. 3.3 Proactive risk management Initially, the students viewed risk management as reactive, responding after adverse events. After the workshop, the students recognized risk management as a proactive process involving prevention, communication, and systematic management: “ Risk management can be planned; strong patient communication and thorough documentation reduce the risks of disputes. ” (Student 098) Some of the students also acknowledged the need for institutional support and teamwork. “ Early warning systems in health-care institutions can help identify issues sooner, reducing errors. ” (Student 008) These reflections indicate a shift from reactive to preventive thinking, emphasizing the role of communication, protocols, and collaboration in minimizing medical risks. Integration of mixed-methods results Joint displays of qualitative and quantitative results were demonstrated in Table 4 . We identified the findings of each item from the quantitative questionnaire that corresponded to similar concepts in the subthemes. However, the subtheme "Legal terminology challenges" did not have a corresponding item in the quantitative questionnaire. Quantitative data showed that “Legal responsibilities associated with medical disputes” improved the most. However, qualitative results revealed that nearly 40% of students did not specifically address this topic in their feedback. This could be attributed to a lack of practical experience or real-world cases through which they could apply the legal knowledge gained from the workshop. Consequently, when providing their reflections, they often shifted their focus to other areas, such as doctor-patient communication or empathy. Additionally, the quantitative data indicated that “Factors contributing to differences in perception” showed the least improvement (+ 0.36). Similarly, in the qualitative analysis, fewer than 40% of students mentioned the subtheme “Addressing common misunderstandings”. This may be due to the abstract cognitive processes involved in the aforementioned item and subtheme. Learning in this area often requires direct interaction and communication with patients to develop relevant skills. However, the students in this study had not yet participated in clinical practice, which likely limited their ability to apply these concepts concretely in their feedback. As a result, the improvement in this domain was less pronounced in the quantitative assessment. Additionally, the qualitative analysis revealed "Medical humanistic concerns" as a significant subtheme (73 mentions, 64.6%), yet this concept lacked corresponding quantitative measures. While the quantitative scale included empathy-related items, students' qualitative reflections extended beyond empathy to encompass broader humanistic considerations such as patient dignity, emotional support during disputes, and moral obligations of healthcare providers. This discrepancy suggests that students' learning experiences transcended the predefined quantitative measures, indicating that the workshop fostered deeper reflection on the human dimensions of medical disputes—aspects that may be difficult to capture through standardized assessments. The prominence of humanistic concerns in student feedback highlights the importance of integrating values-based education into medicolegal training and suggests that future evaluations should incorporate instruments that capture the humanistic dimensions of medical practice. Furthermore, many students' feedback indicated that they felt unfamiliar with legal terminology, hindering the students’ ability to navigate medical disputes and communicate effectively in legal settings. This challenge was likely attributable to the fact that fourth-year medical students have yet to engage in clinical training (ie, fourth-year students have little exposure to real-world medicolegal problems). Given the distinct nature of legal knowledge, medical students inevitably face learning barriers. These findings underscore the need for medical law education to integrate interdisciplinary collaboration with legal professionals while enhancing students’ understanding of legal language to bridge the gap between medicine and law. Future educational efforts should consider targeting residents and attending physicians who have clinical experience. Such individuals are not only more familiar with the dimensions of medical disputes but also better positioned to appreciate the relevance of legal competency in clinical practice. Table 4 Joint displays of qualitative and quantitative results. Qualitative results Quantitative results Theme Subtheme n (%) Illustrative quote Item △ Medicolegal competencies Physicians’ legal accountability 68 (60.2) I was shocked to learn that without proper documentation, a full verbal risk disclosure may still be deemed inadequate, resulting in legal liability. (Student 036) Legal responsibilities associated with medical disputes + 0.68 (p < 0.001) Empathic judicial mediation 83 (73.5) Sincere physician empathy and regret can soften patient and family attitudes, often diffusing tension and reducing blame. (Student 042) Mediation mechanisms + 0.65 (p < 0.001) Judicial mediation and litigation + 0.65 (p < 0.001) Legal procedural insight 52 (46.0) I once thought legal procedures were overly complex, but I now see that each step safeguards fairness and prevents rights from being lost due to procedural gaps. (Student 005) Litigation procedures + 0.65 (p < 0.001) Mutual engagement in communication Medical humanistic concerns 73 (64.6) Focusing only on lab results while neglecting emotional well-being makes building trust difficult. (Student 072) - - Collaborative decision-making 51 (45.1) Some patients seek clear guidance; others prefer full autonomy. I am learning to balance professional advice without overwhelming them. ” (Student 070) Actively listening to patients + 0.38 (p < 0.001) Perspectives from patients + 0.41 (p < 0.001) Addressing common misunderstandings 45 (39.8) Patients may nod in agreement but still misunderstand risks and alternatives. I’ve learned to verify comprehension rather than assume it. ” (Student 081) Effectively using body language + 0.42 (p < 0.001) Factors contributing to differences in perception + 0.36 (p < 0.001) Legal and professional reflections Legal terminology challenges 41 (36.3) Many of the professional terms used by the judge and other experts during the mock court were unfamiliar to me. (Student 058) - - Confidence in managing disputes 76 (67.3) I now understand medical law principles and know which steps to take and whom to consult for support. This gives me newfound confidence. (Student 112) Psychological effects of medical disputes + 0.46 (p < 0.001) Challenges of communication during disputes + 0.36 (p < 0.001) how to resolve medical disputes + 0.50 (p < 0.001) Proactive risk management 63 (55.8) Risk management can be planned; strong patient communication and thorough documentation reduce the risks of disputes. ” (Student 098) Causes of medical disputes + 0.44 (p < 0.001) △: Difference between pre-test and post-test results Discussion This workshop employed a learner-centered approach designed to foster engagement and active learning. Our findings are consistent with situated learning theory, confirming the value of contextualized educational experiences in facilitating knowledge transfer and preparing learners for complex real-world scenarios [ 15 , 21 ]. The simulation-based curriculum demonstrates the capacity to promote both cognitive and affective development while fostering personal resilience, consistent with other research [ 22 ]. Integrating simulated mediation and mock court proceedings provide learners with emotionally charged scenarios that mirrored real-life medical dispute complexities. Students developed a broader understanding of the civil, criminal, and administrative dimensions of medical law through the workshop, consistent with findings from courtroom-based studies [ 5 , 11 , 23 – 26 ]. Significant improvements in students' understanding of medical dispute causes and resolutions demonstrate that simulated learning extended awareness beyond clinical errors to include patient autonomy, information asymmetry, and psychological factors [ 27 , 28 ]. The significant increase in students' recognition of empathy's importance indicates that simulated mediation shifted perspectives from physician-centered to patient-centered approaches, reframing mediation as emotional reconciliation rather than merely a legal mechanism [ 29 – 31 ]. Additionally, students' confidence in responding to medical disputes increased, consistent with other studies demonstrating that immersive simulation enhances preparedness for real-world medicolegal challenges [ 5 , 24 , 25 ]. Our study identified high levels of student satisfaction, particularly with the integration of video content and situational simulations. These findings confirm that interactive, multimedia-enhanced strategies improve learning outcomes [ 32 , 33 ], and highlight the documented value of simulated learning in enhancing medical law understanding and conflict management skills [ 21 , 27 , 34 ]. Limitations Limitations of this study are as follows. First, the study evaluated only short-term learning outcomes, leaving the long-term effects unexamined. Second, the study's reliance on self-reported data may have led to overestimation or underestimation of learning gains. Integrating objective measures (e.g., validated questionnaires or standardized scales) and external evaluations (e.g., observed skill performance) may improve assessment accuracy. Third, this study adopted a single-group intervention design; further comparative studies are warranted to establish the effectiveness of this approach relative to traditional teaching methods. Conclusion Medical students' perceived medicolegal knowledge, empathy, and dispute resolution skills were enhanced by this simulation-based approach, and the high participant satisfaction rates support the effectiveness of simulated learning in medicolegal education. These findings advocate for the broader implementation of practice-based medicolegal training in medical curricula to better prepare physicians for contemporary healthcare challenges and improve patient-physician relationships. Future studies should explore the long-term effects of this strategy on clinical practice, and further comparative studies are also warranted. Declarations Ethics approval and consent to participate This study was approved by the Institutional Review Board of the Tri-Service General Hospital (approval no. B202105040). All research was performed in accordance with the Declaration of Helsinki. All participants signed an informed consent form prior to participation in the study. Consent for publication Students were informed about study objectives and potential publication of anonymized data before participation. All provided written informed consent. Participation was voluntary and did not affect grades. Invalid surveys were excluded, and data were anonymized to ensure confidentiality. Availability of data and materials Data from this study will be available on reasonable request from the corresponding author. Competing interests The authors declare no competing interests. Funding This study was supported by the Ministry of Science and Technology (MOST 110-2511-H-016-002-MY3) and the National Science and Technology Council of Taiwan (NSTC 112-2410-H-016-001-MY3). Clinical trial number Not applicable Author contributions Yi-Chao Zhou and Chih‑Chia Wang contributed to the conception, design, data acquisition, data analysis and interpretation, and drafted and critically revised the manuscript; Wen-Chii Tzeng, Chung Pei Fu, Yin-Ling Hung, Yi-Chih Shiao, Daphne Yih Ng contributed to the qualitative data analysis and interpretation, and critically revised the manuscript. Acknowledgments The authors would like to express their sincere gratitude to their colleagues and the students of the NDMC, who participated in and contributed to the execution of this study. This manuscript was edited by Wallace Academic Editing. Additionally, the authors would like to extend their appreciation to the reviewers and editor for their insightful feedback and constructive comments, which greatly enhanced the quality of this manuscript. Authors' information Y.-C. Zhou is a family physician at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan. W.-C. Tzeng is a professor at the School of Nursing, National Defense Medical Center, Taipei, Taiwan. C.-P. Fu is a professor at the Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. Y.-L. Hung is an intensive care unit nurse at the Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Y.-C. Shiao is a family physician at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan. Daphne Yih Ng is a research assistant at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan. C.-C. Wang is a family physician and a professor at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan. References Brummans BH, Higham L, Cooren F. The work of conflict mediation: Actors, vectors, and communicative relationality. Hum Relat. 2022;75(4):764–91. Sohn DH, Bal BS. Medical malpractice reform: The role of alternative dispute resolution. Clin Orthop Relat Res. 2012;470(5):1370–8. Chen WT, Huang YY, Chen WW, Liu YP, Shih CL, Shiao YC, Wang CC. Fostering guardians for frontline medical disputes: A government-led medical dispute mediator training program in taiwan. BMC Health Serv Res. 2022;22(1):1478. Dimitrov K, Miteva-Katrandzhieva T. Mediation in healthcare: Enhancing conflict resolution between patients and physicians beyond the courtroom. Cureus. 2024;16(12):e75487. Varughese BT, Manoj D, Arakkal AL, Johnson LR, James RI. Mock court: A valuable tool to teach legal procedures to undergraduate medical students. Int J Legal Med. 2024;138(5):1955–64. Chen WT, Fu CP, Chang YD, Shiao YC, Chen PY, Wang CC. Developing an innovative medical ethics and law curriculum-constructing a situation-based, interdisciplinary, court-based learning course: A mixed methods study. BMC Med Educ. 2022;22(1):284. Arbel E, Reese A, Oh K, Mishra A. Medical law and medical school curricula: A systematic review. Cureus. 2024;16(2):e54377. Chen W-T, Fu C-P, Chang Y-D, Shiao Y-C, Chen P-Y, Wang C-C. Developing an innovative medical ethics and law curriculum—constructing a situation-based, interdisciplinary, court-based learning course: A mixed methods study. BMC Med Educ. 2022;22(1):284. Eftekhari MH, Parsapoor A, Ahmadi A, Yavari N, Larijani B, Gooshki ES. Exploring defensive medicine: Examples, underlying and contextual factors, and potential strategies - a qualitative study. BMC Med Ethics. 2023;24(1):82. Balch CM, Oreskovich MR, Dyrbye LN, Colaiano JM, Satele DV, Sloan JA, Shanafelt TD. Personal consequences of malpractice lawsuits on american surgeons. J Am Coll Surg. 2011;213(5):657–67. Abbasi M, Shirazi M, Torkmandi H, Homayoon S, Abdi M. Impact of teaching, learning, and assessment of medical law on cognitive, affective and psychomotor skills of medical students: A systematic review. BMC Med Educ. 2023;23(1):703. Campbell AT. Teaching law in medical schools: First, reflect. J Law Med Ethics. 2012;40(2):301–10. Stowell JM, Pihlak MR, Matzke A, O'Keefe M. Implementation of the court visitor program in a clinical nursing curriculum. J Nurs Educ. 2013;52(12):709–12. Chen W-T, Huang Y-Y, Chen W-W, Liu Y-P, Shih C-L, Shiao Y-C, Wang C-C. Fostering guardians for frontline medical disputes: A government-led medical dispute mediator training program in taiwan. BMC Health Serv Res. 2022;22(1):1478. O'Brien BC, Battista A. Situated learning theory in health professions education research: A scoping review. Adv Health Sci Educ Theory Pract. 2020;25(2):483–509. Shinkaruk K, Carr E, Lockyer JM, Hecker KG. Exploring the development of interprofessional competence and professional identity: A situated learning theory study. J Interprof Care. 2023;37(4):613–22. Lurie SJ, Mooney CJ, Lyness JM. Measurement of the general competencies of the accreditation council for graduate medical education: A systematic review. Acad Med. 2009;84(3):301–9. Chu H-C, Hwang G-J, Tsai C-C, Tseng JCR. A two-tier test approach to developing location-aware mobile learning systems for natural science courses. Comput Educ. 2010;55(4):1618–27. O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: A synthesis of recommendations. Acad Med. 2014;89(9):1245–51. Battista A, Torre D, Konopasky A. Essential concepts for effective mixed methods research in the health professions: Amee guide 173. Med Teach. 2025;47(5):766–78. Jallad ST. Effectiveness of simulation-based education on educational practices of communication skills, satisfaction, and self-confidence among undergraduate nursing students. Creat Nurs. 2024;0(0):10784535241301115. Chan KD, Humphreys L, Mey A, Holland C, Wu C, Rogers GD. Beyond communication training: The maris model for developing medical students' human capabilities and personal resilience. Med Teach. 2020;42(2):187–95. Ahmed S, Al-Mously N, Al-Senani F, Zafar M, Ahmed M. Medical teachers' perception towards simulation-based medical education: A multicenter study in saudi arabia. Med Teach. 2016;38(Suppl 1):S37–44. Hughes KE, Cahir TM, Nordlund D, Keim SM, Hughes PG. Fear not: Utilizing simulation for medical malpractice education. J Med Educ Curric Dev. 2022;9:23821205221096269. Datta R, Upadhyay K, Jaideep C. Simulation and its role in medical education. Med J Armed Forces India. 2012;68(2):167–72. Mohseni F, Mohammadi A, Khajavirad N, Basiri K, Khabaz Mafinejad M. Teaching conflict management skills to medical students: A scoping review. Med J Islam Repub Iran. 2024;38:24. Bylund CL, Vasquez TS, Peterson EB, Ansell M, Bylund KC, Ditton-Phare P, Hines A, Manna R, Singh Ospina N, Wells R, et al. Effect of experiential communication skills education on graduate medical education trainees' communication behaviors: A systematic review. Acad Med. 2022;97(12):1854–66. Coggins A, Santos AL, Zaklama R, Murphy M. Interdisciplinary clinical debriefing in the emergency department: An observational study of learning topics and outcomes. BMC Emerg Med. 2020;20(1):79. Zhang X, Li L, Zhang Q, Le LH, Wu Y. Physician empathy in doctor-patient communication: A systematic review. Health Commun. 2024;39(5):1027–37. Han A, Kim TH. A simulation-based empathy enhancement program for non-medical care providers of older adults: A mixed-methods study. Psychiatry Investig. 2021;18(2):132–9. Krystallidou D, Remael A, de Boe E, Hendrickx K, Tsakitzidis G, van de Geuchte S, Pype P. Investigating empathy in interpreter-mediated simulated consultations: An explorative study. Patient Educ Couns. 2018;101(1):33–42. Mitchell AA, Ivimey-Cook ER. Technology-enhanced simulation for healthcare professionals: A meta-analysis. Front Med (Lausanne). 2023;10:1149048. Elendu C, Amaechi DC, Okatta AU, Amaechi EC, Elendu TC, Ezeh CP, Elendu ID. The impact of simulation-based training in medical education: A review. Med (Baltim). 2024;103(27):e38813. Kong Y. The role of experiential learning on students' motivation and classroom engagement. Front Psychol. 2021;12:771272. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6996222","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":485854356,"identity":"c216ab53-bb1d-478a-9806-2745e1a65209","order_by":0,"name":"Yi-Chao Zhou","email":"","orcid":"","institution":"National Defense Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Yi-Chao","middleName":"","lastName":"Zhou","suffix":""},{"id":485854357,"identity":"6d4d0d4b-37ac-4dd9-880a-24d01a0fbd6a","order_by":1,"name":"Wen-Chii Tzeng","email":"","orcid":"","institution":"National Defense Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Wen-Chii","middleName":"","lastName":"Tzeng","suffix":""},{"id":485854360,"identity":"eda4d81f-5744-4969-9844-940de42102e3","order_by":2,"name":"Chung-Pei Fu","email":"","orcid":"","institution":"Fu Jen Catholic University","correspondingAuthor":false,"prefix":"","firstName":"Chung-Pei","middleName":"","lastName":"Fu","suffix":""},{"id":485854362,"identity":"607d3098-7248-4739-b9bb-67035e9f119d","order_by":3,"name":"Yin-Ling Hung","email":"","orcid":"","institution":"National Defense Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Yin-Ling","middleName":"","lastName":"Hung","suffix":""},{"id":485854363,"identity":"d2c2cdfe-a32d-4c1b-8705-6831cb16c79d","order_by":4,"name":"Yi-Chih Shiao","email":"","orcid":"","institution":"National Defense Medical 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Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4klEQVRIiWNgGAWjYHACNijNfABISMgQVM+D0MKWANLCQ4oWHgOoAAFgz3/82oMfNYflzfnXfH51o8aCh4H98NENeG2RyCk37Dl22HDnjLfbrHOOAR3Gk5Z2A78WnjRpxobbjBtunN1mnMMG1CLBY4ZfC/8ZsBb7DTfOPDPO+UeMFob0YyAtiRvO9zA/zm0jRsuNHDbJnmP/kzfcYDNjzu2T4GEj5Bf2/uPPJH7UpNluOH/48eecb3Vy/OyHj+HVAosOYCQmsEmAaDZ8iqH2PIDQ/AeYPxBWPQpGwSgYBSMRAADj3Uk8uMdWwwAAAABJRU5ErkJggg==","orcid":"","institution":"National Defense Medical Center","correspondingAuthor":true,"prefix":"","firstName":"Chih‑Chia","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2025-06-28 07:38:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6996222/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6996222/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-025-08345-7","type":"published","date":"2025-11-27T15:57:18+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":87038167,"identity":"0a2aabc9-ef0c-4441-ac10-8e5f3a0329e3","added_by":"auto","created_at":"2025-07-18 13:26:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":401173,"visible":true,"origin":"","legend":"\u003cp\u003eThe structured framework of the simulation-based workshop\u003c/p\u003e","description":"","filename":"OnlineFigure1.png","url":"https://assets-eu.researchsquare.com/files/rs-6996222/v1/ed41b64a3833fe12dc24ac3e.png"},{"id":97178293,"identity":"5bbbdf10-741f-4c7f-8e13-437c5347ec90","added_by":"auto","created_at":"2025-12-01 16:07:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1857285,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6996222/v1/8632c2e2-5818-420a-9dba-4c5904791a5e.pdf"},{"id":87038168,"identity":"69e88e4b-1556-4465-a8ac-2632f9507de5","added_by":"auto","created_at":"2025-07-18 13:26:35","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":20719,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementtable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6996222/v1/24dcc0a05d7e6a7b25583e2c.docx"},{"id":87038174,"identity":"f23e2a97-0c5b-4e00-bfc1-041bbe67f4d6","added_by":"auto","created_at":"2025-07-18 13:26:35","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":18062,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementtable2.docx","url":"https://assets-eu.researchsquare.com/files/rs-6996222/v1/b453f3c6fd5885fbd502893a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of a Conflict Management Workshop With Simulated Mediation and Mock Court Proceedings: A Mixed-Methods Study","fulltext":[{"header":"Background","content":"\u003cp\u003eMediation has become an indispensable component of contemporary healthcare dispute resolution, representing a paradigm shift from adversarial litigation toward collaborative problem-solving approaches [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This alternative dispute resolution method addresses the inherent limitations of traditional legal proceedings, which often exacerbate tensions between healthcare providers and patients while failing to address the underlying causes of conflict [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Through structured dialogue facilitated by neutral mediators, this process enables meaningful communication between parties. This approach fosters mutual understanding and preserves the physician-patient relationship, which is fundamental to healthcare quality [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. While mediation offers clear advantages, understanding actual litigation scenarios remains essential for healthcare professionals, as it prepares them for the legal realities they may encounter in clinical practice [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Exposure to real-world court proceedings enables healthcare professionals to comprehend malpractice case complexities, including expected standards of care and evidence scrutinized during litigation [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Nevertheless, most modern medical curricula prioritize clinical skill development, with limited structured training in the legal aspects of health care [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. This gap in education not only contributes to physician anxiety and defensive medicine but also underscores the need for a more integrated approach to medicolegal training in medical education [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Adopting structured medicolegal education can enhance physicians’ confidence in handling legal disputes and increase their overall preparedness for medical litigation [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Traditional legal education is often embedded within medical ethics courses, with these approaches typically adopting a didactic format, limiting opportunities for experiential learning [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Court visits can be incorporated into undergraduate medical curricula. Students engaging in court visits can gain a practical understanding of courtroom proceedings [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Nonetheless, court visits present major logistical and financial challenges, necessitate adherence to judicial protocols, and limit students’ ability to select cases that closely align with their specific educational goals. Additionally, court visits cannot be combined with mediation, which is an essential alternative to litigation in resolving medical disputes, thereby limiting students’ ability to learn about conflict management processes in clinical settings. To enhance medical students’ understanding of medical mediation and litigation, this study developed a workshop-based educational program, incorporating simulated mediation and mock court proceedings. To the best of our knowledge, this is the first study to combine simulated mediation with mock court proceedings in medical education. This study aims to evaluate the effectiveness of this innovative educational intervention in improving medical students' medicolegal knowledge, attitudes toward dispute resolution, and confidence in handling medicolegal challenges.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003e\u003cb\u003eCourse design and learning objectives\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe workshop was developed on the basis of an established framework [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and was grounded in situated learning theory [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The workshop was designed around real medical dispute cases to provide authentic learning experiences, enabling students to understand how physicians and patients engage in dialogue and negotiation to resolve conflicts. Additionally, the workshop incorporated expert-led discussions featuring professionals from interdisciplinary legal and healthcare fields. Overall, the workshop was developed with 3 primary learning objectives. First, the workshop aimed to enhance students’ understanding of the medicolegal principles underlying medical dispute resolution. Second, the workshop aimed to cultivate empathy by familiarizing students with the perspectives of diverse stakeholders involved in medical litigation and mediation. Third, the workshop aimed to enhance students’ dispute resolution skills to effectively navigate complex physician–patient interactions in legally and ethically challenging contexts.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy design and participants\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study employed a convergent, parallel, mixed-methods design, integrating quantitative and qualitative approaches to evaluate the educational intervention. The study was conducted in August 2022 at a medical school in northern Taiwan. Convenience sampling was used to recruit fourth-year medical students from the National Defense Medical Center (NDMC). Students at this institution are required to complete a one-credit compulsory course on medical ethics and medical law as part of their curriculum. The workshop served as an instructional session within this course.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntervention\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe structured framework of the simulation-based workshop is shown in Fig.\u0026nbsp;1. The workshop spanned a total of 150 minutes and comprised 4 sequential sessions. The introductory session was led by the course director, who provided an overview on medical mediation, medical litigation, and a brief introduction to the case scenario, followed by a preworkshop questionnaire to evaluate the students’ baseline understanding of medicolegal concepts. A simulated mediation session was then conducted, involving prerecorded, expert-led video presentations depicting diverse stakeholder perspectives in medical mediation, including patients, physicians, and mediators. Following these video presentations, the students engaged in small-group discussions while faculty members and legal experts observed and provided real-time feedback. A mock court session was then conducted. This session was designed to simulate a stressful civil litigation proceeding guided by a presiding judge to enhance the students’ understanding of legal procedures while fostering their ability to communicate under challenging conditions. The mock court session was joined by a multidisciplinary panel comprising a district court judge, senior representatives from the Taiwan Drug Relief Foundation, and the head of the legal affairs department at a major medical center. The workshop concluded with a debriefing and reflection session. During this session, faculty members and guest experts provided constructive feedback on student performance and addressed misconceptions. Overall, this workshop design emphasizes the development of the 7 core competencies of the NDMC, which strategically align with the 6 core competencies of the Accreditation Council for Graduate Medical Education [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] (Supplement Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMedicolegal professionalism scale (\u003cem\u003en\u003c/em\u003e = 157).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eItem\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePreworkshop\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003ePostworkshop\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStandard deviation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eStandard deviation\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003ePart 1: Medicolegal knowledge\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. I understand the legal responsibilities associated with medical disputes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. I understand the prelitigation mediation mechanisms for resolving medical disputes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. I understand the litigation procedures following the occurrence of a medical dispute.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. I understand the differences between judicial mediation and litigation in medical dispute resolution.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003ePart 2: Empathy\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. During physician–patient communication, I recognize the importance of actively listening to patients.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. During physician–patient communication, I understand the importance of effectively using body language.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. During physician–patient communication, I appreciate the value of empathy and perspectives from patients.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. During physician–patient communication, I understand the factors contributing to differences in perception between physicians and patients.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003ePart 3: Dispute resolution skills\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9. I understand the potential psychological effects of medical disputes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10. I understand the underlying causes of medical disputes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11. I recognize the dynamic nature and challenges of physician–patient communication during medical disputes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e12. I know how to resolve medical disputes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eLearning satisfaction scale (\u003cem\u003en\u003c/em\u003e = 157).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eItem\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStrongly disagree\u003c/p\u003e\u003cp\u003e(1)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDisagree\u003c/p\u003e\u003cp\u003e(2)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003cp\u003e(3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAgree\u003c/p\u003e\u003cp\u003e(4)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eStrongly agree\u003c/p\u003e\u003cp\u003e(5)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMean\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eStandard deviation\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. The goal of this learning activity (videos and scenario simulations) helps me understand how to identify and classify the features of the target learning objects.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5 (3.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e47 (29.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e105 (66.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.545\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. I have endeavored to observe the differences between the target learning objects in this learning activity.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (4.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50 (31.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e100 (63.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. This learning activity was simple to understand yet difficult to successfully complete.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (0.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (4.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e50 (31.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e99 (63.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.61\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. Learning with simulated mediation and mock court proceedings is more challenging or interesting than learning with the traditional approach.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (4.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e46 (29.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e104 (66.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. I acquired new knowledge regarding the target learning objects because I used simulated mediation and mock court proceedings to learn in an actual environment.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8 (5.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e46 (29.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e103 (65.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. I have attempted new methods or thinking styles to learn with simulated mediation and mock court proceedings.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14 (8.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e41 (26.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e102 (65.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. The guidance provided by simulated mediation and mock court proceedings helped me learn how to identify the features of the target learning objects.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10 (6.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e45 (28.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e102 (65.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.61\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. The guidance provided by simulated mediation and mock court proceedings helped me observe the differences within the target learning objects.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (4.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e47 (29.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e103 (65.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e4.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003cb\u003eData collection and instruments\u003c/b\u003e\u003c/p\u003e\u003cp\u003eData were collected using an online questionnaire that had the following 4 sections: medicolegal professionalism (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), learning satisfaction (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and reflective feedback.\u003c/p\u003e\u003ch3\u003e1. Medicolegal professionalism\u003c/h3\u003e\u003cp\u003eMedicolegal professionalism was measured using 12 items designed to evaluate the effectiveness of a workshop in achieving 3 key learning objectives: (1) medicolegal knowledge, (2) empathy, and (3) competency in resolving medical disputes. Each item was rated on a 5-point Likert scale, with endpoints ranging from 1 (\u003cem\u003estrongly disagree\u003c/em\u003e) to 5 (\u003cem\u003estrongly agree\u003c/em\u003e). Multidisciplinary experts were consulted in the development of this section of the questionnaire to ensure content validity. To evaluate internal consistency, we conducted a reliability analysis, which yielded an overall Cronbach’s α coefficient of 0.96, indicating excellent reliability. The reliability coefficients for each subscale were as follows: medicolegal knowledge (Cronbach’s α = 0.96), empathy (Cronbach’s α = 0.94), and physician–patient communication skills (Cronbach’s α = 0.89).\u003c/p\u003e\u003ch3\u003e2. Learning satisfaction\u003c/h3\u003e\u003cp\u003eLearning satisfaction was measured using 8 structured items, each rated on a 5-point Likert scale, with endpoints ranging from 1 (\u003cem\u003estrongly disagree\u003c/em\u003e) to 5 (\u003cem\u003estrongly agree\u003c/em\u003e). This section of the questionnaire was adapted from a validated scale and has been demonstrated to exhibit strong content validity and construct validity for measuring student satisfaction in situated simulation and case-based learning environments [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. To further establish reliability, we conducted a Cronbach’s α analysis, which yielded a coefficient of 0.96, confirming its excellent internal consistency.\u003c/p\u003e\u003ch3\u003e3. Reflective narrative\u003c/h3\u003e\u003cp\u003eReflective narrative was obtained using a semi structured instrument designed to elicit students’ reflections on their learning experiences. The instrument consists of a single open-ended prompt inviting students to articulate their insights. The prompt was, “What aspect of this workshop had the greatest effect on you? What did you learn from it?” By enabling students to provide an unstructured, qualitative response, this instrument provides in-depth insights into students’ learning experiences and the perceived applicability of the workshop content to clinical practice.\u003c/p\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003e\u003cem\u003eQuantitative analysis\u003c/em\u003e\u003c/p\u003e\u003cp\u003eDescriptive statistical analysis, reliability analysis, and paired-samples \u003cem\u003et\u003c/em\u003e tests were conducted using IBM SPSS Statistics version 25.0 (IBM, Armonk, NY, USA). Cronbach’s α coefficients were used to evaluate the reliability of the questionnaire, with a threshold of 0.7 indicating acceptable internal consistency. Paired-samples \u003cem\u003et\u003c/em\u003e tests were used to compare preworkshop and postworkshop mean scores, with statistical significance set at \u003cem\u003eP\u003c/em\u003e \u0026lt; .05.\u003c/p\u003e\u003cp\u003e\u003cem\u003eQualitative analysis\u003c/em\u003e\u003c/p\u003e\u003cp\u003eA social constructivist framework was adopted and a thematic analysis approach was employed to explore the qualitative data. All data were deidentified to ensure the anonymity of the students. The first three authors (Z.-Y.C., T.-W.C., and F.-C.P.) initially conducted open coding of the reflective narratives, identifying concepts that informed the development of a preliminary codebook, which was then revised through iterative review. The finalized version of the codebook was subsequently applied to code the entire dataset. Seven authors (Z.-Y.C., T.-W.C., F.-C.P., H.-Y.L., S.-Y.C., Daphne Yih Ng, and W.-C.C.) conducted an inductive and iterative analysis of the data, consistently revisiting the reflective texts and coded segments to develop an initial set of thematic drafts. This process continued until thematic saturation was reached (i.e., no new themes emerged). Throughout the qualitative research process, we employed deliberately designed reflexivity strategies to continuously examine and challenge our own assumptions about students’ learning experiences. To enhance the rigor of the qualitative analysis, this study was prepared in accordance with the standards for reporting qualitative research [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Additionally, to ensure clarity and linguistic precision, this report was professionally translated by an academic specialist to guarantee that the English version accurately conveyed the original meaning.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMixed-methods results integration\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe integration approach used in this study aligns with the concurrent triangulation design described by Creswell and Clark, as both quantitative and qualitative data were collected and analyzed simultaneously to corroborate and complement each other's findings [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eQuantitative analysis results\u003c/em\u003e\u003c/p\u003e\u003cp\u003eA total of 169 fourth-year medical students were recruited. Of these students, 157 provided valid responses to the questionnaire (response rate, 91%) (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Preworkshop scores for medicolegal knowledge ranged from 3.80 to 3.86, with an overall mean of 3.83 (SD, 1.06). Postworkshop scores were significantly higher, ranging from 4.47 to 4.52, with an overall mean of 4.49 (SD, 0.71; all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Preworkshop scores for empathy ranged from 4.21 to 4.29, with an overall mean of 4.24 (SD, 0.77). Postworkshop scores were significantly higher, ranging from 4.61 to 4.67, with an overall mean of 4.64 (SD, 0.55; all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). Preworkshop scores for assessment of competency in resolving medical disputes ranged from 4.07 to 4.25, with an overall mean of 4.15 (SD, 0.84). Postworkshop scores were significantly higher, ranging from 4.54 to 4.62, with an overall mean of 4.58 (SD, 0.61; all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001). In the learning satisfaction assessment, mean scores ranged from 4.56 to 4.64 (Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), with an overall mean of 4.59 (SD, 0.57).\u003c/p\u003e\u003cp\u003e\u003cem\u003eQualitative analysis results\u003c/em\u003e\u003c/p\u003e\u003cp\u003eA total of 113 student reflections were collected. The reflections were primarily in paragraph form. Thematic analysis identified 3 themes and 9 subthemes (Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The following section provides a detailed description of each theme.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThematic analysis of student feedback (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;113).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSubtheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eMedicolegal competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysicians\u0026rsquo; legal accountability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e60.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmpathic judicial mediation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e73.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLegal procedural insight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e46.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eMutual engagement in communication\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical humanistic concerns\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e64.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCollaborative decision-making\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e39.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAddressing common misunderstandings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e45.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eLegal and professional reflections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLegal terminology challenges\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e36.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eConfidence in managing disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e67.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProactive risk management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e55.8%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 1: Medicolegal competencies\u003c/b\u003e\u003c/p\u003e\u003ch2\u003e1.1 Physicians\u0026rsquo; legal accountability\u003c/h2\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003eThe students initially viewed comprehensive documentation as proof of professional adherence. Their reflections revealed that legal accountability also included informed consent. One student noted the following: \u0026ldquo;\u003cem\u003eI was shocked to learn that without proper documentation, a full verbal risk disclosure may still be deemed inadequate, resulting in legal liability.\u003c/em\u003e\u0026rdquo; (Student 036) The students\u0026rsquo; reflections also underscored how a physician\u0026rsquo;s duty extends beyond proper documentation. One student was particularly shocked by the potential criminal consequences: \u0026ldquo;\u003cem\u003eI never realized that a physician could face involuntary manslaughter charges and imprisonment if a patient dies\u0026mdash;an alarming reality for those dedicated to patient care.\u003c/em\u003e\u0026rdquo; (Student 055) The students recognized that legal accountability extends beyond clinical competence, with noncompliance posing civil and criminal risks.\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e1.2 Empathic judicial mediation\u003c/h2\u003e\u003cp\u003eInitially viewed as a rigid, compensation-driven process, mediation emerged from the students\u0026rsquo; reflections as a structured yet empathetic dialog, fostering trust and mitigating litigation burdens. Some students reflected on this shift in perspective: \u0026ldquo;\u003cem\u003eSimulated mediation revealed that patients and families seek acknowledgment of their suffering more than financial compensation.\u003c/em\u003e\u0026rdquo; (Student 021), \u0026ldquo;\u003cem\u003eSincere physician empathy and regret can soften patient and family attitudes, often diffusing tension and reducing blame.\u003c/em\u003e\u0026rdquo; (Student 042) These reflections highlight physicians\u0026rsquo; attitudes as pivotal in mediation, wherein empathy reduces tension and facilitates constructive dialog.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e1.3 Legal procedural insight\u003c/h2\u003e\u003cp\u003eInitially, students perceived legal procedures as cumbersome but later recognized their role in ensuring due process and judicial integrity: \u0026ldquo;\u003cem\u003eI once thought legal procedures were overly complex, but I now see that each step safeguards fairness and prevents rights from being lost due to procedural gaps.\u003c/em\u003e\u0026rdquo; (Student 005) The students also came to realize that understanding legal procedures increases argument clarity and enhances critical thinking and rebuttal skills: \u0026ldquo;\u003cem\u003eI used to rely on intuition, but now I construct arguments systematically, following legal logic for greater structure and persuasiveness.\u003c/em\u003e\u0026rdquo; (Student 031) These reflections confirm that legal procedures are not mere technicalities but rather essential protective mechanisms for fairness and justice.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 2: Mutual engagement in communication\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Medical humanistic concerns\u003c/h2\u003e\u003cp\u003eThe students recognized the need to adhere to legal regulations to mitigate risks while also fearing that excessive defensive practices can diminish physician\u0026ndash;patient trust: \u0026ldquo;\u003cem\u003ePhysicians must protect themselves legally. Simultaneously, patients need to feel that their doctor genuinely cares.\u003c/em\u003e\u0026rdquo; (Student 014) Some of the students worried that prioritizing legal safeguards may make patients feel unheard: \u0026ldquo;\u003cem\u003eFocusing only on lab results while neglecting emotional well-being makes building trust difficult.\u003c/em\u003e\u0026rdquo; (Student 072) These reflections underscore the need for patient-centered care that balances legal and clinical standards with empathy to ensure that medicine remains both scientifically rigorous and humanistically compassionate.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Collaborative decision-making\u003c/h2\u003e\u003cp\u003eBy engaging in real-world case discussions, the students recognized that clear explanations and shared decision-making increased treatment acceptance and reduced the risk of disputes: \u0026ldquo;\u003cem\u003eI realized that treatment decisions involve not only medical factors but also quality of life, financial concerns, and personal beliefs.\u003c/em\u003e\u0026rdquo; (Student 068) This realization indicated a shift from a physician-centered decision-making approach to a patient-inclusive approach. The students observed that active patient involvement not only enhanced adherence and adaptability but also addressed challenges in practice: \u0026ldquo;\u003cem\u003eSome patients seek clear guidance; others prefer full autonomy. I am learning to balance professional advice without overwhelming them.\u003c/em\u003e\u0026rdquo; (Student 070) These reflections indicate that treatment decisions extend beyond medical factors. Instead, they require physicians to integrate their expertise with an understanding of patient concerns to align care with individual needs.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Addressing common misunderstandings\u003c/h2\u003e\u003cp\u003eInitially, students assumed that medical disputes originated from poor outcomes. Student reflections revealed that the students came to realize that communication failures were often the actual root cause of such disputes: \u0026ldquo;\u003cem\u003eI thought patients questioned physicians only when dissatisfied with outcomes, but I now see that misunderstandings often arise from unclear treatment explanations or unrealistic expectations.\u003c/em\u003e\u0026rdquo; (Student 038) Some of the students believed that providing complete medical information was sufficient for informed decision-making. Simulations revealed the difficulty faced by patients in processing complex information as a result of jargon, stress, or misconceptions: \u0026ldquo;\u003cem\u003ePatients may nod in agreement but still misunderstand risks and alternatives. I\u0026rsquo;ve learned to verify comprehension rather than assume it.\u003c/em\u003e\u0026rdquo; (Student 081) These reflections illustrate a shift from a one-way information delivery model to an interactive, verification-based approach.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 3: Legal and professional reflections\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Legal terminology challenges\u003c/h2\u003e\u003cp\u003eStudents perceived legal terminology as challenging and believed legal terminology limited their ability to understand medical disputes and communicate effectively in legal contexts: \u0026ldquo;\u003cem\u003eMany of the professional terms used by the judge and other experts during the mock court were unfamiliar to me.\u003c/em\u003e\u0026rdquo; (Student 058) They recognized that legal terms were abstract and context-dependent: \u0026ldquo;\u003cem\u003eI was surprised to learn that the same legal term could carry different definitions across civil, criminal, and administrative law.\u003c/em\u003e\u0026rdquo; (Student 077) These reflections indicate that mastering legal terminology requires more than memorization; it necessitates a deep understanding of legal principles.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Confidence in managing disputes\u003c/h2\u003e\u003cp\u003eBefore the workshop, students had concerns regarding litigation and felt unprepared for medical disputes. Structured learning helped them develop legal awareness and confidence: \u0026ldquo;\u003cem\u003eI now understand medical law principles and know which steps to take and whom to consult for support. This gives me newfound confidence.\u003c/em\u003e\u0026rdquo; (Student 112) The students also recognized the psychological effects of disputes and the need for emotional resilience: \u0026ldquo;\u003cem\u003eMedical disputes are sometimes inevitable; the key is to stay calm and respond rationally.\u003c/em\u003e\u0026rdquo; (Student 075) These reflections suggest a shift from fear to preparedness, which enables students to approach disputes with greater confidence and professionalism.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Proactive risk management\u003c/h2\u003e\u003cp\u003eInitially, the students viewed risk management as reactive, responding after adverse events. After the workshop, the students recognized risk management as a proactive process involving prevention, communication, and systematic management: \u0026ldquo;\u003cem\u003eRisk management can be planned; strong patient communication and thorough documentation reduce the risks of disputes.\u003c/em\u003e\u0026rdquo; (Student 098) Some of the students also acknowledged the need for institutional support and teamwork. \u0026ldquo;\u003cem\u003eEarly warning systems in health-care institutions can help identify issues sooner, reducing errors.\u003c/em\u003e\u0026rdquo; (Student 008) These reflections indicate a shift from reactive to preventive thinking, emphasizing the role of communication, protocols, and collaboration in minimizing medical risks.\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntegration of mixed-methods results\u003c/b\u003e\u003c/p\u003e\u003cp\u003eJoint displays of qualitative and quantitative results were demonstrated in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. We identified the findings of each item from the quantitative questionnaire that corresponded to similar concepts in the subthemes. However, the subtheme \"Legal terminology challenges\" did not have a corresponding item in the quantitative questionnaire. Quantitative data showed that \u0026ldquo;Legal responsibilities associated with medical disputes\u0026rdquo; improved the most. However, qualitative results revealed that nearly 40% of students did not specifically address this topic in their feedback. This could be attributed to a lack of practical experience or real-world cases through which they could apply the legal knowledge gained from the workshop. Consequently, when providing their reflections, they often shifted their focus to other areas, such as doctor-patient communication or empathy. Additionally, the quantitative data indicated that \u0026ldquo;Factors contributing to differences in perception\u0026rdquo; showed the least improvement (+\u0026thinsp;0.36). Similarly, in the qualitative analysis, fewer than 40% of students mentioned the subtheme \u0026ldquo;Addressing common misunderstandings\u0026rdquo;. This may be due to the abstract cognitive processes involved in the aforementioned item and subtheme. Learning in this area often requires direct interaction and communication with patients to develop relevant skills. However, the students in this study had not yet participated in clinical practice, which likely limited their ability to apply these concepts concretely in their feedback. As a result, the improvement in this domain was less pronounced in the quantitative assessment. Additionally, the qualitative analysis revealed \"Medical humanistic concerns\" as a significant subtheme (73 mentions, 64.6%), yet this concept lacked corresponding quantitative measures. While the quantitative scale included empathy-related items, students' qualitative reflections extended beyond empathy to encompass broader humanistic considerations such as patient dignity, emotional support during disputes, and moral obligations of healthcare providers. This discrepancy suggests that students' learning experiences transcended the predefined quantitative measures, indicating that the workshop fostered deeper reflection on the human dimensions of medical disputes\u0026mdash;aspects that may be difficult to capture through standardized assessments. The prominence of humanistic concerns in student feedback highlights the importance of integrating values-based education into medicolegal training and suggests that future evaluations should incorporate instruments that capture the humanistic dimensions of medical practice. Furthermore, many students' feedback indicated that they felt unfamiliar with legal terminology, hindering the students\u0026rsquo; ability to navigate medical disputes and communicate effectively in legal settings. This challenge was likely attributable to the fact that fourth-year medical students have yet to engage in clinical training (ie, fourth-year students have little exposure to real-world medicolegal problems). Given the distinct nature of legal knowledge, medical students inevitably face learning barriers. These findings underscore the need for medical law education to integrate interdisciplinary collaboration with legal professionals while enhancing students\u0026rsquo; understanding of legal language to bridge the gap between medicine and law. Future educational efforts should consider targeting residents and attending physicians who have clinical experience. Such individuals are not only more familiar with the dimensions of medical disputes but also better positioned to appreciate the relevance of legal competency in clinical practice.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eJoint displays of qualitative and quantitative results.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eQualitative results\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eQuantitative results\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSubtheme\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIllustrative quote\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eItem\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e△\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eMedicolegal competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysicians\u0026rsquo; legal accountability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e68\u003c/p\u003e\u003cp\u003e(60.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eI was shocked to learn that without proper documentation, a full verbal risk disclosure may still be deemed inadequate, resulting in legal liability.\u003c/em\u003e (Student 036)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLegal responsibilities associated with medical disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.68\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEmpathic judicial mediation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e83\u003c/p\u003e\u003cp\u003e(73.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eSincere physician empathy and regret can soften patient and family attitudes, often diffusing tension and reducing blame.\u003c/em\u003e (Student 042)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMediation mechanisms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.65\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eJudicial mediation and litigation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.65\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLegal procedural insight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003cp\u003e(46.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eI once thought legal procedures were overly complex, but I now see that each step safeguards fairness and prevents rights from being lost due to procedural gaps.\u003c/em\u003e (Student 005)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLitigation procedures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.65\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eMutual engagement in communication\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical humanistic concerns\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73\u003c/p\u003e\u003cp\u003e(64.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eFocusing only on lab results while neglecting emotional well-being makes building trust difficult. (Student 072)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCollaborative decision-making\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003cp\u003e(45.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eSome patients seek clear guidance; others prefer full autonomy. I am learning to balance professional advice without overwhelming them.\u003c/em\u003e\u0026rdquo; (Student 070)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eActively listening to patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.38\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePerspectives from patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.41\u003c/p\u003e \u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAddressing common misunderstandings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e45\u003c/p\u003e\u003cp\u003e(39.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ePatients may nod in agreement but still misunderstand risks and alternatives. I\u0026rsquo;ve learned to verify comprehension rather than assume it.\u003c/em\u003e\u0026rdquo; (Student 081)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEffectively using body language\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.42\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFactors contributing to differences in perception\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.36\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eLegal and professional reflections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLegal terminology challenges\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003cp\u003e(36.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eMany of the professional terms used by the judge and other experts during the mock court were unfamiliar to me. (Student 058)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eConfidence in managing disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e76\u003c/p\u003e\u003cp\u003e(67.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cem\u003eI now understand medical law principles and know which steps to take and whom to consult for support. This gives me newfound confidence.\u003c/em\u003e (Student 112)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePsychological effects of medical disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.46\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eChallenges of communication during disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.36\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ehow to resolve medical disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.50\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProactive risk management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e63\u003c/p\u003e\u003cp\u003e(55.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eRisk management can be planned; strong patient communication and thorough documentation reduce the risks of disputes.\u003c/em\u003e\u0026rdquo; (Student 098)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCauses of medical disputes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e+\u0026thinsp;0.44\u003c/p\u003e\u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e△: Difference between pre-test and post-test results\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis workshop employed a learner-centered approach designed to foster engagement and active learning. Our findings are consistent with situated learning theory, confirming the value of contextualized educational experiences in facilitating knowledge transfer and preparing learners for complex real-world scenarios [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The simulation-based curriculum demonstrates the capacity to promote both cognitive and affective development while fostering personal resilience, consistent with other research [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Integrating simulated mediation and mock court proceedings provide learners with emotionally charged scenarios that mirrored real-life medical dispute complexities. Students developed a broader understanding of the civil, criminal, and administrative dimensions of medical law through the workshop, consistent with findings from courtroom-based studies [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan additionalcitationids=\"CR24 CR25\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Significant improvements in students' understanding of medical dispute causes and resolutions demonstrate that simulated learning extended awareness beyond clinical errors to include patient autonomy, information asymmetry, and psychological factors [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The significant increase in students' recognition of empathy's importance indicates that simulated mediation shifted perspectives from physician-centered to patient-centered approaches, reframing mediation as emotional reconciliation rather than merely a legal mechanism [\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Additionally, students' confidence in responding to medical disputes increased, consistent with other studies demonstrating that immersive simulation enhances preparedness for real-world medicolegal challenges [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Our study identified high levels of student satisfaction, particularly with the integration of video content and situational simulations. These findings confirm that interactive, multimedia-enhanced strategies improve learning outcomes [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], and highlight the documented value of simulated learning in enhancing medical law understanding and conflict management skills [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eLimitations of this study are as follows. First, the study evaluated only short-term learning outcomes, leaving the long-term effects unexamined. Second, the study's reliance on self-reported data may have led to overestimation or underestimation of learning gains. Integrating objective measures (e.g., validated questionnaires or standardized scales) and external evaluations (e.g., observed skill performance) may improve assessment accuracy. Third, this study adopted a single-group intervention design; further comparative studies are warranted to establish the effectiveness of this approach relative to traditional teaching methods.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eMedical students' perceived medicolegal knowledge, empathy, and dispute resolution skills were enhanced by this simulation-based approach, and the high participant satisfaction rates support the effectiveness of simulated learning in medicolegal education. These findings advocate for the broader implementation of practice-based medicolegal training in medical curricula to better prepare physicians for contemporary healthcare challenges and improve patient-physician relationships. Future studies should explore the long-term effects of this strategy on clinical practice, and further comparative studies are also warranted.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board of the Tri-Service General Hospital (approval no. B202105040). All research was performed in accordance with the Declaration of Helsinki. All participants signed an informed consent form prior to participation in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudents were informed about study objectives and potential publication of anonymized data before participation. All provided written informed consent. Participation was voluntary and did not affect grades. Invalid surveys were excluded, and data were anonymized to ensure confidentiality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData from this study will be available on reasonable request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Ministry of Science and Technology (MOST 110-2511-H-016-002-MY3) and the National Science and Technology Council of Taiwan (NSTC 112-2410-H-016-001-MY3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYi-Chao Zhou and Chih‑Chia Wang contributed to the conception, design, data acquisition, data analysis and interpretation, and drafted and critically revised the manuscript; Wen-Chii Tzeng, Chung Pei Fu, Yin-Ling Hung, Yi-Chih Shiao, Daphne Yih Ng contributed to the qualitative data analysis and interpretation, and critically revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their sincere gratitude to their colleagues and the students of the NDMC, who participated in and contributed to the execution of this study. This manuscript was edited by Wallace Academic Editing. Additionally, the authors would like to extend their appreciation to the reviewers and editor for their insightful feedback and constructive comments, which greatly enhanced the quality of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eY.-C. Zhou\u003c/strong\u003e is a family physician at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eW.-C. Tzeng\u003c/strong\u003e is a professor at the School of Nursing, National Defense Medical Center, Taipei, Taiwan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eC.-P. Fu \u003c/strong\u003eis a professor at the Department of Occupational Therapy, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eY.-L. Hung\u003c/strong\u003e is an intensive care unit nurse at the Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eY.-C. Shiao\u003c/strong\u003e is a family physician at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDaphne Yih Ng\u003c/strong\u003e is a research assistant at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eC.-C.\u003c/strong\u003e \u003cstrong\u003eWang\u003c/strong\u003e is a family physician and a professor at the Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBrummans BH, Higham L, Cooren F. 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Mock court: A valuable tool to teach legal procedures to undergraduate medical students. Int J Legal Med. 2024;138(5):1955\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen WT, Fu CP, Chang YD, Shiao YC, Chen PY, Wang CC. Developing an innovative medical ethics and law curriculum-constructing a situation-based, interdisciplinary, court-based learning course: A mixed methods study. BMC Med Educ. 2022;22(1):284.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArbel E, Reese A, Oh K, Mishra A. Medical law and medical school curricula: A systematic review. Cureus. 2024;16(2):e54377.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen W-T, Fu C-P, Chang Y-D, Shiao Y-C, Chen P-Y, Wang C-C. Developing an innovative medical ethics and law curriculum\u0026mdash;constructing a situation-based, interdisciplinary, court-based learning course: A mixed methods study. BMC Med Educ. 2022;22(1):284.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEftekhari MH, Parsapoor A, Ahmadi A, Yavari N, Larijani B, Gooshki ES. Exploring defensive medicine: Examples, underlying and contextual factors, and potential strategies - a qualitative study. BMC Med Ethics. 2023;24(1):82.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBalch CM, Oreskovich MR, Dyrbye LN, Colaiano JM, Satele DV, Sloan JA, Shanafelt TD. Personal consequences of malpractice lawsuits on american surgeons. J Am Coll Surg. 2011;213(5):657\u0026ndash;67.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAbbasi M, Shirazi M, Torkmandi H, Homayoon S, Abdi M. Impact of teaching, learning, and assessment of medical law on cognitive, affective and psychomotor skills of medical students: A systematic review. BMC Med Educ. 2023;23(1):703.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCampbell AT. Teaching law in medical schools: First, reflect. J Law Med Ethics. 2012;40(2):301\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStowell JM, Pihlak MR, Matzke A, O'Keefe M. Implementation of the court visitor program in a clinical nursing curriculum. J Nurs Educ. 2013;52(12):709\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChen W-T, Huang Y-Y, Chen W-W, Liu Y-P, Shih C-L, Shiao Y-C, Wang C-C. Fostering guardians for frontline medical disputes: A government-led medical dispute mediator training program in taiwan. BMC Health Serv Res. 2022;22(1):1478.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eO'Brien BC, Battista A. Situated learning theory in health professions education research: A scoping review. Adv Health Sci Educ Theory Pract. 2020;25(2):483\u0026ndash;509.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShinkaruk K, Carr E, Lockyer JM, Hecker KG. Exploring the development of interprofessional competence and professional identity: A situated learning theory study. J Interprof Care. 2023;37(4):613\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLurie SJ, Mooney CJ, Lyness JM. Measurement of the general competencies of the accreditation council for graduate medical education: A systematic review. Acad Med. 2009;84(3):301\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChu H-C, Hwang G-J, Tsai C-C, Tseng JCR. A two-tier test approach to developing location-aware mobile learning systems for natural science courses. Comput Educ. 2010;55(4):1618\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eO'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: A synthesis of recommendations. Acad Med. 2014;89(9):1245\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBattista A, Torre D, Konopasky A. Essential concepts for effective mixed methods research in the health professions: Amee guide 173. Med Teach. 2025;47(5):766\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJallad ST. Effectiveness of simulation-based education on educational practices of communication skills, satisfaction, and self-confidence among undergraduate nursing students. Creat Nurs. 2024;0(0):10784535241301115.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChan KD, Humphreys L, Mey A, Holland C, Wu C, Rogers GD. Beyond communication training: The maris model for developing medical students' human capabilities and personal resilience. Med Teach. 2020;42(2):187\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAhmed S, Al-Mously N, Al-Senani F, Zafar M, Ahmed M. Medical teachers' perception towards simulation-based medical education: A multicenter study in saudi arabia. Med Teach. 2016;38(Suppl 1):S37\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHughes KE, Cahir TM, Nordlund D, Keim SM, Hughes PG. Fear not: Utilizing simulation for medical malpractice education. J Med Educ Curric Dev. 2022;9:23821205221096269.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDatta R, Upadhyay K, Jaideep C. Simulation and its role in medical education. Med J Armed Forces India. 2012;68(2):167\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMohseni F, Mohammadi A, Khajavirad N, Basiri K, Khabaz Mafinejad M. Teaching conflict management skills to medical students: A scoping review. Med J Islam Repub Iran. 2024;38:24.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBylund CL, Vasquez TS, Peterson EB, Ansell M, Bylund KC, Ditton-Phare P, Hines A, Manna R, Singh Ospina N, Wells R, et al. Effect of experiential communication skills education on graduate medical education trainees' communication behaviors: A systematic review. Acad Med. 2022;97(12):1854\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCoggins A, Santos AL, Zaklama R, Murphy M. Interdisciplinary clinical debriefing in the emergency department: An observational study of learning topics and outcomes. BMC Emerg Med. 2020;20(1):79.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang X, Li L, Zhang Q, Le LH, Wu Y. Physician empathy in doctor-patient communication: A systematic review. Health Commun. 2024;39(5):1027\u0026ndash;37.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHan A, Kim TH. A simulation-based empathy enhancement program for non-medical care providers of older adults: A mixed-methods study. Psychiatry Investig. 2021;18(2):132\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKrystallidou D, Remael A, de Boe E, Hendrickx K, Tsakitzidis G, van de Geuchte S, Pype P. Investigating empathy in interpreter-mediated simulated consultations: An explorative study. Patient Educ Couns. 2018;101(1):33\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMitchell AA, Ivimey-Cook ER. Technology-enhanced simulation for healthcare professionals: A meta-analysis. Front Med (Lausanne). 2023;10:1149048.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eElendu C, Amaechi DC, Okatta AU, Amaechi EC, Elendu TC, Ezeh CP, Elendu ID. The impact of simulation-based training in medical education: A review. Med (Baltim). 2024;103(27):e38813.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKong Y. The role of experiential learning on students' motivation and classroom engagement. Front Psychol. 2021;12:771272.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Conflict management, simulated mediation, mock court proceedings, medicolegal competencies, empathy, physician-patient communication","lastPublishedDoi":"10.21203/rs.3.rs-6996222/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6996222/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eInadequate medicolegal training contributes to physician anxiety and defensive medicine practices. To address this issue, we implemented a novel pedagogical approach incorporating simulated mediation and mock court proceedings into a medical course to enhance medicolegal competency among medical students.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis study was conducted in August 2022 that recruited medical students preparing for clinical rotations. Students completed a 4-part 150-minute workshop that covered simulated mediation, mock court, debriefing, and reflection sessions. During the simulated mediation session, the participants watched expert-recorded videos of different medical mediation perspectives, followed by small-group discussions with real-time feedback. During the mock court session, a judge-led multidisciplinary expert group demonstrated actual litigation process. Data were collected by using an online questionnaire, including structured and semi-structured items.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFor quantitative analysis, 157 valid responses were analyzed and the questionnaire had satisfactory internal consistency. Quantitative analysis revealed significant improvements in medicolegal knowledge, empathy, and physician\u0026ndash;patient communication, with postworkshop mean scores being significantly higher than preworkshop scores. Participant feedback indicated high satisfaction levels, with 66.9% of participants endorsing the effectiveness of simulations for learning. Qualitative analysis of 113 student reflections identified 3 themes: medicolegal competencies, mutual engagement in communication, and legal and professional reflections.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThis brief conflict management workshop using simulated mediation and mock court proceedings effectively enhanced medical students' perceived medicolegal knowledge, empathy, and dispute resolution skills. However, students' unfamiliarity with legal terminology highlighted learning barriers that require interdisciplinary collaboration with legal professionals. Integrating such simulations with legal expert involvement in future medicolegal education is recommended.\u003c/p\u003e","manuscriptTitle":"Effect of a Conflict Management Workshop With Simulated Mediation and Mock Court Proceedings: A Mixed-Methods Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 13:26:30","doi":"10.21203/rs.3.rs-6996222/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-04T13:32:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-23T02:43:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-21T09:52:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17625452709736516110698499763809642132","date":"2025-10-13T14:55:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"175123380145856751543425237819123264246","date":"2025-10-08T07:05:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"41574025744784420215115621301265160465","date":"2025-10-06T12:32:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"174034566637844891226379949428939232585","date":"2025-09-17T12:33:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-15T03:55:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"219673718290460997945271823378184082226","date":"2025-09-08T00:15:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"145896678628943264532191188049573484615","date":"2025-08-19T00:58:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"241771590956929271477589474900036982839","date":"2025-08-18T06:55:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-14T13:08:29+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-09T10:52:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-08T12:12:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-08T12:08:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-06-28T07:22:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9e3fea61-4add-47a5-ac39-d98e96764ff1","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-01T16:00:35+00:00","versionOfRecord":{"articleIdentity":"rs-6996222","link":"https://doi.org/10.1186/s12909-025-08345-7","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-11-27 15:57:18","publishedOnDateReadable":"November 27th, 2025"},"versionCreatedAt":"2025-07-18 13:26:30","video":"","vorDoi":"10.1186/s12909-025-08345-7","vorDoiUrl":"https://doi.org/10.1186/s12909-025-08345-7","workflowStages":[]},"version":"v1","identity":"rs-6996222","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6996222","identity":"rs-6996222","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}