Programme of triple-I mediator education (TIME) to improve medical disputes in clinical settings in Taiwan: a Delphi study

Yi-Chih Shiao; Ruo-Nan Shen; Wen-Wen Chen; Yueh-Ping Liu; Chung-Liang Shih; Chih-Chia Wang

doi:10.1136/bmjopen-2021-058880

Programme of triple-I mediator education (TIME) to improve medical disputes in clinical settings in Taiwan: a Delphi study

BMJ Open. 2022 Aug 26;12(8):e058880. doi: 10.1136/bmjopen-2021-058880.

Authors

Yi-Chih Shiao^{1

2}, Ruo-Nan Shen³, Wen-Wen Chen³, Yueh-Ping Liu^{4

5}, Chung-Liang Shih⁵, Chih-Chia Wang⁶

Affiliations

¹ Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
² College of Law, National Chengchi University, Taipei, Taiwan.
³ Taiwan Drug Relief Foundation, Taipei, Taiwan.
⁴ Department of Medical Affairs, Ministry of Health and Welfare, Taipei, Taiwan.
⁵ Ministry of Health and Welfare, Taipei, Taiwan.
⁶ Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center; School of Medicine, National Defense Medical Center, Taipei, Taiwan tsghccwang@gmail.com.

Abstract

Objectives: To establish a training programme to cultivate trainee mediation skills through time investment, skill incorporation and formation of in-house mediation services.

Design: A four-round consensus conference was conducted by a number of seasoned experts selected in the manner of purposive sampling to determine core competences and relevant curricula through the modified Delphi process.

Setting: Responses collected from enrolled experts through four rounds of the Delphi process from 11 November 2018 to 17 May 2019.

Participants: Onboard seasoned mediators with different specialties.

Outcome measures: Items with a median rating of 4 or more on a Likert scale of 1-7 points and 70% or more in agreement were identified as core competence and curricula.

Results: Eleven enrolled experts reached the consensus about the training syllabus based on the 4-round agreement with four pillars of core competence, including 'knowledge base of law', 'internalisation of the denotative and connotative meanings of care', 'effective, smooth and timely communication' and 'conflict resolution'. To grasp the dynamics and diversity of medical disputes on target, it is necessary to have sufficient knowledge and skills. We arrange our course in the order of teaching materials with pure didactics in the former two and with mixed contents comprising lectures and field exercises in the rest two.

Conclusions: The sample developed a syllabus to train apprentices to take intermediate responses to medical disputes through the skills of conflict resolution and establishment of effective communication to improve the relationship between patients/relatives and medical staff, as a result of eventually reducing the conversion rate from dispute into litigation or alternative pathway. Policy-makers in healthcare and top management in healthcare institutions can use this syllabus to guide their future education and training programme.

Keywords: Health policy; MEDICAL EDUCATION & TRAINING; PUBLIC HEALTH.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Clinical Competence
Curriculum
Delphi Technique
Dissent and Disputes*
Education, Medical, Undergraduate*
Humans
Taiwan