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

Abstract

To establish a training programme to cultivate trainee mediation skills through time investment, skill incorporation and formation of in-house mediation services. 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. Responses collected from enrolled experts through four rounds of the Delphi process from 11 November 2018 to 17 May 2019. Onboard seasoned mediators with different specialties. 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. 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. 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.