Impact of medical law education based on the IRAC model on the medical law reasoning of internal medicine and surgery residents

Medical-legal challenges have intensified over the past decade, leading to substantial financial burdens and psychological distress for physicians. Literature reviews indicate that the medical law skills of specialists and residents, particularly their medical law reasoning abilities, are insufficient, underscoring the necessity for appropriate educational interventions. This study aimed to determine the impact of medical law education based on the IRAC (Issue, Rule, Analysis, Conclusion) model on the medical law reasoning of internal medicine and surgery residents at Zanjan University of Medical Sciences. A quasi-experimental study employing a non-randomized control group with a pretest-posttest design was conducted. The ADDIE model guided the design of the educational intervention. Residents were non-randomly assigned to an intervention group ( n = 27) receiving IRAC-based training and a control group ( n = 27) receiving no such training. Attitudes toward medical law reasoning were assessed using the Medical Law Reasoning Attitude Questionnaire (MLRAQ), while cognitive medical law reasoning was assessed using the participant-completed, scenario-based Medical Law Reasoning Skill Test (MLRST), which measures respondents’ reasoning judgments in hypothetical medico-legal scenarios. Data were analyzed using independent t-test, paired t-test, Chi-square, and Welch. No statistically significant differences were observed between the groups in baseline total attitude scores ( P = 0.213) or total medical law reasoning skill scores ( P = 0.572). Posttest results, however, revealed significant differences favoring the intervention group in total attitude scores (101.48 ± 9.32 vs. 82.63 ± 13.08; P < 0.001) and all its subscales. Similarly, the intervention group demonstrated significantly higher total medical law reasoning skill scores posttest (79.00 ± 8.27 vs. 58.81 ± 7.39; P < 0.001) across all subscales. The primary between-group analysis of pretest-to-posttest change confirmed these improvements for both outcomes ( P < 0.001), and supplementary Welch’s tests on posttest scores were consistent. The IRAC-based medical law education intervention was associated with significant improvements in residents’ measured attitudes and cognitive reasoning scores. This model offers a practical framework for medical educators and curriculum planners to employ creative, integrated, model-based, and active learning strategies to enhance legal reasoning competencies. Ultimately, fostering these skills may help reduce future legal disputes, mitigate physicians’ criminal and civil liabilities, and ensure better adherence to patient rights.