Risk and safety
Give clinicians a safe place to practice high-stakes safety conversations
Last updated: October 2026
Clinicians rehearse disclosure, goals of care, family meetings, and de-escalation with AI patients. Each private report shows strengths and areas for practice against a published framework or institution policy. Leaders review completion or aggregate patterns under institution-defined access rules. ClinicalSim does not monitor patient care or predict claims.
What's at stake
The indemnity math on a single case
Average indemnity on a communication-failure malpractice case runs from $386,000 in general medicine to $944,000 in obstetrics, and that is before defense costs. Communication claims are also more than twice as likely to top $1 million than other claims (Humphrey et al., Journal of Patient Safety 2022).
The share of claims is rising
Candello found communication factors in 40% of asserted malpractice cases from 2014 through 2024, compared with 30% in its earlier analysis. Those claims also carried 39% greater odds of closing with an indemnity payment. The data describes association, not the effect of a training product.
Sentinel events keep coming back to communication
The Joint Commission has repeatedly named communication a leading root cause of sentinel events in Sentinel Event Alert 58. That alert is qualitative and attaches no percentage, which is part of why a risk office struggles to size the exposure and defend a training budget against it.
Credit exists for courses, evidence of practice does not
Carriers award premium credits of 5 to 19% for completing an approved risk-reduction course (CRICO and New York Regulation 124 premium programs). ClinicalSim holds no approved-course designation and has not been studied against claims.
The numbers
average indemnity per communication-failure case, general medicine to obstetrics, before defense costs
CRICO 2015 specialty indemnity averages
of asserted malpractice cases included communication factors from 2014 through 2024
Candello 2025 Benchmarking Report
greater odds that a communication-failure claim closes with an indemnity payment
Candello 2025 Benchmarking Report
How ClinicalSim helps
Practice the conversations that appear in claims
The library covers goals-of-care conversations, diagnosis disclosure, advance care planning, family meetings, and de-escalation. Clinicians practice by voice, on demand, from any device, and each conversation is scored against a published framework such as SPIKES or Calgary-Cambridge, or against your institution's own disclosure or consent policy, with their own words quoted under every score.
Participant feedback and reporting rules set by you
Clinicians see their own feedback after each simulated conversation. The institution chooses completion reporting, agreed coaching access, or aggregate patterns before practice begins.
Extends the simulation program you already fund
CRICO's obstetric safety program combined simulation with team training and other safety work. ClinicalSim adds repetitions between scheduled standardized patient encounters and drills. It has not been studied against claims.
Volume without new scheduling
A risk office can offer focused practice without adding standardized patient hours or booking sim lab time, because sessions run from any device at any hour.
Faculty development
Faculty can rehearse corrective feedback, professionalism concerns, bedside teaching, and peer conversations before they lead them in person. Each conversation is scored against the framework named on the case, with the faculty member's own words quoted under every score, to review privately or with a coach.
Related insights
What the evidence says about communication training
Candello found a communication factor in 40% of asserted malpractice cases, and Chung's review of 20 training studies rated the evidence very low to low quality. Neither supports an ROI headline. What a program can measure is its own learners, scored against a named framework.
Breaking bad news is a practice problem, not a knowledge problem
A framework can organize a conversation, but learners still need repeated spoken practice with feedback. The evidence shows how little formal training many residents receive and what a program can do about it.
Questions we get from this seat
What does a communication-failure claim actually cost?
Average indemnity on a communication-failure malpractice case runs from $386,000 in general medicine to $944,000 in obstetrics, before defense costs (CRICO 2015 specialty indemnity averages). Candello found communication factors in 40% of asserted malpractice cases from 2014 through 2024, and those claims carried 39% greater odds of closing with an indemnity payment. Communication claims were also more than twice as likely to top $1 million in Humphrey et al. (Journal of Patient Safety, 2022).
Is there evidence that communication training changes claim rates?
A published report on CRICO's multi-part obstetric safety program described lower OB claim rates after a program that included simulation, team training, and other safety work (Schaffer et al., Obstetrics and Gynecology 2021). The change cannot be attributed to simulation alone. In a randomized vignette study of 804 U.S. adults, 41% said they would contact a lawyer after a missed diagnosis without shared decision-making, against 11 to 12% when the physician used it (Schoenfeld et al., Annals of Emergency Medicine 2019). That measured stated intent, not filed claims, and a 2015 systematic review found too little data to say whether shared decision-making reduces litigation (Durand et al., BMC Health Services Research). ClinicalSim has not been studied against claim rates.
Does ClinicalSim qualify for a malpractice premium credit?
Carriers award premium credits of 5 to 19% for completing an approved risk-reduction course (CRICO and New York Regulation 124 premium programs), and approval is the carrier's decision rather than ours. ClinicalSim holds no approved-course designation today. It provides records from simulated practice under the reporting rules the institution sets before launch.
Does this replace our standardized patient program?
No. Standardized patient encounters stay the high-stakes assessment, and ClinicalSim adds repetitions between those encounters. Live assessment and human judgment remain with the program.
Does any patient data enter the platform?
Every patient in a ClinicalSim case is synthetic and written from clinical literature rather than a patient record. The product still handles learner recordings, transcripts, account data, and institutional data. Full detail is on our trust and data handling page.