Medical and health science students' interpretation of miscommunication in simulated scenarios: the role of language, gender, and perceived professional authority.

Introduction: Little is known about how language, gender, and perceived professional authority simultaneously influence medical communication between doctors and patients. This study addresses this gap by examining Saudi medical and health science students' attribution of miscommunication in four medical simulation scenarios. Methods: Two groups of students observed two scenarios each, in which the agents' linguistic backgrounds, genders, and professional roles were systematically varied. Using a mixed-method design, students provided written responses to an elicitation task, followed by focus group and semi-structured interviews. Results: Blame for miscommunication was mostly attributed to patients. Lexical issues, communication strategies, and discourse were the main linguistic reasons cited, though further analysis of blame attribution by linguistic category and interlocutor provided more nuanced explanations. Discussion: Miscommunication is a complex process that goes beyond language, with gender and perceived professional authority playing a central role in how it is interpreted. Communication should be viewed as a shared, co-constructed responsibility, shaped by individuals' socially situated and perceived experiences.