A cross-sectional survey of 281 physicians in Southern Switzerland has identified specific social and psychological factors that influence a doctor’s intention to apologize after a medical error. The study, published in BMC Health Services Research, applied the Theory of Planned Behavior to examine how attitudes, social norms, and perceived behavioral control shape these intentions. By utilizing a Structural Equation Model, the research team aimed to clarify the complex interplay between these determinants and the willingness to engage in open communication following adverse events.
The participants were employed in the public hospital network of Southern Switzerland, providing a focused regional context for the findings. The sample consisted of 281 physicians with an average age of 46 years, ranging from 26 to 67. Approximately 62% of the respondents were male, and they reported an average of 20 years of working experience.
The study was designed to investigate how physicians perceive the social and psychological factors that drive their intentions to apologize. The researchers posited that open communication and apologies are ethically sound and crucial for maintaining trust and restoring the doctor-patient relationship. By applying the Theory of Planned Behavior, the team sought to move beyond simple correlations and model the structural relationships between beliefs, attitudes, norms, and behavioral intentions.
The primary analytical method used was a Structural Equation Model, which enabled the researchers to test the direct and indirect effects of various variables on the intention to apologize. The model assessed the strength of predictors such as behavioral control, positive attitudes, and social norms. It also examined the mediating roles of attitudes and behavioral control in the relationship between underlying beliefs and the final intention.
The results indicated that behavioral control and positive attitudes toward apologizing were the strongest predictors of the intention to apologize. Behavioral control, defined as the physician’s sense of ability and confidence to engage in such communication, emerged as a critical factor. While social norms remained a significant predictor, their influence was comparatively weaker than that of attitudes and perceived control in this specific sample.
Furthermore, the analysis revealed that positive attitudes and behavioral control mediated the relationship between beliefs and intention. Additionally, beliefs regarding the impact of an apology on the doctor’s professional identity were found to be directly linked to the intention to apologize.
The findings suggest that protecting professional identity and reinforcing supportive social norms within healthcare settings may encourage more open communication following medical errors. These results complement existing communication frameworks that aim to guide and support apology practices in clinical contexts, offering a theoretical basis for designing targeted support systems.
As a cross-sectional survey, the study provides a snapshot of physicians’ perceptions and intentions at a single point in time. It does not establish causality or predict actual apology behaviors in real-world clinical scenarios. The findings are specific to the public hospital network in Southern Switzerland and may not be generalizable to other healthcare systems or populations.
Subject of Research: Social and psychological determinants of doctors' willingness to apologize after medical errors
Article Title: Social and psychological determinants of doctors’ willingness to apologize after medical errors: a cross-sectional survey applying the theory of planned behavior
Article References: Petrocchi, S., Schulz, P. J., Cerutti, D., Colombo, R. A., Degiorgi, A., Di Serio, C., & Ferrari, P. (2026). Social and psychological determinants of doctors’ willingness to apologize after medical errors: a cross-sectional survey applying the theory of planned behavior. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15533-8
Image Credits: AI Generated
DOI: 10.1186/s12913-026-15533-8
Keywords: medical errors, apology, physician communication, theory of planned behavior, patient safety, structural equation model, health services research, professional identity, Social, psychological, determinants, doctors
News Source: Ophelia Keating. (November 10, 2026). Positive Attitudes and Control Predict Doctors’ Apology Intentions. Scienmag.
