Instructions: Rate your agreement with the following statements regarding your attitudes toward disclosing a medical error to patients or their significant others. With this tool, medical error refers to an error made by any member of the healthcare team during patient care delivery.
Item	Rating 1 = strongly disagree 2 = disagree 3 = neutral 4 = agree 5 = strongly agree
I am confident in my ability to offer an effective apology in terms of disclosing a medical error to a patient.
Fear of litigation affects my willingness to disclose a medical error to a patient.
Fear of a disciplinary action affects my willingness to disclose a medical error.
Fear of losing patient trust affects my willingness to disclose a medical error.
Fear of losing colleague respect affects my willingness to disclose a medical error.
Fear of losing colleague support affects my willingness to disclose a medical error.
I am not sure how much I should disclose to a patient/family member in the event I am involved in a medical error.
My employing institution supports disclosure of medical errors by health care providers.
I receive mixed messages from my employing institution regarding the process of disclosing an error.
I receive mixed messages from my employing institution regarding what types of errors should be disclosed.
The physician should take full responsibility for the error, even when non-physician healthcare providers on the team may have played a role in the error (e.g. “I lead the team; this happened on my watch, therefore my fault.”)
Non-physician healthcare providers do not have a role in disclosing medical errors, even when such providers on the team may have played a role in the error (i.e. only the physician should disclose the error).