# Attitudinal Profiles Toward Medical Mediation Among Healthcare Professionals: Evidence from a Scenario-Based Survey and Latent Class Analysis

## TL;DR

Greek healthcare professionals strongly support medical mediation despite limited training, suggesting a need for institutional integration.

## Contribution

Identifies distinct attitudinal profiles among healthcare professionals toward medical mediation using latent class analysis.

## Key findings

- High support for medical mediation across ethically complex scenarios, especially in medical error disclosure.
- Three distinct attitudinal profiles were identified, with 73.3% being strongly supportive of mediation.
- Strong endorsement of institutional training despite minimal formal exposure to medical mediation.

## Abstract

What are the main findings?
Greek healthcare professionals show consistently high support for medical mediation across ethically complex scenarios, particularly in medical error disclosure.Latent class analysis identified three distinct attitudinal profiles, with nearly three-quarters of respondents strongly supportive despite minimal formal training.

Greek healthcare professionals show consistently high support for medical mediation across ethically complex scenarios, particularly in medical error disclosure.

Latent class analysis identified three distinct attitudinal profiles, with nearly three-quarters of respondents strongly supportive despite minimal formal training.

What are the implications of the main findings?
There is a clear mismatch between strong professional support for medical mediation and its limited institutionalization and related training in the Greek healthcare system.The findings provide empirical justification for integrating structured medical mediation training and services into healthcare policy and clinical ethics frameworks.

There is a clear mismatch between strong professional support for medical mediation and its limited institutionalization and related training in the Greek healthcare system.

The findings provide empirical justification for integrating structured medical mediation training and services into healthcare policy and clinical ethics frameworks.

Medical mediation (MM) is a collaborative tool for resolving ethically complex disputes in healthcare. Background/Objectives: Though widely recognized in international clinical ethics, it has only been recently introduced in Greece. The objective of this study was (i) to quantify agreement with MM across three clinical scenarios, (ii) to estimate the proportion of professionals that support mediation and institutional training, and (iii) to identify distinct attitudinal profiles using latent class analysis (LCA). Methods: A structured, cross-sectional online questionnaire was completed by 431 healthcare professionals across Greece. The survey included three clinical vignettes (on (1) end-of-life care, (2) religious refusal of treatment, and (3) medical error disclosure), Likert-scale items on attitudes toward mediation, and demographic information. LCA was used to identify patterns of response across the scenarios and differentiate between strongly supportive, moderately supportive, and cautiously positive professional profiles. Results: Participants expressed strong support for mediation across all scenarios (median scores ≥ 9), with the highest support for medical error disclosure (mean 8.67 ± 2.10 and a median of 10). Most participants (97.2%, n = 419) considered mediation at least sometimes effective, and 80.7% (n = 348) endorsed institutional training. However, only 3.0% (n = 13) reported formal training and 1.9% (n = 8) reported being very familiar with MM. LCA revealed three distinct respondent profiles: strongly supportive (73.3%, n = 316), moderately supportive (14.6%, n = 63), and cautiously positive (12.1%, n = 52). Significant trends were observed across profiles for the perceived effectiveness of mediation and support for institutional training (p < 0.01). However, formal training and familiarity with mediation among the participants were low (<5%). Conclusions: Despite limited training and formal implementation, Greek healthcare professionals show high support for MM. The demand and need for structured mediation training and integration into the Greek healthcare system is strong. The identification of distinct attitudinal profiles provides insight into potential variation in organizational readiness for implementing structured mediation training