Malpractice fear and work motivation in anesthesiologists: an occupational self-efficacy perspective

Medical malpractice fear (MF) is a growing concern that adversely affects physicians’ professional behaviors and motivation. Owing to the high-risk nature of their specialty, anesthesiologists are particularly vulnerable to malpractice-related stress and defensive medical practices. Occupational self-efficacy (OS-E), as a key psychological resource, may protect against the negative impact of MF on anesthesiologists’ work motivation (WM). This study examines whether OS-E moderates the relationship between MF and WM among anesthesiologists in Türkiye. In this study, explanatory correlational design was employed, and data were collected from 239 anesthesiologists using online questionnaires comprising the MF, WM, and OS-E scales. WM has been addressed in two sub-dimensions: intrinsic WM (IWM) and extrinsic WM (EWM). Participants were recruited using the virtual snowball sampling method. Pearson correlation analyses were conducted to examine relationships among MF, IWM, EWM and OS-E. Moderation effects were tested using regression-based path analysis. MF showed a negative correlation with IWM (r = − 0.255, p < 0.001), EWM (r = − 0.367, p < 0.001), and OS-E (r = − 0.253, p < 0.001). Moderation analysis showed that OS-E significantly moderated both the relationship between MF and IWM (β = −0.11, ΔR² = 8%, F(3, 295) = 25.473, p < 0.001) and the relationship between MF and EWM (β = −0.15, ΔR² = 5.1%, F(3, 295) = 32.980, p < 0.001). MF’s negative effect on both IWM and EWM becomes more pronounced when OS-E is high. In light of the study findings, OS-E does not function as a uniform protective resource in the relationship between MF and WM. In fact, OS-E may function as a context-dependent reinforcing factor rather than a buffering mechanism in the relationship between MF and WM. Based on these findings, it may be useful to examine the interaction between negative motivational outcomes associated with MF in high-responsibility healthcare fields such as anesthesiology and external factors such as organizational factors and working conditions, in addition to psychological factors related to employees.