Conflict Management in Medicine

Conflict Management in Medicine

• Addressing conflict in the medical field is important for reducing turnover and improving patient care quality.
• Teaching conflict resolution techniques to medical personnel can aid in conflict management.
• Curriculum designers should understand the medical environment and conflict management tools.
• Potential topics include sources of medical conflict and conflict resolution tools.

Significance of Conflict Management

• Conflict is common in medical environments and can negatively impact medical teams and patient outcomes.
• Poor teamwork can lead to increased hospital stays and higher patient mortality.
• Curriculum on conflict resolution can help create more collaborative working environments.

Sources of Medical Conflict

• Decision-making processes involving many people can increase the likelihood of conflict.
• Time constraints, power imbalances, and the significance of decisions contribute to medical conflict.
• Stress can challenge effective communication and lead to conflict.
• Limited options for dispute management can leave conflicts unresolved disrupting teamwork.
• Interprofessional conflict contributes to medical errors and adverse patient outcomes among medical residents.
• Understanding conflict definitions is important as perceptions of conflict vary (positive or negative).
• Individual or group negativity due to another individual or group is conflict.
• Task-related and relationship-focused conflicts can arise, with the latter involving personality differences and anger.
• In-group ethnocentrism, where one group views itself as superior, can hinder collaboration and patient care.
• Lack of collaboration can also increase hospital stays and patient mortality in the ICU.
• Relational conflict can be exacerbated by high stress, time constraints, and communication barriers.
• Stress, abuse, dissatisfaction, overwork, sleep deprivation, and inadequate supervision are also factors.
• Fatigue is a significant issue, with a large percentage of residents admitting to making medical mistakes due to fatigue.
• Time perception differences between nurses and doctors also leads to conflict.
• Pressure from patients/families and differing time pressures affect conflict.
• Power inequities and ambiguities can lead to conflict.
• Nurses refusing to provide care based on safety/moral objections can create disputes.
• The "forcing" style of conflict resolution, using power to achieve goals, can lead to more conflict.
• Task conflict arises from disagreements on task completion.
• Differing perceptions of team interaction also leads to conflict.
• Conflicting views on how to make decisions are also factors.
• Physician/patient conflict can arise from misunderstandings or the family's desire to be heard.
• Differences in opinion on diagnoses/treatments and religious beliefs are sources of patient conflict.

Conflict Resolution Tools and Training

• Negotiation and mediation are appropriate tools for mitigating conflict.
• Negotiation involves resolving divergent interests with common interests.
• Mediation involves a neutral third person facilitating negotiation.
• Formal negotiations involve scheduled meetings and prepared positions.
• Negotiations can reduce conflict, frustration, and increase creative problem-solving.
• Informal negotiation styles may be better suited for medical personnel due to time constraints.
• Conflict management education positively impacts medical work settings and reduces employee stress.
• Training improves participant attitudes on psychological and interpersonal strain.
• Physicians, nurses, and other team members are not always trained in communication/resolution skills.
• Effective training should demonstrate relevance and value in possessing these skills, which is part of the Mager and Beach curriculum design model.
• Training can result in retained positive attitudes towards conflict and a willingness to engage in conflict management.
• Nurses who perceive physicians as collaborative are more likely to take a collaborative approach.
• Studies suggest that training on conflict management is beneficial, leading to perception/attitude changes and behavioral changes.

Curriculum Models

• Curriculum models can be applied to develop specific or broad conflict management training programs.
• Peer mediation training can be developed using Mager's model due to its instructional focus.
• DACUM (Designing A Curriculum) can determine specific skills/tasks needed; or Tylers models could also be used.
• Tyler's model is suitable for broad conflict education programs but needs adjustment for the K-12 environment focus such as age of participants/experience.

Considerations for Curriculum Design

• Conflict management skills education require consideration of specific field aspects.
• Time constraints and teamwork are present in medicine.
• Curriculum designers must consider legal aspects due to the high risk of litigation.
• Time constraints lead to quick decision-making, long hours, and potential power dynamics.
• Address time pressures within the curriculum or implement multiple short interventions.
• Build a sustainable environment of collaboration and require evidence and modeling of skills.
• Educators must consider power structures as a source of conflict and potentially train upper levels of the hierarchy first.
• Ensure that participants possess essential skills or address them in the curriculum.
• Consider organizational culture and legal implications.

Importance of Legal Considerations

• Legal concerns are vital due to high litigation risk in the medical field.
• Corporate training on customer service may conflict with legal counsel on apologies.
• Understanding organizational culture and legal implications is critical in the preparation phase.

Conclusion

• There is a need for targeted curriculum to prepare medical professionals to manage conflict effectively.
• Conflict education has shown promise in improving perceptions and self-efficacy.
• The unique environment of medicine poses challenges for curriculum developers.
• Investe in the investigation of the medical environment and the organization to design effective curriculum using the preparation phase.