Conflict styles in a cohort of graduate medical education administrators, residents, and board-certified physicians

An Exploratory Qualitative Content Analysis of First-Year Veterinary Students' Perspectives on Conflict

Teamwork among health professionals is a requirement for the delivery of excellent medical care; effective teamwork leads to improved patient outcomes and greater job satisfaction for health care professionals. A critical component of successful teamwork is effective conflict management. While preliminary evidence suggests that many health care providers have negative perceptions of conflict and conflict-avoidant tendencies, no existing research to-date has explored veterinary students' perspectives on conflict. Understanding the ways in which veterinary students perceive conflict represents an important first step in helping them identify strategies for future conflict management. The purpose of this exploratory study was to describe the first-year veterinary students' perspectives on conflict. Students responded to two open-ended prompts as part of a reflection assignment following an instructional module on conflict. Results from the qualitative content analysis showed that students demonstrated an understanding of (a) the role of feelings and emotions in conflict, (b) the importance of relying on facts and observations as opposed to evaluations and judgment in conflict, (c) the value of competent communication in conflict, and (d) self-awareness of personal factors related to conflict. These findings highlight the power of self-reflection to learners' awareness of default tendencies when faced with conflict, the impact of their attitudes and experiences on conflict behavior, and a willingness to incorporate a collaborative approach to conflict resolution in the future.

Do programme coordinators contribute to the professional development of residents? an exploratory study

BACKGROUND

With the development of training programmes for health professions, the role of programme coordinators has become increasingly important. However, their role in providing educational support for the professional development of resident trainees has not been investigated well. This study aimed to qualitatively analyse the involvement of programme coordinators in educational support for residents.

METHODS

Semi-structured reflective writing on 'support for residents' was collected from programme coordinators in teaching hospitals in Japan in 2017-18 using a web-based questionnaire. Descriptions were qualitatively analysed thematically, using the professional identity formation (PIF) framework.

RESULTS

A total of 39 cases of "support for residents" by 31 coordinators were analysed. We found that residents most commonly faced prior personal problems, including mental health issues and insufficient social skills/unprofessional behaviour. A thematic analysis revealed that coordinators played a variety of educational roles: 1) requesting supervisors to reconsider their teaching; 2) protecting residents from the negative influence of clinical experiences; 3) facilitating residents' self-assessment and confidence; 4) creating a safer learning environment; 5) providing support for prior personal problems through 5-1) fostering a better atmosphere for the mental health of residents, and 5-2) intervening for residents with insufficient social skills/unprofessional behaviour; 6) providing support for isolated residents; and 7) preventing problems with peers.

CONCLUSIONS

This study identified seven educational roles of programme coordinators for residents from a standpoint of PIF of residents. Based on these findings, four valuable attributes for coordinators were established: non-hierarchical relationships with residents, parenting attitudes, sensitivity to residents' changes, and the perspective of the citizen and a member of the public. These attributes would underpin coordinators' educational roles and facilitate the professional development of residents. This study provides a basis for defining and revising the role profiles of programme coordinators, and for improving staff development.

Understanding Conflict Management Styles in Anesthesiology Residents

BACKGROUND

Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios.

METHODS

Twenty-two first-year anesthesiology residents (first postgraduate year) participated in this study, which aimed to assess and summarize conflict management styles by 3 separate metrics. One metric was self-assessment with the Thomas-Kilmann Conflict Mode Instrument (TKI), summarized as percentile scores (0%-99%) for 5 conflict styles: collaborating, competing, accommodating, avoiding, and compromising. Participants also completed self- and counterpart ratings after interactions in a simulated conflict scenario using the Dutch Test for Conflict Handling (DUTCH), with scores ranging from 5 to 25 points for each of 5 conflict styles: yielding, compromising, forcing, problem solving, and avoiding. Higher TKI and DUTCH scores would indicate a higher preference for a given conflict style. Sign tests were used to compare self- and counterpart ratings on the DUTCH scores, and Spearman correlations were used to assess associations between TKI and DUTCH scores.

RESULTS

On the TKI, the anesthesiology residents had the highest median percentile scores (with first quartile [Q1] and third quartile [Q3]) in compromising (67th, Q1-Q3 = 27-87) and accommodating (69th, Q1-Q3 = 30-94) styles, and the lowest scores for competing (32nd, Q1-Q3 = 10-57). After each conflict scenario, residents and their counterparts on the DUTCH reported higher median scores for compromising (self: 16, Q1-Q3 = 14-16; counterpart: 16, Q1-Q3 = 15-16) and problem solving (self: 17, Q1-Q3 = 16-18; counterpart: 16, Q1-Q3 = 16-17), and lower scores for forcing (self: 13, Q1-Q3 = 10-15; counterpart: 13, Q1-Q3 = 13-15) and avoiding (self: 14, Q1-Q3 = 10-16; counterpart: 14.5, Q1-Q3 = 11-16). There were no significant differences (P > .05) between self- and counterpart ratings on the DUTCH. Overall, the correlations between TKI and DUTCH scores were not statistically significant (P > .05).

CONCLUSIONS

Findings from our study demonstrate that our cohort of first postgraduate year anesthesiology residents predominantly take a more cooperative and problem-solving approach to handling conflict. By understanding one's dominant conflict management style through this type of analysis and appreciating the value of other styles, one may become better equipped to manage different conflicts as needed depending on the situations.

Assessment of Physician Well-being, Part Two: Beyond Burnout

Part One of this two-article series reviews assessment tools to measure burnout and other negative states. Physician well-being goes beyond merely the absence of burnout. Transient episodes of burnout are to be expected. Measuring burnout alone is shortsighted. Well-being includes being challenged, thriving, and achieving success in various aspects of personal and professional life. In this second part of the series, we identify and describe assessment tools related to wellness, quality of life, resilience, coping skills, and other positive states.

Applying Conflict Management Strategies to the Pediatric Operating Room

Effective communication is essential in today's health care environment, and poor communication can lead to conflict among health care providers. Differences in cultures and beliefs can further incite conflict among health care team members, families, and patients. Pediatric patient care has a higher potential for conflict because decision-making responsibilities are shared among patients, parents/guardians, and clinicians. It is important to understand the phases and types of conflict because each conflict situation requires a different approach to optimize management. Equally important is an understanding of styles used by individuals to manage conflict. The Thomas-Kilmann Conflict Mode Instrument and the Dutch Test for Conflict Handling are 2 validated tools used to assess conflict management styles. The different styles include competing/forcing, collaborating/problem solving, compromising, avoiding, and yielding/accommodating. A successful physician should be able to identify the phases and types of conflict to use the conflict management approach most suitable for the given conflict.There are several techniques for managing conflict in the pediatric operating room. Acknowledging and managing one's own emotions during conflict is a pivotal first step toward diffusing the situation. Active listening is an important communication skill that improves team dynamics. Aligning the interests of the parties involved in conflict will encourage collaborative problem solving. Cultural competency training can improve communication and conflict management skills. Effective conflict management through formal education of all perioperative team members can lead to improved communication and teamwork and better patient outcomes.

Associations among student conflict management style and attitudes toward empathy

INTRODUCTION

Pharmacy education standards include a focus on interprofessional education and communication skills, specifically naming conflict management and patient-centered communication as key areas. This study aimed to explore the association between conflict management style and attitudes toward empathy among first year pharmacy students (P1s) in professional encounters.

METHODS

A cross-sectional design was implemented among two cohorts of P1s who completed an online survey including the Thomas-Kilmann Conflict Mode Instrument professional version (TKCI-P) and the Kiersma-Chen Empathy Scale (KCES).

RESULTS

Those scoring higher on the competing mode reported significantly lower attitudes toward empathy (p < 0.05). Those scoring higher on the accommodating mode reported significantly higher attitudes toward empathy (p < 0.05). Some student characteristics, including gender and race, were significantly associated with KCES score and/or TKCI-P mode.

CONCLUSIONS

These results suggest that awareness and training in empathy and conflict management should be incorporated in curricular content to support the likelihood of future pharmacists to be effective in their future patient and interprofessional interactions.