Conflict Resolution: Practical Principles for Surgeons

Lee, Liz; Berger, David H.; Awad, Samir S.; Brandt, Mary L.; Martinez, George; Brunicardi, F. Charles

doi:10.1007/s00268-008-9702-x

Cited by 35 publications

(23 citation statements)

References 11 publications

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“…Clear and open communication helps to minimize conflicts as well as reduce misunderstandings and surgical errors; 43% of mistakes in orthopaedic patient care arise from communication issues23,24 .…”

mentioning

confidence: 99%

Teaming: An Approach to the Growing Complexities in Health Care

Nawaz¹,

Edmondson²,

Tzeng³

et al. 2014

The Journal of Bone and Joint Surgery-American Volume

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Confronted with rising costs and patients who often have multiple comorbidities, the orthopaedic surgeon needs to face the challenge of providing high-quality health care. One solution is to increase and improve coordination, communication, and teamwork. The orthopaedic surgeon also needs to work effectively and efficiently to manage a fluid and shifting mix of health-care personnel partners from other disciplines and specialties to deliver high-quality patient care. The orthopaedic surgeon must collaborate in a new way with fellow health-care professionals, providing care by following teaming protocols.In the appropriate leadership role and employing the necessary motivational, communication, and conflict-management skills, the orthopaedic surgeon must build the proper foundations for teaming through the selection of compatible, effective team members and establish the necessary collaborative teaming environment. The orthopaedic surgeon needs to lead these teams and promote communication, listening, and collaboration. The emphasis on effective communication through a horizontal hierarchy rather than an autocratic management style by the orthopaedic surgeon allows the seamless incorporation of specialty physicians as needed and facilitates teaming among orthopaedic staff.With a facilitative environment and clear communications, teaming in patient care will occur as a learning cycle of diagnosis, design, action, and reflection. Each of these steps is critical for teaming to be successful. During diagnosis, the orthopaedic surgeon needs to effectively frame the situation. In design, the orthopaedic surgeon needs to encourage participation in the determination of the next appropriate steps for patient care. During the action step, teaming protocol emphasizes both the process of care through care-tracking and the result of that care, which is critical for reflection. Reflection is necessary for the team to improve its effectiveness and learn from its experience. However, for successful reflection and learning, the orthopaedic surgeon needs to be truly open to criticism.Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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confidence: 99%

Teaming: An Approach to the Growing Complexities in Health Care

Nawaz¹,

Edmondson²,

Tzeng³

et al. 2014

The Journal of Bone and Joint Surgery-American Volume

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“…In the PubMed database, we searched the literature using ''conflict styles'' (222 hits), ''Thomas-Kilmann Conflict Mode Instrument (TKI)'' (2 hits), and ''conflict resolution in resident physicians'' (3 hits). We found only 1 study 27 on principles of conflict resolution in surgeons, and none involving residents. From the perspective of individual development and optimizing team building during residency training, it is important to investigate conflict styles and resident performance.…”

Section: Introductionmentioning

confidence: 99%

“…Few studies exist that examine conflict styles of residents or modes of practicing that could facilitate the development of an appropriate training program. In contrast, there are several studies [18][19][20][21] using the TKI to understand conflict management styles in nurses and articles [22][23][24][25][26][27] providing models of conflict management and resolution for practicing physicians and academic leaders. In the PubMed database, we searched the literature using ''conflict styles'' (222 hits), ''Thomas-Kilmann Conflict Mode Instrument (TKI)'' (2 hits), and ''conflict resolution in resident physicians'' (3 hits).…”

Section: Introductionmentioning

confidence: 99%

The Associations Between Residents' Behavior and the Thomas-Kilmann Conflict MODE Instrument

Ogunyemi¹,

Fong²,

Elmore³

et al. 2010

Journal of Graduate Medical Education

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Objective To assess if the Thomas-Kilmann Conflict MODE Instrument predicts residents’ performance. Study Design Nineteen residents were assessed on the Thomas-Kilmann conflict modes of competing, collaborating, compromising, accommodating, and avoiding. Residents were classified as contributors (n = 6) if they had administrative duties or as concerning (n = 6) if they were on remediation for academic performance and/or professionalism. Data were compared to faculty evaluations on the Accreditation Council for Graduate Medical Education (ACGME) competencies. P value of < .05 was considered significant. Results Contributors had significantly higher competing scores (58% versus 17%; P = .01), with lower accommodating (50% versus 81%; P 5 .01) and avoiding (32% versus 84%; P = .01) scores; while concerning residents had significantly lower collaborating scores (10% versus 31%; P = .01), with higher avoiding (90% versus 57%; P = .006) and accommodating (86% versus 65%; P = .03) scores. There were significant positive correlations between residents’ collaborating scores with faculty ACGME competency evaluations of medical knowledge, communication skills, problem-based learning, system-based practice, and professionalism. There were also positive significant correlations between compromising scores and faculty evaluations of problem-based learning and professionalism with negative significant correlations between avoiding scores and faculty evaluations of problem-based learning, communication skills and professionalism. Conclusions Residents who successfully execute administrative duties are likely to have a Thomas-Kilmann profile high in collaborating and competing but low in avoiding and accommodating. Residents who have problems adjusting are likely to have the opposite profile. The profile seems to predict faculty evaluation on the ACGME competencies.

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“…13 There were similar findings in a study of surgeons. 14 Skjorshammer described the polarizing nature of most physician-nurse conflicts and the role of professional cultures and stereotypes in exacerbating this polarization. 15 Successful conflict management appears to be built on a foundation of self-reflection, self-awareness, and flexibility.…”

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confidence: 99%

A Conflict Management Scale for Pharmacy

Austin¹,

Gregory²,

Martin³

2009

Am J Pharm Educ

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Objectives. To develop and establish the validity and reliability of a conflict management scale specific to pharmacy practice and education. Methods. A multistage inventory-item development process was undertaken involving 93 pharmacists and using a previously described explanatory model for conflict in pharmacy practice. A 19-item inventory was developed, field tested, and validated. Results. The conflict management scale (CMS) demonstrated an acceptable degree of reliability and validity for use in educational or practice settings to promote self-reflection and self-awareness regarding individuals' conflict management styles. Conclusions. The CMS provides a unique, pharmacy-specific method for individuals to determine and reflect upon their own conflict management styles. As part of an educational program to facilitate selfreflection and heighten self-awareness, the CMS may be a useful tool to promote discussions related to an important part of pharmacy practice.

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Conflict Resolution: Practical Principles for Surgeons

Cited by 35 publications

References 11 publications

Teaming: An Approach to the Growing Complexities in Health Care

Teaming: An Approach to the Growing Complexities in Health Care

The Associations Between Residents' Behavior and the Thomas-Kilmann Conflict MODE Instrument

A Conflict Management Scale for Pharmacy

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