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LETTER TO THE EDITOR
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To air or to ignore: Highlighting the importance of conflict management training in undergraduate curriculum


1 Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
2 Department of Anatomy, Pondicherry Institute of Medical Sciences, Puducherry, India

Date of Submission23-Dec-2019
Date of Decision07-Jan-2020
Date of Acceptance30-Apr-2020

Correspondence Address:
V Dinesh Kumar,
Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry - 605 006
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_352_19



How to cite this URL:
Kumar V D, Murugan M. To air or to ignore: Highlighting the importance of conflict management training in undergraduate curriculum. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2021 Dec 6]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=320708



Dear Sir,

Cooperative interdependence constitutes the crux for interprofessional teams. Ironically, healthcare teams, in reality, suffer from competitive quest, vested interests, and unhealthy power struggles. The terminology “conflict” in organizational settings can be defined as, “the process which begins when one party perceives that the counterpart has frustrated, or is about to frustrate, one or other concern of his.”[1] Academic healthcare center, being one of the hierarchical-based social organizations, is prone for conflicts due to communication problems, common source utilization, interdependence among different cadres, difference in intended goals, and hiccups arising when organizational tasks are shared. Healthcare profession demands individuals to work in collaborative groups, form team with members belonging to different levels of hierarchy, and operate under intense environments such as intensive care units.[2] A recent study[3] documented that an average number of conflicts faced by clinical staff was significantly higher compared to administrative staff of the same hospital. Similarly, there was a positive correlation between increase in the years of job experience and levels of perceived conflict.

Irrespective of the reasons and nature, conflicts are often viewed with pessimism because they could disrupt the cohesion between team members, could hamper the professional productivity, and might eventually depreciate the quality of patient care. The conflicts can be completely task related when the team members fail to arrive at a consensus regarding the action plan of it or can be relationship oriented when there are personal incompatibilities or can be process oriented arising out of logistical grievances.[4] Interestingly, the perception regarding the existence of conflict is highly asymmetrical, i.e. some members of team might perceive a particular situation as conflict whereas others might not perceive it at all.[5] The team building and operative cohesiveness depend upon the degree of organizational trust existing in the working environment. The organizational trust can be horizontal, which is the degree of affinity between peers working in the same department, or vertical, which is the relationship among interprofessional members belonging to different hierarchy.[6] The conflicts thus can hamper the effective functionality of a department or unit in two ways: (1) reducing the ability to tap the maximum potential of human resources and (2) threatening the organizational trust as such.

When viewed under optimistic lens, conflicts can be considered as unique learning opportunities, which would help the graduate medical students to get acquainted with the norms of interprofessional team-based approaches. Schulz-Hardt et al.,[7] at the end of their psychological team-based experiment, postulated that conflicts help in eliminating the discussion bias and, by ensuring free flow of thoughts, help in bringing forward the perspectives of team members. This is much better than avoiding the conflicts owing to hierarchical power or denying its presence because, eventually, the team performance gets fine-tuned. On the other hand, if the conflicts are repressed or ignored for a long time, it could rather lead to unrepairable damages.

To promulgate better team functioning in organizational settings, we need to identify and solve different types of conflicts popping up in the due course. Students need to be taught about the potentialities of conflicts and strategies which could be used to resolve them, such as transparent communication, readiness to explore feasible solutions, meeting the needs of others, and recognizing the differing priorities existing among team members.[2] However, the need for developing structured pedagogy for conflict management is still unaddressed in our undergraduate/postgraduate curriculum. The Accreditation Council of Graduate Medical Education has highlighted the traits of conflict resolution skills in 8/21 milestone-based subcompetencies required for pediatric residency.[8] The Team Strategies and Tools to Enhance Performance and Patient Safety is yet another beneficial model for teaching interprofessional relationship, in terms of communication, mutual support, and situation monitoring, among healthcare professionals.[9] Therefore, we earnestly plea the medical educators to include training in effective management skills as one of the components in undergraduate Attitude, ethics and communication [AETCOM] curriculum. Making students understand the antecedents of different types of conflict would be a fruitful venture because they could perceive them earlier and act accordingly. If conflicts are considered as double-edged swords, why can't we use the use the positive side of it by developing appropriate conceptual frameworks?

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Conard JR, Franklin JF. Addressing the art of conflict management in health care systems. Disput Resolut Manage 2010;16:14-7.  Back to cited text no. 1
    
2.
Wolfe AD, Hoang KB, Denniston SF. Teaching conflict resolution in medicine: Lessons from business, diplomacy, and theatre. MedEdPORTAL 2018;14:10672.  Back to cited text no. 2
    
3.
Panahi Tosanloo M, Adham D, Ahmadi B, Rahimi Foroshani A, Pourreza A. Causes of conflict between clinical and administrative staff in hospitals. J Educ Health Promot 2019;8:191.  Back to cited text no. 3
    
4.
Janss R, Rispens S, Segers M, Jehn KA. What is happening under the surface? Power, conflict and the performance of medical teams. Med Educ 2012;46:838-49.  Back to cited text no. 4
    
5.
Jehn KA, Rispens R, Thatcher SM. The effects of conflict asymmetry on work group and individual outcomes. Acad Manage J 2010;53:596-616.  Back to cited text no. 5
    
6.
Laschinger HK, Finegan J, Shamian J. The impact of workplace empowerment, organizational trust on staff nurses' work satisfaction and organizational commitment. Health Care Manage Rev 2001;26:7-23.  Back to cited text no. 6
    
7.
Schulz-Hardt S, Brodbeck FC, Mojzisch A, Kerschreiter R, Frey D. Group decision making in hidden profile situations: Dissent as a facilitator for decision quality. J Pers Soc Psychol 2006;91:1080-93.  Back to cited text no. 7
    
8.
The Pediatrics Milestone Project: A Joint Initiative of the Accreditation Council for Graduate Medical Education and the American Board of Pediatrics; 2013. Available from: http://www.acgme.org/acgmeweb/Portals/0/PDFs/Milestones/Pedia tricsMilestones.pdf. [Last accessed on 2019 Apr 19].  Back to cited text no. 8
    
9.
King HB, Battles J, Baker DP, Alonso A, Salas E, Webster J, et al. TeamSTEPPS™: Team strategies and tools to enhance performance and patient safety. In: Henriksen K, Battles JB, Keyes MA, Grady ML editors. Advances in Patient Safety: New Directions and Alternative approaches: Performance and Tools. Vol. 3. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43686/. [Last accessed on 2020 Jan 24].  Back to cited text no. 9
    




 

 
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