RP201 – Session 1: Conflict (12 Feb 2020)



Session Readings

 

Intro to RP201 (Thinking on Action):

In RP201, we are afforded the time to pause and reflect on our experiences during the clerkship year, and to explore important topics that will become increasingly relevant to you as you near graduation and the start of your residency training.  It is our hope that these sessions will offer you time to re-connect with your classmates, further develop and share personal insight, enhance your compassion and ability to effectively care for others, and offer strategies for decreasing burnout and building resilience.  Today’s session explores the topic of conflict in the healthcare setting, and is linked to a subsequent LEAD session on Conflict Resolution for next week.


CONFLICT

Background:

 “The passions are the same in every conflict, large or small.” Mason Cooley, PhD.

Physicians encounter conflict (both internal and external) no less frequently than others in society.  Whether the conflict is with other members of the healthcare team, our patients, our patients’ families, or ourselves, both the conflict itself and our reactions to it have the potential to impact the care of our patients.  Reflecting on conflicts you have observed (or in which you were engaged) during your core clerkship rotations (or perhaps in past clinical roles you have had) is a first step in helping you to better respond to these situations in the future.


Assignment (submit papers in Sakai under the Assignments Tab):

** please note that this RP201 writing assignment is combined with the paper due for the B3 LEAD session = 1 paper for 2 sessions**

Reflect on a clerkship experience that involved a conflict (ideally, one in which you were directly involved) that had an impact on the care of your patient and/or impacted interpersonal/team interactions.  Include a description of the experience, including pertinent background information. In your writing, include the following:

  1. Describe the situation. Set the stage and be specific to help the reader more fully appreciate the context in which the conflict occurred and what led to the conflict itself.

  1. Examine how you reacted to the conflict. Is this how you thought you would react in such a situation? How have you reacted to similar situations in the past? In your reflection, consider the influence your personal context (your background) had on your reactions.

  1. Analyze the impact* that this conflict had on the care your patient received. How did your reaction affect your interaction with your patient, their family, support staff, colleagues, residents, and/or faculty?  How did the reactions of other team members impact the way they may have cared for the patient?   *If you did not perceive an impact on patient care, then analyze how the conflict impacted the function of your team.  How might this altered team function potentially have impacted patient care?

  1. Use the Leader-Follower Framework to analyze the conflict and identify key contributing factors. Consider aspects of Communication, Context, Competency & Character at the Personal, Interpersonal, Team, and Organizational levels. Please refer to readings included in LEAD materials to help guide your response.
  1. Describe the insights you gained about yourself and the healthcare environment through reflecting on this experience.  How will this experience impact your practice of medicine in the future? How could you have been better prepared to handle the situation? How might you respond differently in the future?


PANEL SESSION:

Speaker: CAPT Jeffrey D. Quinlan, MD, FAAFP is Professor and Chair of the USU Department of Family Medicine.  His distinguished Navy career has spanned various overseas and CONUS locations, where he has taught and practiced full scope family medicine including surgical obstetrics.  He has held many leadership positions, including program director of a family medicine residency, and has deployed three times in support of Operation Enduring Freedom.


Objectives:

By the end of the small group session on “Conflict”, students will demonstrate the ability to:

  1. Identify situations during their core clerkship rotations during which they observed or experienced interpersonal conflict.
  2. Examine the impact of this conflict on the care of their patients and on the function of the medical team.
  3. Reflect on the cognitive and/or affective insights gained from this experience.
  4. Consider how this experience will effect how they will approach conflict in the future.
  5. Consider how leadership and followership are integral to conflict management.
TEDxDare to Disagree by Margaret Heffernan Conflict is often labeled as negative, but is this always, or even frequently, true? In this talk, Margaret Heffernan explores conflict and the positives that can come from it. As healthcare becomes increasingly interprofessional, understanding the benefits of conflict is essential.
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New York TimesSunday Dialogue: Conversations between Doctor and Patient A series of letters that debate whether clinicians should be assertive or let the patient decide.
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CaptureThe Roots of Tribalism - Lack of Empathy Meebo cofounder Seth Sterberg describes watching tribalism unfold in the workplace and unveils his strategy to discount such issues by encouraging his employees to empathize with each other's personal struggles.
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AtlanticSamuel Shem, 34 Years After 'The House of God' Reflecting on the importance of community and connection among junior doctors navigating the "brutality of medical training" and the clinical world.
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logo-postmedj-artConflict management: a primer for doctors in training Conflict in the health arena is a growing concern and is well recognised for doctors in training. Its most extreme expression, workplace violence is on the increase. There is evidence that many conflicts remain unsatisfactorily resolved or unresolved, and result in ongoing issues for staff morale. This paper describes the nature of conflict in the health care system and identifies the difference between conflict and disagreement. Using a conflict resolution model, strategies for dealing with conflict as it arises are explored and tips are provided on how to effectively manage conflict to a satisfactory resolution for all parties.
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New York TimesWhen the Nurse Disagrees with the Doctor by Theresa Brown How we engage in a dialogue when conflict exists between healthcare professionals is often the most important issue.
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Session originally created by: Adam Saperstein | Uniformed Services University | Admissions Medical Officer, USNA | Assoc Prof. Family Medicine