RP401 – Session 2.4: Conflict

Session Readings




Conflict is pervasive in many areas of life. How we perceive conflict, however, can vary a great deal as some perceive conflict as both inevitable and beneficial while others perceive conflict as inherently bad and needing continual resolution. Regardless, conflict in the medical field has been associated with poor retention and reduced quality of care, especially when that conflict is not resolved. Conflict in medicine can be triggered by many sources including diagnostic uncertainty, personality differences, discordant goals, and unmet needs, among others. In addition, it is important to recognize that conflict can arise between us and our patients, colleagues and/or coworkers.

There are generally four phases in which thoughts and emotions interact with actions to create conflict. (COVEY, S. R. (2004). The 7 habits of highly effective people: restoring the character ethic. New York, Free Press.) In the first phase, one or more parties involved in the conflict will experience frustration. Frustration is a strong emotion that almost always demands our rapid attention driving us to find a cause. Conceptualization of the cause is often the second phase and usually rapid and often inaccurate. Phase three involves expression directed at our constructed ‘‘cause’’. The conflict situation is cemented when our behaviors result in a series of destructive outcomes in phase four.

In this session, we will reflect on our experiences with conflict, consider our reactions to these situations, examine the implications of these reactions for future patient care, and work to develop a plan moving forward.


  1. Watch both of the videos below as an introduction to conflict and its resolution. Then read the three references as a framework for exploring and discussing conflict in our small group.
  1. Think about a time in your medical career when you have experienced interpersonal conflict. This could be with a classmate,fellow resident, coworker, faculty member, a patient, or their family. Come to the group prepared to:
    1. Set the stage in which the conflict arose
    2. Describe the conflict and the stimulus that started it.
    3. Describe your reaction and where you attributed cause.
    4. Analyze how your emotional response to the attributed cause framed your behaviors.
    5. Describe your response, if and how this conflict was resolved, and the aftermath that may have followed.
  1. Now, reflect on how you might have handled the situation differently if you could go back using the conflict resolution strategies described in reference 3:
    1. How would you have defined the issue in neutral terms?
    2. How would you describe yours needs and those of the person(s) with whom you experienced this conflict?
    3. How might you have engaged the other party in shared problem solving?
    4. Described how you think the consensus reached might have been different if you had used these conflict resolution strategies.
TEDxThe walk from "no" to "yes" William Ury, author of "Getting to Yes," offers an elegant, simple (but not easy) way to create agreement in even the most difficult situations — from family conflict to, perhaps, the Middle East. (Filmed at TEDxMidWest.)
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logo-hhspaConflict and emotional exhaustion in obstetrician-gynaecologists: a national survey Conflicts over treatment decisions are associated with physicians' empathy, gender, immigration history and level of emotional exhaustion. With respect to the latter, conflict in the clinical encounter may represent an overlooked source or sign of burnout among ob/gyns.
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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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logo-jopPut Conflict Resolution Skills to Work Although confrontation is especially hard for those who are just starting out, or those who are not in positions of authority, avoiding it is a common human trait.
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Session originally created by: Scott Petersen | WRNMMC | Residency Program Director | OBGY/MFM