Conclusion Amidst any conflict that may arise, prioritizing patient care should always remain the primary focus for healthcare providers. The key elements for effective conflict resolution include fostering mutual respect, maintaining self-awareness, and operating under the assumption that all parties involved share the common goal of doing what is best for the patient. By upholding these principles, healthcare professionals can navigate conflicts in a manner that ultimately promotes optimal patient care and outcomes.
as well as other medical disciplines, there is often a shared objective, such as achieving pain control or performing an appendix removal, albeit through different approaches. Establishing universal recognition and buy-in of this common goal serves as a helpful initial step. Starting with shared assumptions reminds everyone involved that they are part of the same team, working towards the shared objective of providing optimal patient care. Understanding the Cause of Conflict When a disagreement evolves into a conflict, it becomes increasingly important to understand its underlying cause while being mindful of one’s word choice, tone of voice, and demeanor. Active listening plays an important role in fostering meaningful conversations, whereas interrupting or avoiding eye contact can convey disregard. Engaging in deliberate eye contact, along with appropriate facial expressions and a non- threatening posture, are effective strategies for de-escalating conflict. Healthcare providers are typically highly motivated and educated individuals. These
interpreter service. Additionally, healthcare providers should remain aware of cultural differences and demonstrate understanding towards patients or their companions when reminded of these disparities. The Role of Simulation Simulations have been utilized to explore various skills and techniques for initiating difficult conversations. In industries like aviation, the benefits of simulation are evident. Replicating rare and dangerous scenarios in a non- threatening, lower-stress, simulated environment allows for immediate feedback and repetition of real-world circumstances. However, there are notable differences between simulation in aviation and medicine. In aviation, the operator faces the same immediate danger as the passengers, which is generally not the case for healthcare providers and patients. While simulation can be useful for training in conflict resolution, applying a uniform, one-size-fits- all solution is challenging in medicine due to differences in team composition and culture, even within geographically proximate institutions. Simulating the individuality of providers involved in real-world conflicts poses difficulties. A recent systematic review of conflict resolution identified six studies investigating simulated interventions for anesthesia care providers at all levels. The largest cohort involved 71 participants. The outcome measures for these interventions primarily focused on the likelihood of respectful challenges to mistakes made by authority figures in stressful circumstances. Three studies found that the interventions increased trainees’ likelihood of challenging authority, while three others found them to be ineffective. Another small study examined the impact of a short course utilizing ten video vignettes on conflict resolution. It found that anesthesia trainees who took the course were more likely to successfully negotiate changes to loud and distracting music controlled by the surgeon in a simulated operating room compared to those who had not taken the course. Despite the challenges, simulation is expected to play an increasingly significant role in teaching perioperative conflict resolution skills in the future.
attributes often contribute to a common but frequently overlooked cause of disagreement: a lack of sufficient evidence to unequivocally support one approach to patient management over another (e.g., choosing between a regional anesthesia technique and a general anesthesia approach). In such circumstances, providers must assume that those with opposing viewpoints have the best of intentions, regardless of how their objections are expressed. Even when there is an objectively correct position, conveying this information in a condescending manner can stymie efforts to guide the team towards the optimal course of action. Conflict in perioperative settings can stem from various sources, such as inadequate communication during critical stages of a procedure or a failure to acknowledge the concerns of others. Engaging in discussions about potentially contentious topics, particularly during demanding parts of a procedure or with authoritative figures, can be intimidating and challenging. Many individuals may opt to avoid such interactions altogether due to fear of escalating conflict. Unfortunately, avoiding potentially uncomfortable discussions can detract from patient care and contribute to burnout among healthcare professionals. Conflict Between Providers and Patients Conflicts can also arise between providers and their patients, as well as with the patient’s family members or decision-making proxies. Patient- provider conflicts may be rooted in personality clashes, disbelief regarding prognosis, misunderstandings, language or cultural barriers, adverse events, or disagreements concerning treatments. Frequent and clear communication plays a vital role in preventing or mitigating conflicts between providers and patients or their loved ones. During initial encounters, clinicians should prioritize speaking in a slow, neutral, and supportive tone, emphasizing the patient’s medical and psychological well-being. Actively listening to the concerns of patients and their family members while minimizing interruptions helps maintain a positive rapport. When a language barrier exists, it is imperative to utilize an appropriate, institutionally verified medical
The standing clinician exudes a sense of defiance, while the sitting one displays dismissiveness.
Emphasizing the significance of nonverbal cues, body language emerges as a vital component of effective communication.
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WHAT DID YOU SAY?
CONFLICT DE-ESCALATION 123
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