Beyond fight or flight: The need for conflict management training in medical education

Date01 May 2018
Published date01 May 2018
Beyond fight or flight: The need for conflict
management training in medical education
Nan Cochran
| Paul Charlton
| Virginia Reed
| Peter Thurber
Elliott Fisher
Department of Medicine, Geisel School of
Medicine at Dartmouth, Hanover, New Hampshire
The Dartmouth Institute for Health Policy and
Clinical Practice, Lebanon, New Hampshire
Department of Emergency Medicine, University
of Washington, Seattle, Washington
Department of Community and Family Medicine,
Geisel School of Medicine at Dartmouth,
Hanover, New Hampshire
Paul Charlton, Department of Emergency
Medicine, University of Washington, 325 Ninth
Avenue, Box 359702, Seattle, WA 98104.
This article reviewed the literature on conflict manage-
ment training in medicine, proposed a set of competen-
cies that health professionals need to learn in order to
effectively deal with conflict in health care settings, and
described a pilot project designed to teach many of these
competencies at Dartmouth. Our review of the evidence,
discussions with experts, and pilot findings highlight the
potential value of incorporating comprehensive conflict
management training in medical education. Further
research is needed to evaluate the optimal timing and
most effective ways to teach these skills in medical
school, residency, and beyond.
Conflict is widespread and manifests in multiple ways in health care settings. From managing a com-
plex patient while working with family members and specialists who have divergent points of view,
to learning to work in newly established interdisciplinary teams, to implementing evidence-based
guidelines on a system level, to negotiating the merger of a hospital, the health care field exposes phy-
sicians, nurses, and health care administrators to conflict on a daily basis (Anderson & D'Antonio,
2005). Evidence is emerging that poorly managed conflict in health care causes serious adverse conse-
quences (The Joint Commission, 2008). Poor communication has been identified as one of the major
causes of medical errors (Leonard, Graham, & Bonacum, 2004; Rosenstein & O'Daniel, 2008). Inef-
fective teamwork, often in the context of unprofessional behavior, negatively impacts patient care
(Riskin et al., 2017) and contributes to physician, student, and staff burnout (Spence Laschinger,
Leiter, Day, & Gilin, 2009). Health care reform increases the need for effective conflict management
skills because of the transition to team-based care models, such as Patient-Centered Medical Homes,
and the emergence of new organizational forms that require collaboration across traditional organizational
boundaries, such as Accountable Care Organizations (Kohn, Corrigan, & Donaldson, 2000).
It is no surprise, therefore, that major health care and nongovernmental organizations are calling
for increased training in communication, negotiation, and conflict management skills. In this article,
Received: 15 October 2017 Revised: 2 March 2018 Accepted: 6 March 2018
DOI: 10.1002/crq.21218
© 2018 Association for Conflict Resolution and Wiley Periodicals, Inc.
Conflict Resolution Quarterly. 2018;35:393402. 393

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT