Introduction
In a typical healthcare team, professionals from different streams work together, closely collaborating to provide optimal care to the patient. However, there hasn’t been a clear model that can inspire them collaborate better . Researchers have, therefore, developed a two-part model. Part one of the model has five components: “interdependence, newly created professional activities, flexibility, collective ownership of goals, and reflection of process”. Part two of the model consists of four influences on collaboration: “professional role, structural characteristics, personal characteristics and a history of collaboration”. Further research has found two major themes in the context of the complexity of delivering patient care . Firstly, there is a need of specialized health care professionals in the healthcare system. Secondly, there is a need for these professionals to collaborate as team. In this kind of environment, two major issues arise; those related to medical education system and those related to the content of the education.
System Issues
We will first elaborate on the system issues. It has been found that there is a relative lack of interdisciplinary education, even though interdisciplinary work environment is a rule than the exception. However, examples have commonly been found where education is in an interdisciplinary manner. Here teams are made up of a combination of undergraduate and graduate students: from streams such as, medicine, nursing, social work, psychology, pharmacy, and health administration.
Several studies have indicated that learning to work in the interdisciplinary teams should be early in the education process. This approach promotes better collaboration later in the career of the healthcare professionals. There are some who argue further that such collaboration should begin as early as the second year of the medical education. In contrast, there are some who believe that medical students should first secure a competency in their field, before they embark on interdisciplinary method of education.
Traditional didactic approach to teaching does not apply to the interdisciplinary approach. What is required are problem-based learning (PBL) and the service/learning models. PBL, which integrated theory and clinical component is done are small group format. Similarly, service/learner model uses clinical settings to challenge the learners to work together. Concerns have been raised that physicians have been reluctant to participate in such educational activities. Without such interactive tools, it becomes very difficult to inculcate the concept of interdisciplinary work culture.
Next, let us elaborate on the content issues. It is known that they healthcare professional learn their traditional role through the education process. This becomes integrated into their “cognitive map”, and creates hindrance in coming together as an interdisciplinary team. Further, some team members may not realize other’s potential, and this may lead to underutilization of the potential.
It has been observed that members of such teams need not necessarily have equal attributes. Therefore, these differences in attributes may lead to conflict between the members. This necessitates the need for conflict resolution skills among all the members of the team.
Recommendations
We will begin with identifying key principles of conflict resolution that can be applied to interdisciplinary teams. We will then try to apply them in the context of the teams. We will also explore and try to distinguish between normal conflict management and management of differences . We will also try to gain insight into how to apply conflict management skills in leadership roles. Finally, we will have to distinguish between identity-based and interest-based conflict, and elaborate on the best approach to dealing with them.
In interdisciplinary teams, like anywhere else, the leaders should treat a conflict as a tool to demonstrate their leadership skills. The secret lies in bringing the parties together to identify the root-cause of the issue, and to work towards finding a solution. Effective conflict management begins with taking into account that people involved differ in various ways. Also, parties to the conflict are unequal, and one party may have greater influence than the others. The leaders should, therefore, create equity in the team, and then bring the members towards the mutually agreed solution. The leaders in healthcare environment, like anywhere else, should take into account historical factors that might come into play. Like, for instance, the evolution of nursing as a profession mimics the women’s right movement.
Avoiding Unnecessary Conflict
Conflict is an essential component of human interaction, and shouldn’t be seen as something negative. It is an indication of differences, and leaders should rather concentrate on managing conflict, than avoiding it. In that direction, there are certain conditions that help in preventing unnecessary conflict.
Among other factors, an environment of openness and trust has a significant impact on creating harmonious team environment. Therefore, a leader’s personal style of relating to others and communicating with them has perceptible influence on team’s culture. In this kind atmosphere, it does not take long for team members to understand what is acceptable and what is not.
Another effective way of preventing conflict is by aligning individual’s goals with that of the organization. In such circumstance, people are “more open, cooperative, engaged, and supportive and less angry and frustrated”. However, it has to be accepted that this aligning of goals is not always possible. Therefore, in such situations, an opportunity should be given to the team members to openly express their differences.
Further, the leaders should spend quality time to recognize the source of conflict right away, than to spend avoiding them. In case of structural conflicts, they should to change non-equitable control and non-equitable power and authority. In case of value conflicts, relationship to the world and ideology and identity can be change. Further, in the case of information conflicts, they should try to bring about change in differences in information and their interpretation. And, in interaction conflicts, it is the perception of the others, and communication and language, which can bring about change. Finally, in interest conflicts, any change in competition and position, and politics and processes can bring about necessary resolution.
Team-Based Conflict Issues
In healthcare environment, atmosphere can be intense and can easily lead to conflict. Leaders should, therefore, give attention to relationship issues and keep everything in context. As most members of a team lie anywhere between generator and avoider of conflict, their always is a likely hood of a conflict. Therefore, the leader must be on the lookout for the main factors that lead to a conflict. He must realize that if members feel they are at the end of inequitable treatment, they’ll descend down the Maslow’s ladder.
Even though everyone in the team does not know everything, there shouldn’t be lack of essential information. In addition, the members must have a common understanding of the information, and should see it in correct context. Next, the leaders and the rest of the team must realize that game playing almost always leads to conflict. But, that does not mean that the members don’t recognize each other’s uniqueness. At the same time, behaviour based on some hidden agenda almost always leads to conflict, and is extremely hard to resolve. If the members are allowed to pursue their own hidden agenda, the team eventually breaks down. This may have catastrophic effect on patient outcomes.
In addition, there should always be an element of mutual appreciation. The members should realize that they a value in the team and are there because they make unique contribution. Further, the importance of power in healthcare teams cannot be underscored. This is especially true when members in such teams have unequal power. It should be realized that such team work as a community and it is incumbent upon the team leader to instil such a feeling.
In summary, getting ahead of the game in resolving conflicts is the best method of diffusing them and mitigating any adverse consequence. The leader should, therefore, not avoid conflicts, but create an environment where differences and conflict are a part of routine interaction. They should make an effort to expose and resolve conflicts. Finally, by valuing and accepting differences between the team-members, a leader reduces the number of conflict. Thereby, reducing the chances where conflict might go on to have a crippling effect.
References
Bronstein, L. R. (2003). A Model for Interdisciplinary Collaboration. Social Work, 48(3), 294-306. Retrieved from http://sw.oxfordjournals.org/content/48/3/297.short
Hall, P., & Weaver, L. (2001, Sep). Interdisciplinary education and teamwork: a long and winding road. Medical Education, 35(9), 867-875. Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2923.2001.00919.x/full
Porter-O'Grady, T., & Malloch, K. (2007). The Leader as Peacemaker: Managing the Conflicts of a Multifocal Workplace. In T. Porter-O'Grady, & K. Malloch, Quantum Leadership: A Resource for Health Care Innovation (pp. 81-115). Sudbury, MA, USA: Jones and Bartlett Publishers.
