“Conflict is a normal part of human interaction. In health care, conflict of some sort has been estimated to occur in the management of a half to two thirds of patients. This conflict most commonly arises between clinicians but also occurs between the clinician and the patient” (Services for Australian Rural and Remote Health, 2013).
Therefore, given this, it is likely to assume that Clinical Educators or supervisors will experience conflict at some time in this role. Clinical supervisors should be well versed on conflict resolution skills, not only for their own practice but also to guide their students through conflict. It is important to recognise that conflict is a normal part of any relationship. Segal and Smith (2013) state that “The ability to successfully resolve conflict depends on your ability to:
- Manage stress quickly while remaining alert and calm
- Control your emotions and behaviour
- Pay attention to the feelings being expressed
“Conflict can be productive when, as a result of listening to other perspectives, a solution is found that may not have been considered previously. It can be destructive when issues are left unresolved or there is coercion and dominance by one group over others" (Services for Australian Rural and Remote Health, 2013).
Conflicts between student and supervisor can occur for a number of reasons and impact on each person’s experience of the clinical placement.
Identifying conflict in a clinical placement setting
- differences in theoretical orientation and beliefs about effective interventions
- differences in supervisory style (e.g. too little supervision, a lack of positive reinforcement, the absence of constructive criticism or little opportunity to observe one’s supervisor actually doing the work)
- personality differences that interfere with the supervisory relationship or situations in which there are varying perceptions of the relationship
- conflict when trainees are unsure of supervisory expectations
- a mismatch between student-supervisor expectations
- when students receive conflicting messages about expectations
Tools for dealing with conflict
It is an important area to address early so that placements are a successful part of the clinical journey.
Moving on from conflict can be difficult as we often get stuck in our own thoughts, beliefs and opinions. It is worth considering the ‘Positions of Perception’ when addressing a conflict. What am I feeling or doing that may impact on the other person? How might the other person feel? How might this impact on the team/organisation/client?
Consideration of the three positions of perception can help resolve a conflict by removing the ‘you versus me versus them’. Understanding all positions can lead to a focus on the fourth position of perception, creating a sense of the whole system and how to achieve the goal.
Strategies to Assist Conflict Resolution
Katz (2007) lists five mechanisms commonly used in conflict resolution:
Mechanisms of conflict resolution
Avoidance Inconsequential disagreement
Yielding Own position is wrong
Collaboration Focus on goals, “win-win”
Compromise Unable to reach collaborative agreement
Competition Issue of great importance, no conciliation possible
There are circumstances when each mechanism is valid to apply.
Katz (2007) divides strategies for conflict resolution into institutional and personal.
- Establish an institution-wide conflict management program.
- Build a culture that welcomes normative conflict resolution.
- Foster group cohesion.
- Anticipate conflict.
- Develop communication skills.
- Identify the precise source of the conflict.
- Establish rules of conduct.
- Find a nonjudgmental starting point for the discussion.
- Establish shared standards and goals.
- Recognise any shared frustrations
- If confrontation with a colleague is necessary, it should be conducted in a private setting.
- Have a low threshold for intervention by a third party.
- If conflict is ultimately irreconcilable, transfer patient care to an uninvolved colleague.
Adapted from Moskowitz and Rupert, 1983, & Olk and Friedlander, 1992, cited in Giddings, Vodde, & Cleveland, 2008
- Services for Australian Rural and Remote Health (2013).Conflict Resolution. Retrieved from: https://sarrah.org.au/content/conflict-resolution
- Segal, Jeanne and Smith, Melinda (2013). Conflict Resolution Skills. Retrieved from: http://www.helpguide.org/mental/eq8_conflict_resolution.htmGiddings, M., Vodde, R., & Cleveland, P. (2004). Examining Student-Field Instructor Problems in Practicum, The Clinical Supervisor, 22(2), 191-214.
- Katz, Jonathan (2007) Conflict and its resolution in the operating room. Journal of Clinical Anaesthesia, vol 19, pp. 152-158; 2007.
- Giddings, M., Vodde, R. & Cleveland, P. (2004) Examining student-field instructor problems in practicum. The clinical Supervisor 22(2): 191-214 https://doi.org/10.1300/J001v22n02_12
- Hoag, J. (2013). NLP Perceptual positions. Retrieved from NLP Training, coaching, therapy: http://www.nlpls.com/articles/perceptualPositions.php