Training paediatric healthcare staff in recognising, understanding and managing conflict with patients and families: findings from a survey on immediate and 6-month impact

Arch Dis Child. 2017 Mar;102(3):250-254. doi: 10.1136/archdischild-2016-310737. Epub 2016 Apr 20.

Abstract

Background: Conflict is a recognised component of healthcare. Disagreements about treatment protocols, treatment aims and poor communication are recognised warning signs. Conflict management strategies can be used to prevent escalation, but are not a routine component of clinical training.

Objective: To report the findings from a novel training intervention, aimed at enabling paediatric staff to identify and understand the warning signs of conflict, and to implement conflict resolution strategies.

Design and setting: Self-report measures were taken at baseline, immediately after the training and at 6 months. Questionnaires recorded quantitative and qualitative feedback on the experience of training, and the ability to recognise and de-escalate conflict. The training was provided in a tertiary teaching paediatric hospital in England over 18 months, commencing in June 2013.

Intervention: A 4-h training course on identifying, understanding and managing conflict was provided to staff.

Results: Baseline data were collected from all 711 staff trained, and 6-month follow-up data were collected for 313 of those staff (44%). The training was successful in equipping staff to recognise and de-escalate conflict. Six months after the training, 57% of respondents had experienced conflict, of whom 91% reported that the training had enabled them to de-escalate the conflict. Learning was retained at 6 months with staff more able than at baseline recognising conflict triggers (Fischer's exact test, p=0.001) and managing conflict situations (Pearson's χ2 test, p=0.001).

Conclusions: This training has the potential to reduce substantially the human and economic costs of conflicts for healthcare providers, healthcare staff, patients and relatives.

Keywords: Health services research; conflict; paediatrics; training.

MeSH terms

  • Child
  • Clinical Competence
  • Conflict, Psychological*
  • Dissent and Disputes
  • England
  • Follow-Up Studies
  • Health Personnel / education*
  • Hospitals, Pediatric
  • Hospitals, Teaching
  • Humans
  • Inservice Training / methods
  • Negotiating
  • Pediatrics / education*
  • Professional-Family Relations*
  • Self Report