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Dysfunctional Teams

Dysfunctional Teams. Instructor Name. Learning Objectives. Describe types of conflict and various management approaches Use a basic framework to problem-solve Develop techniques to assist a difficult team member. Conflict. No one likes it Adds to stress Can destroy team dynamics

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Dysfunctional Teams

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  1. Dysfunctional Teams Instructor Name

  2. Learning Objectives • Describe types of conflict and various management approaches • Use a basic framework to problem-solve • Develop techniques to assist a difficult team member

  3. Conflict • No one likes it • Adds to stress • Can destroy team dynamics • Can influence career goals • Can influence personal life

  4. Some Conflict is Good • Leading cause of business failure among major corporations → Too much agreement among top management” • Lack of tension → Complacency • Essential, ubiquitous part of organizations

  5. Reflection • Reflect on a time when you had conflict w/ a person (or a team) that didn’t function well • Describe it • What was the problem? • How did you handle it?

  6. Types of Conflict • Issues • Decision-making • Topic-oriented • People • Emotional • Feeling of resentment • Relationships

  7. Conflict Management Approaches • Forcing – Getting your way • Avoiding – Ignore, don’t deal • Compromising – Agreement quickly • Accommodating – Don’t upset other person (taking advantage of you?) • Collaborating – Solve the problem together

  8. Example • You are one of 2 residents on GI wards • You both want a GI fellowship • Your colleague is constantly interrupting you on rounds, contradicting you • They are making you look bad • Rounds lose focus, drag on, important issues lost • Confused attending and interns

  9. Example cont’d • You are bitter and angry • You tell everyone how awful he/ she behaves • You refuse to give up your weekend off to help him/her • You confront the resident, tell them to back off, • YOU are killing me, and I can’t wait until this month is over . I hope I don’t have to work with you again!

  10. What would have been a better solution? • Should you have involved others in the solution? If so, who? • Is timing an issue? Could this have been headed off before it escalated?

  11. General Framework for Collaborative Problem-Solving • Establish common goals • Separate the people from the problem • Avoid making conclusions or judgments • Encourage 2-way discussion • Objective criteria to measure outcome

  12. Establish Common Goals • Focus on what both parties share in common • We both want a GI fellowship • We both want to spend time with our families and have weekends off • We both want what is best for the patient

  13. Separate the People from the Problem • Depersonalize the situation • Make the issue the behavior not the person • People get less defensive • Easier to resolve conflict

  14. XYZ Approach • When you (behavior), then (consequences), and I feel (feeling)…

  15. XYZ Approach • Example 1: Interrupt me on rounds When you interrupt me on rounds, we bothlook badto the attending and I feel like you are hurting our chancesfor fellowship.

  16. XYZ Approach • Example 2: Resident interrupts intern on rounds When you interrupt me on rounds, then I can’t communicate my plan and I feel like my learning is affected .

  17. XYZ Approach • Example 3: Intern ignoring nurses pages When you ignore the nurses pages, the patient suffers, and I feel like you are not taking your responsibilities seriously. Do you want to be a doctor?

  18. XYZ Approach • Example 3: Intern ignoring nurses pages When you ignore the nurses pages, then you aren’t accessible in an emergency, and I am concerned the patient may suffer. Better approach!!

  19. Avoid Making Conclusions or Judgments Don’t say: • You are lazy! • You are wrong! • You are mean!

  20. Make It a 2-way Conversation • Do say: • Do you realize you are doing this? • How were you taught to do this? • You don’t seem engaged - Help me understand what’s going on. • Is there a reason you are struggling? • How can I help you? What have you tried already?

  21. Continue until Understood • Keep your opening statement brief • The longer your opening, the more worked up you get, the more defensive the other person becomes, the longer it takes to find a resolution • Ensure understanding • Clarify, ask questions • This is important for both of us

  22. Objective Criteria to Measure Outcome • How will you know if your conversation worked? • How can we evaluate our plan? • Keep track of a measure? • Number of interruptions, hours on rounds • Less tantrums • Let’s try it, and in 2 days sit down and reassess

  23. Be Nice • Agree with something (if you can) • Yes, it’s stressful worrying about fellowship. • I remember getting annoyed with so many pages, especially when many weren’t important, but …

  24. Be Nice • Approach multiple problems incrementally • Choose your battles • Basic problem first • We’ll work on more later (i.e., next problem) • I want this to be a great month and I want to help you learn

  25. Example • Using your earlier example • Working in pairs or a group • How could you have handled your situation better?

  26. General Framework for Collaborative Problem Solving • Establish common goals • Separate the people from the problem • Avoid making conclusions or judgments • Encourage 2-way discussion • Continue until understood • Objective criteria to measure outcome

  27. The Difficult Learner There seems to always be at least one!!!

  28. Difficult Learners? • Dealing with a difficult learner is a teacher’s worst nightmare • Human nature – Blame the learner • Coping Strategy – Ignore the learner • Difficulties are not always 1-sided • Interpersonal skills involve 2-people

  29. What to Do • Become better acquainted w/ learner • Understanding his/her perspective = possible solution . . . . sooner! • Inform leaner, “I am committed to your learning.” • Take the problem seriously – don’t ignore

  30. Why Are Some Learners Difficult? List several reasons why you think some people struggle or are “difficult” learners

  31. Reasons for Difficult Learners • Stressed • Sick • Poor coping skills • Frustrated with a lack of support • Feel vulnerable • Feel scared • Family situation • Drugs, alcohol • Financial strain • Tired • May not know any better • …

  32. Categories • Capacity • Lack physical / mental capacity to cope • Cognitively inadequate or unable • Personality traits • Motivation • Distractions • Outside work (domestic, financial) • Appear disorganized, can’t make decisions, make mistakes

  33. Specific Behaviors & Suggestions to Consider • Slow • Familiarize learner w/ time expectations • Poor knowledge or skills • References, suggestions, give extra time • Fear of failure • Provide expectations & feedback • “Mistakes are expected” • “Think out loud to help me better understand your reasoning”

  34. Specific Behaviors &Suggestions to Consider • Poor interactions, interpersonal skills • Make sure he/she understands how others perceive his/her actions • XYZ Approach works well here • Unmotivated - Most difficult • Provide clear expectations • Change the behavior, not the personality • Grade accurately

  35. For the Biggest Problems • Don’t be afraid to involve the clerkship or program directors • We all have a vested interest • Medicine is a profession • Keep it that way

  36. General Framework for Collaborative Problem Solving • Establish common goals • Separate the people from the problem • Avoid making conclusions or judgments • Encourage 2-way discussion • Continue until understood • Objective criteria to measure outcome

  37. References • Whetten D, Cameron K, Developing Management Skills, 7th edition, Pearson Prentic Hill, 2007 • BMJ Career Focus 2002;325:S43 • Mahan,The Clinical Teaching Handbook, Ohio State University College of Medicine, 2007

  38. Questions???

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