Rural Physician Leadership Curriculum

1. Rural Physician Leadership Curriculum West Virginia University Rural Family Medicine Residency Program

2. Rural Physician Leadership Curriculum Module 5 Conflict Resolution

3. Rural Physician Leadership Curriculum Description • Funded by HRSA Grant D22HP00306 • Objective 1 • Develop a competency based longitudinal curriculum in Rural Physician Leadership Konrad C. Nau, MD Principle Investigator Chair, Dept of Family Medicine-Eastern Division WVU Rural Family Medicine Residency Program

4. Rural Physician Leadership Curriculum Learning Objectives : Module 5 • Understand the positive and negative attributes of conflict • Review conflict resolution strategies • Identify effective Interpersonal Communication Skills in Conflict Resolution

5. Conflict : What is it ? Mental struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands Merriam-Webster

6. Conflict : What is it ? • When the needs or values of one individual or group come into opposition with those of another individual or group. • Individual vs Individual • Group vs Group • Individual vs Group Joan A. Stepsis Pfiffer’s Classic Activities for Managing Conflict at Work , 2003, John Wiley and sons, Inc. p 19.

7. Conflict : What is it ? • Conflict occurs when two or more people attempt to occupy the same “space” at the same time. • Physical • Psychological • Political H.B. Karp Pfiffer’s Classic Activities for Managing Conflict at Work , 2003, John Wiley and sons, Inc. p 5.

8. Destructive Conflict • Diverts time and energy • Delays decisions • Obstructs option exploration • Drive non-confrontational members to the sidelines Gerry E. Wiley. Pfiffer’s Classic Activities for Managing Conflict at Work , 2003, John Wiley and Sons, Inc. p 27.

9. Destructive Conflict • Leaves losers resentful • Prompts underdogs to sabotage • Causes defensiveness • Interferes with empathy • Arouses disruptive anger Gerry E. Wiley. Pfiffer’s Classic Activities for Managing Conflict at Work , 2003, John Wiley and Sons, Inc. p 27.

10. Constructive Conflict • Exposes us to diverse ideas and perspectives • Increases our alternatives and options • Injects excitement and passion into the group’s task Julia T. Wood. Pfiffer’s Classic Activities for Managing Conflict at Work , 2003, John Wiley and Sons, Inc. p 68-71

11. Constructive Conflict Udia Pareek. Pfiffer’s Classic Activities for Managing Conflict at Work , 2003, John Wiley and Sons, Inc. p 68-71

12. Conflict : Why ? • Different views of Content (Fact) • Different views of Process (Methods) • Different views of Goals (Ends) • Different Views of Ethics (Morality)

13. Conflict : What ? Objective Subjective Fact…..Process…..Goals……Ethics

14. Conflict : What ? Objective Subjective VOLATILITY Fact…..Process…..Goals……Ethics

15. Conflict Management & Outcomes • Lose/Lose • Win/Lose • Win/Win

16. Conflict Management & Outcomes • Lose/Lose • Ignore the Conflict • Executive Imposed Solution • Protest or Strike • Riot

17. Conflict Management & Outcomes • Win/Lose • Majority Vote • Arbitration • Positional Negotiation • Mediation • Jury Trial

18. Conflict Management & Outcomes • Win/Win • Principled Negotiation • Collaborative Problem Solving with Interaction Method

19. Harvard Negotiation Project • Part of Program on Negotiation at Harvard Law School • Consortium of scholars from Harvard, MIT, Simmons, and Tufts • Working to improve theory and practice of conflict resolution

20. Harvard Negotiation Project • Principled Negotiation • NOT usual positional bargaining • Participants are Problem-Solvers • Goal is a wise outcome reached efficiently and amicably Fischer,Ury,Patton Getting to Yes, Negotiating Agreement Without Giving In , 1991, New York,NY : Penguin Books.

21. Harvard Negotiation Project Method • People Separate the people from the problem • Interests Focus on interests, not positions • Options Generate possibilities before deciding • Criteria Insist that results are based on objective standards

22. Harvard Negotiation Project :Separate the People from Problem • Put yourself in their shoes • Don’t deduce their intentions from your fears • Speak about “yourself”, not about “them” • Make your proposals consistent with their values (face-saving)

23. Harvard Negotiation Project :Focus on Interests, not Positions • Behind opposed positions, lie shared and compatible interests • The most powerful interests are basic human needs • Look forward not back • Identify interests by asking “why ?”

24. Harvard Negotiation Project :Invent Options for Mutual Gain • Options are powerful tools • Obstacles for inventing options • Premature Judgment • Searching for the Single Answer • Assuming a fixed pie • Thinking that solving their problem is their problem

25. Harvard Negotiation Project : Invent Options for Mutual Gain • Brainstorming • Change the environment • Use a facilitator • Seat participants side-by-side • “No-criticism” ground rule • Record ideas in full view

26. Harvard Negotiation Project : Invent Options for Mutual Gain • Consider brainstorming with the “opposition” • Invent agreements of different strengths • Permanent vs Trial • Comprehensive vs Partial • Identify shared interests • Dovetail differing interests

27. Harvard Negotiation Project : Insist on Objective Criteria • Frame each issue as a joint search for objective criteria • Be open to reason which standards are appropriate • Never yield to pressure, only to principle

28. Harvard Negotiation Project : BATNA • “Best Alternative To a Negotiated Agreement” • Most useful if negotiating with a more powerful opponent • The more easily and happily you can walk away from a negotiation – the greater your capacity to effect its outcome

29. Harvard Negotiation Project : BATNA • List possible actions you might take if no agreement made • Covert best ones to practical alternatives • Select the best one and know it’s costs

30. The Interaction Method • Research supported by Carnegie Corporation, Rockefeller Foundation and Social Security Administration. • Collaborative Problem Solving for Organizations M. Doyle & D. Straus How to Make Meetings Work , 1982, New York,NY : The Berkley Publishing Group.

31. The Interaction Method:Structuring Conflict Meetings • 4 well defined roles in meetings • Equal importance • Collectively form checks and balances • Equal responsibility for success • No one traditional leader

32. The Interaction Method: roles • Facilitator • Recorder • Group Members • Manager/Chairperson

33. The Interaction Method: roles • Facilitator • Neutral servant of the group • Does not evaluate or contribute ideas • Helps group focus energies • Protects members from attack • Ensures free contribution

34. Interaction Method: roles • Recorder • Neutral non-evaluating servant of the group • Writes down basic ideas in front of group • Tries to always use direct quotes

35. Interaction Method: roles • Group Member • Active participant • Keeps facilitator & recorder neutral • Can make procedural suggestions

36. Interaction Method: roles • Manager/Chairperson • Active participant • Does not run the meeting • Retains responsibilities of their position • Urges members to accept tasks and deadlines

37. Interaction Method: Different Types of Meetings • Reporting / Feed-forward Meetings • Reactive / Feedback Meetings • Problem Solving Meetings • Decision Making Meetings • Strategic Planning Meetings

38. Interaction Method: Reaching Consensus • Establish criteria for choosing between options • Use straw votes to build consensus and create options to enable people to support a given choice. • Management retains “executive decision” as a last resort

39. Summary: Conflict Resolution • Conflict is unavoidable • Conflict well managed can create growth and new opportunities • Conflict poorly managed can be destructive and dominate your organization

40. Summary: Conflict Resolution • Proven methods of successful conflict resolution • Principled Negotiation • Harvard Negotiation Project • Interaction Method • Collaborative Problem Solving for Organizations