Interprofessional Education:Facilitation and Conflict

Management

Goals of IPE Session for Student Trainees

• Recognize one another’s roles in healthcare• Learn team-building and collaborative roles in

the context of a patient case• Identify characteristics of functional teams• Review strategies for team-building and

conflict resolution

Outline of Student Session

IPE Faculty Roles

• Recognize one another’s professional roles• Collaborate to achieve trainee learning

objectives• Facilitate small group (team-based) case

discussion and decision-making• Give feedback to your teams• Summarize and reflect on learning

Today’s Learning Objectives

By the end of session, you will:

• Recognize one another’s professional roles• Identify characteristics of functional teams• Identify characteristics of effective IPE

facilitation• Roleplay facilitation of role recognition among

learners

Learning Objective 1: Identify characteristics of effective IPE facilitation

As you watch this video, identify the characteristics of effective and ineffective IPE facilitation.

• What was done well in facilitation?• What could be improved, and how?• What are consequences of poor facilitation?

Consider how you might improve your own IPE facilitation style.

Facilitator Roles

• Directing/Forming: set climate, clarify roles and goals, build group identity

• Coaching/Storming: legitimize concerns, invite feedback, accept and expect tension

• Norming/Performing: offer resource, share leadership, consult and coach (1 on 1)

• Delegating/Separating: adjust style, let go, anticipate termination

Role Recognition

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Learning Objective 2: Facilitate role recognition among learners

Watch the video and…

• Consider what would you do as a facilitator

Pitfalls in Facilitating Role Recognition

Usual Facilitation IPE FacilitationPitfall Solution/Remedy/Prevention

Role Recognition

• Sets climate for team work

• Gives equal voice to every team member

• Corrects misperceptions or assumptions

• Opens learning conversation for cross-fertilization

• Establishes common vocabulary for learning

• Anticipates future conflicts

Team Dynamics and Conflict

• Consider power dynamics and hierarchy

• Were ground rules established?

• Is diversity strength or hindrance?

• What are underlying assumptions? (gender, status, seniority, age, education)

• What is antecedent for decision-making?

Managing Potential Conflict

Proactive• Observe team behavior• Use tools (e.g., MBTI)• Establish trust early (e.g., personal histories)

Reactive• Acknowledge potential conflict• Facilitate problem-solving: respect, support,

process• Team effectiveness exercise• Member strength/weakness exercise

1. Zwarenstein M, et al. Cochrane Database Syst Rev. 2009;(3):CD000072.2. Reeves S, et al. Cochrane Database Syst Rev. 2008;(1):CD002213.

Learning Objective 3: Dynamics and Processes

Watch the video and observe:• What team dysfunctions are apparent?• What escalated conflict?• Which stakeholders were affected by the

process?• Where dysfunction could be addressed?

How might you act as a facilitator for this team?

Dynamics and Processes

• What team dysfunctions are apparent?• What escalated conflict?• Which stakeholders were affected by the

process?• Where dysfunction could be addressed?

What would you do if you were the facilitator for this team?

Dynamics and Processes

*http://ipe.utoronto.ca/educators/competencies.html

Inattention to Results

Avoidance of Accountability

Lack of Commitment

Fear of Conflict

Absence of Trust

• Status and Ego

• Low Standards

• Ambiguity

• Artificial Harmony

• Invulnerability

Address Conflict and Dynamics

Build trust• Understand motivation• Personal stories of origin (autobiographies)

2. Establish ‘conflict culture’ (safety)• Profile team and members (Thomas-Killman)• Conflict norming

3. Manage meetings (‘Death by meeting’)• Use ‘Lightning rounds’• Encourage voices

Address Conflict and Dynamics

Get commitment• Remove assumptions• Get ‘buy in’ and ‘clarity’• Commitment ≠ Consensus• Use cascading communication

5. Establish accountability• Common thematic goals (‘patient outcome’)• Peer to peer communication• Facilitator leadership (strength/weakness exercise)• Keep scoreboard (list milestone accomplishments)

Ask for Team Assessment ≈ Reflection

• How did we do today as a team?• What enabled/supported our collaboration?• Were team members heard and respected?

If not, how can we improve?• Did anything interfere with ability to

contribute?• What else might improve our interaction?

REFLECT

Provide Your Feedback to IPE Team

Feedback should • Start with team self-assessment• Be based on direct observation• Be clearly stated and prefaced• Be regular• Be balanced• Be specific

Use ‘teach-back’ to ensure message is received

Faculty Exercise (Role Play)

• Break into groups of 6 to 8• Two will be faculty mentors, the rest will be trainees

from the 3 professions (one scribe)• Faculty: using the script, go through case with your

trainees and facilitate case discussion using steps described

• After 10 to 15 minutes• Scribe will list record strengths and weaknesses of the

process• Report findings to large group

Summary

IPE involves:

1. Creation of IP teams2. Facilitation3. Role recognition4. Conflict management5. Building trust6. Reflection