Part 2, Conflict management. How to shape positive relationships in medical practices and hospitals

Managing workplace conflict is one of the most important, stressful, and time-consuming tasks faced by today's physician leaders. In Part 1 of this article series, the authors describe how to assess an organization's interpersonal dynamics. True change comes from interventions that help an organization to become a positive interpersonal culture, one that fosters cooperation and collaboration. Part 2 offers seven steps to solving the disruptive physician problem: (1) provide protection to complainants; (2) listen, empathize, and avoid communication triangles; (3) confront offenders with data, authority, and compassion; (4) if needed, get outside help; (5) offer workplace training and experiences that foster positive relationships; (6) follow-up; and (7) practice what you preach. The self-assessment and intervention guidelines discussed in this series of articles can help physician executive move beyond struggling with episodes of conflict to shaping stress-resilient medical organizations.     

The Management of Workplace Conflict: Contrasting Pathways in the HRM Literature

This paper reviews the human resource management literature on the management of workplace conflict. It suggests that workplace conflict is commonly viewed in the literature as a symptom of management failure: the notion that conflict may be intrinsic to the nature of work because employees and managers have hard‐to‐reconcile competing interests is given short‐shrift. At the same time, the paper identifies important differences in the literature, which the authors call ‘pathways’, about the best methods to manage problems at the workplace. It is argued that four contrasting pathways can be detected in the literature with regard to how organizations approach workplace conflict management practices. Each pathway is examined fully and their respective strengths and weaknesses are assessed.     

Stressors beget stressors: The effect of passive leadership on employee health through workload and work–family conflict

The current study examined passive leadership as a potential antecedent of two commonly studied workplace stressors (i.e. workload and work–family conflict), and investigated its negative effect on employee burnout and physical symptoms via these stressors. We collected two waves of data from 274 focal participants, and one wave of data from their co-workers. Results showed that both self-reported and co-worker-reported passive leadership was positively related to employee burnout and physical symptoms, as well as workload and work–family conflict. Additionally, workload and work–family conflict partially mediated the effects of passive leadership on burnout and physical symptoms, respectively. Our findings support the notion that passive leadership can create a stressful workplace and have a detrimental effect on employees’ health.     

The Price Chameleons Pay: Self‐monitoring,Boundary Spanning and Role Conflict in the Workplace*

The vast majority of research on self‐monitoring in the workplace focuses on the benefits that accrue to chameleon‐like high self‐monitors (relative to true‐to‐themselves low self‐monitors). In this study, we depart from the mainstream by focusing on a potential liability of being a high self‐monitor: high levels of experienced role conflict. We hypothesize that high self‐monitors tend to choose work situations that, although consistent with the expression of their characteristic personality, inherently involve greater role conflict (i.e. competing role expectations from different role senders). Data collected from a 116‐member high‐tech firm showed support for this mediation hypothesis: relative to low self‐monitors, high self‐monitors tended to experience greater role conflict in work organizations because high self‐monitors were more likely to occupy boundary spanning positions. To help draw a more realistic and balanced portrait of self‐monitoring in the workplace, we call for more theoretically grounded research on the price chameleons pay.     

Work-related stress in the UK: a new, ‘Management Standards’ approach

Abstract

Workplace victimization has recently emerged as an important topic in occupational health psychology. One of the major limitations of this research is that it generally employs cross-sectional designs. The current study, however, used a 13-month two-wave prospective design to examine the relationship between target personality and workplace interpersonal conflict in a sample of 166 non-faculty employees at a Midwestern university in the United States. Results suggested that victims' positive affectivity, negative affectivity, and core self-evaluations were associated with interpersonal conflict. Furthermore, employee personality was related to subsequent interpersonal conflict from supervisors even after initial levels of interpersonal conflict were controlled. Analyses further suggested that target negative affectivity might be an especially strong predictor of interpersonal conflict. Consistent with past theorizing, we found evidence that initial interpersonal conflict with co-workers can result in subsequent interpersonal conflict with supervisors. We conclude with a discussion of the practical and theoretical implications of our findings.     

Exploring the effects of workplace support on work-life experience: a study of Malaysia

To date most studies of workplace support and work-life experience have been of contexts where government policies and legislation to protect employee work-life balance interests are well established, such as US, UK, and other European countries. Little scrutiny has been given to these issues in less developed economies, where support and protection in terms of work-life policies and legislation at the national level is rather limited. Malaysia, the setting of this study, provides such a context. Two types of organizational support, work flexibility and superior support, are studied for their impact on work-life experience of Malaysians. The findings of this study are based on a national survey of working adults in Malaysia. Work-life experience is conceptualized to capture conflict and enrichment aspects, as well as bidirectional effects between work and nonwork. Results show that work flexibility and superior support lower work-life conflict marginally but facilitate greater work-life enrichment among Malaysians. The paper also draws out implications of these findings for human resource development professionals operating in workplace settings within national contexts with limited mandatory work-life provisions.     

Due process key element of physician grievance.

The concept of grievance procedures, when applied to physicians, has a foreign ring to it. We ordinarily associate grievance procedures with unions and labor relations activities unrelated to professional conduct and behavior. As described in the preceding article, grievance procedures usually are extremely limited, having been created to resolve very specific violations of collective bargaining agreements in a unionized company or of conflict resolution policies in a nonunion environment. In health care organizations, "due process provisions" are designed to resolve specific conflicts in the relationship between the medical staff and individual medical practitioners.     

Abusive interaction and role state stressors: Relative impact on student residence assistant stress and work attitudes

Despite the recognition that poor working relationships can contribute to strain (Chen and Spector 1991, Cooper and Marshall 1978, Kahn and Byosiere lY92, Spector 1987, Spector et al. 1988) and increasing concern over violence and aggression in the workplace (Northwestern National Life Insurance Co. 1993), little research attention has been paid to hostile interpersonal interaction as a work-related stressor. While recent work has focused on interpersonal conflict and sexual harassment as stressors, emotionally abusive interactions have remained largely unaddressed by the organizational stress literature. These interactions are characterized by hostile verbal and non-verbal, non-physical behaviours directed by one or more persons towards another that negatively affect the target's sense of him/herself as a competent person and worker (Keashly et al. 1994, Leymann 1990). The current study examined whether emotional abuse contributed uniquely to understanding work-related stress in student residence assistants (RAs). Seventy-six RAs employed by a Canadian university responded to a questionnaire on the quality of their work experience. The stressors examined were role conflict, role overload, role ambiguity, and number, frequency, and impact of abusive events with dormitory residents. Outcome variables included job-related tension, job satisfaction, job commitment, and intention to leave. Emotional abuse contributed similar amounts of unique variance as the role state stressors to the variables of tension, job satisfaction and intention to leave suggesting emotional abuse is an important and uniquc workplace stressor. Implications of these findings for future research are discussed.     

The Use of Mental Models in Chemical Risk Protection: Developing a Generic Workplace Methodology

We adopted a comparative approach to evaluate and extend a generic methodology to analyze the different sets of beliefs held about chemical hazards in the workplace. Our study mapped existing knowledge structures about the risks associated with the use of perchloroethylene and rosin-based solder flux in differing workplaces. "Influence diagrams" were used to represent beliefs held by chemical experts; "user models" were developed from data elicited from open-ended interviews with the workplace users of the chemicals. The juxtaposition of expert and user understandings of chemical risks enabled us to identify knowledge gaps and misunderstandings and to reinforce appropriate sets of safety beliefs and behavior relevant to chemical risk communications. By designing safety information to be more relevant to the workplace context of users, we believe that employers and employees may gain improved knowledge about chemical hazards in the workplace, such that better chemical risk management, self-protection, and informed decision making develop over time.     

The barrier effect of conflict with superiors in the relationship between employee empowerment and organizational commitment

The author proposes the idea that conflict with superiors has a barrier effect in the positive relationship between employee empowerment and organizational commitment. Superiors with higher authority rankings set and pursue organizational goals and values to which employees with lower authority rankings are expected to become committed. Conflicts with those superiors may hinder empowered employees to develop or maintain high levels of organizational commitment. A questionnaire survey among 91 secondary school teachers in The Netherlands provides empirical support for this suggestion. The moderator effect of conflict with superiors that was proposed and found in this study suggests that psychological empowerment in the workplace interacts with other employee experiences in its effects on an employee's commitment to the organization.     

知识共享在人际互动与创新之间的中介作用研究

本文的目的是揭示个体层面上知识共享对创新的影响作用,首先论证了知识共享对创新直接的积极影响,接着进一步提出知识共享在人际互动和创新之间起到中介作用.据此,提出研究假设,确立知识共享作为中介变量,在人际沟通与创新、任务冲突与创新之间的影响作用.研究在不同行业中,以上司与下属配对方式收集了168套问卷,实证检验的结果验证了所提出的理论假设.     

The barrier effect of conflict with superiors in the relationship between employee empowerment and organizational commitment

The author proposes the idea that conflict with superiors has a barrier effect in the positive relationship between employee empowerment and organizational commitment. Superiors with higher authority rankings set and pursue organizational goals and values to which employees with lower authority rankings are expected to become committed. Conflicts with those superiors may hinder empowered employees to develop or maintain high levels of organizational commitment. A questionnaire survey among 91 secondary school teachers in The Netherlands provides empirical support for this suggestion. The moderator effect of conflict with superiors that was proposed and found in this study suggests that psychological empowerment in the workplace interacts with other employee experiences in its effects on an employee's commitment to the organization.     

Teaching managers to regulate their emotions better: insights from emotional intelligence training and work-based application

Despite the prevalence and significance of regulating emotions in the workplace, there is a major gap in the literature on the training and work-based application of emotion regulation strategies. This study seeks to fill this gap by investigating how emotion regulation strategies are taught to managers on three emotional intelligence training courses, the events associated with their use in the workplace and any constraints. Drawing on qualitative data from participant observations and interviews with managers and trainers, the study identifies the use of eight emotion regulation strategies that are classified as attention deployment, cognitive change and response modulation. Managers use a variety of the strategies at work, sometimes combining and adapting them. These strategies were reportedly used during situations of interpersonal conflict, interpersonal interactions, organizational change, to relieve boredom and cope with work overload. Managers described constraints as dispositional, physical, time, effort, status and unfeasibility/lack of realism of tools.     

Engaging Professionals in Sustainable Workplace Innovation: Medical Doctors and Institutional Work

This paper investigates the role of medical professionals in the success and longevity of the implementation of workplace innovation and organizational change in the Accident and Emergency (A&E) Departments of two large public hospitals, in Australia and Canada, during the introduction of process improvement using Lean Management (LM) methodologies. We ask why and how doctors resist, influence or enable LM initiatives in healthcare. Using a qualitative methodology, we contribute to institutional work theory by unpacking the complex forms of boundary and practice work undertaken by key actors who effectively use their professional status and power to enable practice changes to be embedded. Our findings lend support to the importance of the involvement and ownership of senior doctors in the design, introduction and implementation of successful workplace innovation and organizational change. Senior doctors use their professional expertise, positional and political power at the industry, organization and workplace levels to influence strategically the use of resources designated for workplace innovation to improve efficiencies, quality of patient care and maintain their dominance. The significant organizational change achieved reflected the ownership and leadership of the workplace innovation by senior doctors in ‘hybrid roles’ who captured the rhetoric and minimized adversarialism among key stakeholders.     

Resolving conflicts: principles and practice

Physicians and other medical professionals undergo extensive professional training for the privilege of obtaining their professional licenses. For most physicians, clinical training is conducted in extremely competitive circumstances. Many physicians endorse competition as an appropriate method for producing greater individual and collective competence within the profession. Competition, however, is a very limited way to resolve conflicts. And, in the current environment of greater resource restrictions and reform, the competitive model, at best, seems short-sighted. Many of the current relationships involving physicians and others are transitional, involving various partners in numerous practice and professional relationships. For example, medical practices are merging; hospitals are engaging physicians in numerous business structures, even employment. However, longer term relationships are enhanced by mutual respect and collaboration, rather than chronic competition to "win" one's rights over another. Thus, the need among physicians to enhance their conflict resolution skills is expanded in today's environment.     

拒绝职场边缘化:模型与检验

初入职场,大学生员工希望被组织接纳而不是被边缘化。本文试图建模表现在如同"政治舞台"的职场中员工努力避免被边缘化的过程。为达到以上研究目标,执行了两项研究:预研究在国务院11个部委机关的公务员群体中收集数据,开发了职场边缘化的测量工具;主研究对16家制造型企业中的343个员工、662个同事及343个直接领导的配对数据进行实证分析,发现员工工作绩效、公民行为以及与上司的私人关系(Guanxi)与职场边缘化之间呈负向关联。相对而言,在政治氛围淡漠的企业中,上司关系与职场边缘化之间的负向关联更强。     

孵化互动、专用性人力资本和在孵企业成功毕业

基于合作生产理论,本文以307个新创在孵企业为样本,构建生存模型研究孵化互动介入模式和创业专用性人力资本对在孵企业成功毕业的影响。研究发现,行业专用性人力资本、创业家庭背景促成了创业成功,而创业经历对创业成功没有显著影响。同时,孵化互动在促成在孵企业成功毕业方面的调节作用则表现出很大的异质性:孵化互动模式Ⅳ和Ⅴ对行业专用性人力资本有促进性调节作用,而所有孵化互动模式对家庭背景的存在都有抑制性调节作用,但是孵化互动模式对创业经历没有显著的影响。这说明,对于包含诸多隐性成分的行业专用性知识,孵化器经理的参与意愿和介入频率是影响孵化效果的关键因素;同时,孵化互动部分替代了家庭支持的作用,降低了创业者对家庭的依赖。     

Preserving the soul of medicine and physicians: a talk with David Whyte. Interview by Richard L. Reece

Richard L. Reece, MD, interviewed David Whyte, a poet, consultant, and author of The Heart Aroused, on December 15, 1999, to discuss preserving the soul of physicians in corporate America. David describes the soul as "a measure of our belonging in the world. When there is little sense of belonging, there is very little sense of soul." In the workplace, he thinks about whether "people have a sense of belonging to the particular work or the organization." He talks about life in the upper world of the workplace and life in the dark subterranean caves where the soul lives. The soul is where people's true creativity and imagination resides ... and by inviting it into the workplace, organizations and employees can become more successful, innovative, and adaptable. In corporate settings, he uses poetry to bring an understanding of the process of change, helping clients to understand individual and organizational creativity to transform the workplace. The poetry can teach and touch those places that the corporate language cannot speak to.     

A model of injustice,abusive supervision,and negative affect

In this study we test a model of workplace interactional injustice, abusive supervision, and subordinate outcomes (work–family conflict and job performance) using affect to explain behavior. In a sample of 200 full-time workers from various industries, their supervisors, and workers' family members, for a total sample of 600 respondents, we position state negative affect as the explanatory mechanism for both how supervisors' perceptions of injustice are associated with subordinates' perceptions of abusive supervision, and also how abusive supervision, in turn, may be associated with subordinates' job performance and their family members' perceptions of work–family conflict. Organizational justice theory underpins our model.