Negotiation and Conflict Management at PIMS Islamabad

2015 Team members Maria Khan Aminah Parvez Maham Zupash Kamran NEGOTIATION AND CONFLICT MANAGEMENT (PIMS)  TABLE OF CONTENTS Acknowledgement………………………………………………………………………………3 Literature Review…………………………………………………………………………….....4 Overview (PIMS)……………………………………………………………………………….13 Conflict inTeams……………………………………………………………………………......14 i.Causes of teams…………………………………………………………………………….15 ProblemStatement………………………………………………………………………………16 Examining Conflict inPIMS……………………………………………………………………16 Hypothesis……………………………………………………………………………………….18 Methodology…………………………………………………………………………………….18 Sampling Area…………………………………………………………………………………..18 Data Collection and Analysis…………………………………………………………………..19 Graphical Representation of Results………………………………………………………….20 Causes of conflict……………………………………………………………………………….30 Findings…………………………………………………………………………………………31 Comparison of results …………………………………………………………………………32 Questionaire used……………………………………………………………………………….33 References…………………………………………………………………………………….....35 Literature Review Articles Team conflict management and team effectiveness: the effects of task interdependence and team identification. (Anit Somech, Helena Syna Desivilya and Helena Lidogoster). A Helping Hand? The Moderating Role of Leaders’ Conflict Management Behavior on the Conflict–Stress Relationship of Employees. (Moritz Römer, Sonja Rispens, Ellen Giebels, and Martin C. Euwema) The understanding of the moderating effect of leadership styles on the relationship between hierarchical conflicts and employee satisfaction. (Koen Buisman) Leaders and Subordinates Conflict. (Moritz Römer, Martin C. Euwema, Ellen Giebels, Sonja Rispens) Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals. (Tova Hendel PhD, Miri Fish MA, and Vered Galon) Conflict on interprofessional primary health care teams – can it be resolved? (Judith Brown, Laura Lewis, Kathy Ellis, Moira Stewart, Thomas R. Freeman and M. Janet Kasperski) Task versus Relationship Conflict, Team Performance, and Team Member Satisfaction: A Meta-Analysis. (Carsten K. W. De Dreu, Laurie R. Weingart) Politeness in Conflict: Identity Management and Politeness Strategies Used During a Conflict (Carly Gabrielle Sheridan) The Difference of Conflict Management Styles and Conflict Resolution in Workplace (Lim Jin Huan and Rashad Yazdanifard) Handshaking Promotes Cooperative Dealmaking. (Juliana Schroeder, Jane Risen, Francesca Gino, and Michael I. Norton) Conflict management and effectiveness in virtual teams. (Pilar pazos) Superiors' Conflict Management Strategies and Subordinate Outcomes.(Deborah Weider-Hatfield and John D. Hatfield) Acknowledgement We would like to thank Al Mighty ALLAH for enabling us to complete this project. This Project would not have been completed without the generous cooperation of many Individuals. We would like to thank Dr. Ghazalla Mahmud for giving us time from her hectic routine. We would also like to thank our teacher Mr. Ijaz Amed for providing us knowledge about this course which enabled us to complete this Project. Literature Review Research into team effectiveness has traditionally searched for characteristics of effective teams. The complexity of team functioning precludes reducing teams to their least number of components. Rather, a systems theory approach recognizes the relationships and interdependence between and within teams. Given the importance of teamwork to delivering healthcare, a better understanding of how teams function effectively will be invaluable for educating and developing teams. Leadership and conflict management in organizations The effective management of an organization demands the integration of providers who may vary enormously in scale and influence, who may possess contrasting cultures, and who may be dominated by professionals coming from different disciplines based upon conflicting paradigms (Bryant 2003). There is a constant interplay between culture and leadership. The presence of personal and emotional tensions – conflicts – in the organization is one dimension of organizational culture. How leaders react to problems, resolve crises, reward and punish followers is all relevant to an organization’s culture. Leaders who are concerned about organizational renewal will seek to foster organizational cultures that are hospitable and conductive to creativity, problem solving, risk taking and experimentation. Their perspectives on power tend to influence their strategies in conflict and enhance people to work together effectively. It seems logical that the employee/relations orientation of the leader has a positive correlation with trust and a negative correlation with conflicts (Bass & Avolio 1994, Ekvall 1996). The role of group leadership in intergroup conflict is an important element. The leader influences and directs individuals and groups, and requires many qualities and skills in order to effectively handle conflicts. A facilitative leader has the capacity to help the antagonistic groups work together towards their shared goals. He/ she also provides encouragement and support, releases tensions, harmonizes misunderstanding and deals with disruptive or aggressive behaviour (O’Hearn Woodlti 1987, Fisher 2000). Findings of a research by Sullivan et al. (2003) revealed that experienced and new head nurses, in describing their developmental needs, focused on conflict resolution management with multiple personalities, disciplines and cultures. In a multi phased project by Russell and Scoble (2003) nurse managers’ identified their future educational needs. Respondents’ identified knowledge and skill deficits concerning human resources management including conflict resolution. In the research article “Culture and Negotiation Strategy”, by Wendi Adair, Jeanne Brett, Alain Lempereur, Tetsushi Okumura, Peter Shikhirev, Catherine Tinsley, and Anne Lytle have investigated the relationship between culture and joint gains by examining the role of information sharing and power strategies in intra-cultural negotiations. Previously, the authors found that the relationship between cultural values or norms and joint gains was uncertain in six cultures: France, Russia, Japan, Hong Kong, Brazil, and the United States. Of the five values and norms measured, only norms for information sharing in negotiation were directly related to joint gains. This article explores and extends prior findings by investigating the strategies used by negotiators in the same six cultures. Cultures that maximized joint gains used direct information sharing strategies or a combination of indirect and direct strategies. Power strategies may help or hurt joint gains, depending on a culture’s values and norms for power and whether or not power-based influence is used in conjunction with sufficient information exchange. The findings suggest that understanding the other party’s cultural characteristics and strategies can help negotiators plan how to focus on information exchange and deal with unusual power strategies that they may encounter. This basic assumption taken was that uncertainty and tension caused by conflicts are reduced by these leadership styles in their own specific way. The assumption is supported that in case of little conflict the effect of charismatic and transactional leadership on satisfaction is positive and the effect of passive leadership on satisfaction is negative. With low levels of conflict, passive leadership has a negative effect on satisfaction. The effect is such that high levels of passive leadership go together with low levels of satisfaction. Regardless of the amount of passive leadership shown, high levels of task conflict go together with low levels of satisfaction. This is noticeable, because findings for the three conflict types are quite similar in respect to their direct effect on satisfaction and the moderating effect of charismatic and transactional leadership on the relationship between conflicts and satisfaction. Conflicts were found to have a negative relationship with satisfaction. As predicted charismatic and transactional leadership have a moderating effect on the relationship between conflicts and satisfaction, such that the negative effect of conflicts on satisfaction is reduced. The degree of passive leadership does not have significant effect in case of high conflict. However, in case of low task conflict passive leadership has a significant effect on satisfaction, such that a high degree of passive leadership leads to low satisfaction. Finally, autocratic leadership reduces the negative effect of relationship conflict. According to the results of the research, there exists a positive relationship between charismatic leadership and satisfaction. The effect is such that the higher the amount of charismatic leadership, the higher the satisfaction of the employee. The results showed that regardless of the amount of passive leadership shown, high levels of task conflict go together with low levels of satisfaction. However, in case of low levels of task conflict, high levels of passive leadership result in lower satisfaction, than low levels of passive leadership. The study also shows a positive main effect of transactional leadership on satisfaction. This effect is such that the higher the amount of transactional leadership, the higher the satisfaction of the employee. Transactional leadership reduces the negative effect of conflicts on satisfaction. There is a significant moderation effect for autocratic leadership in case of relationship conflict. Autocratic leadership reduces the negative effect of relationship conflict on satisfaction. The effect is such that an employee with an autocratic leader is more satisfied in case of relationship conflict. The results provide insufficient support in case of task and process conflict. Yet in another study, Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals by TOVA HENDEL PhD, RN, MIRI FISH MA, RN and VERED GALON BA identified conflict mode choices of head nurses in general hospitals and examine the relationship between leadership style, choice of strategy in handling conflicts and demographic characteristics. Nurse managers deal with conflicts daily. The choice of conflict management mode is associated with managerial effectiveness. The ability to creatively manage conflict situations, towards constructive outcomes is becoming a standard requirement. The use of appropriate conflict-handling modes in daily decision-making is one of many challenges facing nurse managers and is influenced both by the individual and the environment in which the person works. The Compromising mode was found to be the most frequent mode in use by head nurses in conflict management and Collaborating was found second most frequent. These results support some earlier research findings. Research studies, aimed at identifying dominant conflict modes in conflict management in nursing, have been published, mainly in the 1970s and 1980s, and presented varied results. Booth (1978) found that Smoothing (Accommodating) was used most frequently, Bargaining (Compromising) was second most frequent used mode, followed by Avoidance, Confrontation (Collaborating) and Forcing (Competing), in that order A decision resulting from Compromising (Bargaining) is often a short-term solution. The same issue may need to be dealt with by confrontation at a later date. It is not the optimal strategy to resolve conflict. It may be useful when a temporary solution is needed in a complex issue. Unfortunately, this strategy often leads to antagonism between groups. Each group frequently perceives that they have given more than the other, which results in a feeling of loss (Dove 1998). Constructive management of conflict can be viewed as a creative, cooperative problem-solving process, in which the conflict is defined as a mutual problem to be solved (Deutsch 2000). The mode of choice, as reflected in the literature, is Collaboration (Confrontation). Transformational organizational cultures tend to be characterized by flexibility and creativity with emphasis on questioning policies, strategies and methods used, to accrue effective organizational performance. Strongly centralized decision systems are associated with climates that restrict creativity and innovation (Ekvall 1996). Transformational leaders futuristic focus value creativity and innovation, and they are able to create synergistic environments that enhance collaboration towards change (Wolf et al. 1994). Organizational leadership sets the tone for conflict management. The nurse manager’s organizational work experience and her perspective on power may influence her choice of strategies in conflict management. The study results may be modified by the effect of the daily internal and external conflicts that they are involved in. The pattern of modification may be to reduce the rating of Collaboration and increase the rating of Experienced head nurses tend to prefer strategy that will maintain relationships in the long run, and no risk or harm relations with other members who are involved in the decisions. Organizational experience may have thought head nurses that in a competitive, unstable and hectic work environment, when colleagues have often superior power, a direct competition should be avoid and a pragmatic-oriented approach and a non-confrontational style is preferred. Through the process of organizational socialization, head nurses adopted, during the years, a submissive approach towards those who traditionally control the organization. Many developed a tendency not only to avoid direct confrontation, but also to prefer to adhere to none confrontational style. However, head nurses, with many years in position, who gain confidence, feel freer, than others, to use Collaborating as strategy in conflict management, as was found in the present study. Another result of this study indicate that approximately half of the respondents use only one mode in conflict management, i.e. their behavior characteristics in one conflict area characterized it in others. They did not adjust their choices to specific conditions and therefore may have not handle the conflict effectively. A leader should recognize which conflict management qualities and skills or solutions strategy is most appropriate for each situation (Marquis & Huston 1996). The literature emphasizes the importance that individuals and/or groups avoid becoming chronically committed to any one strategy, instead remaining skilled at each of them, particularly when trying to achieve enhanced environment or personal power (Coleman 2000). Leaders and Subordinates Conflict by Moritz Römer (KU Leuven/Schouten & Nelissen) discusses moderating effects of managerial conflict management styles on the relationship between task, relationship, and process conflicts among subordinates and individual well-being is examined. In this survey study 151 subordinates participated. Results confirmed that leaders’ forcing third party behavior amplifies the negative effects of all three different types of conflict on well-being and found no such moderator effects for problem solving and avoiding behavior with different kind of conflicts. This study contributes to the discussion of moderators on the detrimental effects of conflict with the integration of leader’s conflict management in different types of subordinates’ conflict and its effects. First, the effects of different kinds of leader’s Conflict management style on the conflict-outcome relation s examined and then the moderating effects of leaders’ conflict management style for three different types of conflict: task, relationship, and process conflict are studied. Correlation analyses showed that the three types of conflict are interrelated. The correlations of the three types of conflict are significant and similar to other studies. Conflict is associated with decreased employee’ well-being. This study investigated the moderator role of leader’s third party conflict management style on the subordinates’ conflict-outcome relationship. It was hypothesized leader’s third party problem solving, forcing, and avoiding conflict management style that affects the conflict-conflict stress relationship. Since conflict is associated with decreased individual well-being, understanding how leaders can deal with subordinates’ conflict can help organizations prevent conflicts’ detrimental effects. This research findings revealed that leaders’ behavior can have an amplifying effect on the relationship between conflict and individual well-being. The results confirmed that direct expression of power can create employee’ negative feelings and harm individuals’ well-being. To avoid harmful effects on employee’ well-being alternative strategies to express power on an indirect way should be employed. The results revealed no effects of avoiding behavior on the relationship between conflict and conflict stress. Organizational leaders should be aware of how employees perceive their third party conflict management style. Perceiving forcing behavior by the leader is likely to come together with higher conflict stress and therefore greater chance to affect performance. The results further revealed no different effects of conflict type. Accordingly, organizational leaders do have to be more aware of their own behavior and employees’ perception of that than what the conflict issue is about. Judith Brown, in his article “Conflict in inter professional primary health care teams” examined PHCTs members’ experiences with conflict and responses to conflict. The analysis revealed three main themes: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Sources of team conflict included: role boundary issues; scope of practice; and accountability. Barriers to conflict resolution were: lack of time and workload; people in less powerful positions; lack of recognition or motivation to address conflict; and avoiding confrontation for fear of causing emotional discomfort. Team strategies for conflict resolution included interventions by team leaders and the development of conflict management protocols. Individual strategies included: open and direct communication; a willingness to find solutions; showing respect; and humility. Conflict is inherent in teamwork. However, understanding the potential barriers to conflict resolution can assist PHCTs in developing strategies to resolve conflict in a timely fashion. While the issues of lack of time and workload cannot be eliminated, they can be addressed through creative strategies collectively designed by the team and endorsed by the overall organization. Participants identified how individuals in less powerful positions could be a barrier to conflict resolution. While nurses may have achieved more equality in the team environment, other team members with less status remain vulnerable as evidenced in this study. Mickan and Rodger’s (2000), literature review on characteristics of effective team work suggests that conflict resolution is impeded when the concerns and views of team members are devalued or dismissed. Participants expressed both frustration and concern about team functioning when individuals on the team either failed to recognize a conflictual situation or were not motivated to address the conflict. This was distinct from participants’ active avoidance of confrontation in order to protect other team members from emotional discomfort. In this instance, the participants viewed conflict avoidance as intentional, and while it may have been at the expense of team effectiveness, it appears to have been utilized to spare a breach in team. Conflict avoidance can lead to alliances and behaviors which are ultimately detrimental to overall team building and sustainment. In contrast, conflicts which are more instrumental or procedural maybe less threatening and more amenable (Payne, 2000). An important team strategy described by participants in addressing for conflict was the development and active use of conflict resolution protocols. Positions of leadership, as reported by the participants, were frequently filled by family physicians on the PHCT. Leaders must understand the essential elements of conflict in order to apply conflict resolution strategies. In addition, the participants identified specific characteristics of leaders as facilitating conflict resolution such as being accessible, non-judgmental, and employing good-listening skills. At an individual level, participants highlighted open and direct communication, a willingness to find solutions, showing respect, and the practice of humility. Perhaps, humility is the foundation on which good communication transpires and respect is enacted. Collectively these strategies support individuals, and teams as a whole, as they engage in seeking solutions to conflictual situations. Working together PHCTs can generate creative and innovative problem-solving skills to minimize the destructive influence of conflict on their teams. Finally, this study did not examine the specific developmental stage of the teams in relation to conflict and conflict resolution. In summary, conflict is inherent in team work. However, armed with an understanding of the potential barriers to conflict resolution PHCTs can be assisted in developing strategies to resolve conflict in a timely fashion and therefore improve both team functioning and patient care. Another study Task Versus Relationship Conflict, Team Performance, and Team Member Satisfaction by Carsten K. W. De Dreu and Laurie R. Weingart explained that Teamwork in organizations is increasingly the norm, yet the challenges of working effectively in teams are considerable. One challenge is conflict—the process resulting from the tension between team members because of real or perceived differences. Because team members contribute to the team through social inputs and task inputs, conflict in teams is concerned with relationship and task issues. Examples of relationship conflict are conflicts about personal taste, political preferences, values, and interpersonal style. Examples of task conflict are conflicts about the distribution of resources, procedures and policies, judgments and interpretation of facts. In the past 10 years, there has been a growing tendency in the literature to assume that, although relationship conflict hurts team effectiveness, task conflict can, under certain circumstances, be beneficial to team effectiveness. This study provides a meta-analysis of research on the associations between relationship conflict, task conflict, team performance, and team member satisfaction. Consistent with past theorizing, results revealed strong and negative correlations between relationship conflict, team performance, and team member satisfaction. In contrast to what has been suggested in both academic research however, results also revealed strong and negative (instead of the predicted positive) correlations between task conflict, team performance, and team member satisfaction. As predicted, conflict had stronger negative relations with team performance in highly complex (decision making, project, mixed) than in less complex (production) tasks. Finally, task conflict was less negatively related to team performance when task conflict and relationship conflict were weakly, rather than strongly, correlated. The study Politeness in Conflict: Identity Management and Politeness Strategies Used During a Conflict by Carly Gabrielle Sheridan aimed to assess the relationship between identity integration and politeness strategies used in a conflict that pulls at two aspects of a participants’ identity. Results found that there is a negative correlation between identity integration and overall politeness. In other words, participants who integrated their boss and friend identities were less polite (or less indirect) when criticizing the soldier. As mentioned, this trend was opposite to what was found in past studies with American participants, suggesting that verbal strategies used for politeness can be interpreted in different ways across cultures. Results also found that there is a positive correlation between the frequencies of strategies used and the overall category of politeness for the response. Additionally, the more impolite strategies used, the longer the response was. Contrary to predictions based on the Politeness Theory, these surprising results may be attributed to the fact that impolite people speak directly and are choosing to get their point across, which uses more words than a more polite response that sidesteps the real issue and therefore may save face by speaking less (Brown & Levinson, 1978; Holtgaves, 1986). Additionally, the longer one speaks, the more opportunity one has to use multiple strategies. Taking other people’s perspectives and understanding their feelings and actions can contribute to an increase in helping and understanding others as well as taking moral actions .This form of “self-other identification” can be important understanding one’s points of view which may enable people to assuage a conflict. Even in teams, perspective taking can positively impact conflict management by perceiving conflict as task-oriented rather than people-oriented, which places the blame on the task and minimizes intolerance towards an individual (Sessa, 1996). Norms of communication between the cultures may be different, as there may be a difference between the definition of politeness and what context it is most appropriately used. Regarding the study, an individual, being a commander and a friend, may care tremendously for his/her friend, but may feel like being direct, and therefore “impolite” according to the American definition, may be the best way to solve the problem and express their love and concern. In contrast, individuals from the United States may believe that being “polite” is the best way to express their concern, as they do not want to hurt their friends’ feelings. Thus, participants in both cultures are still expressing themselves in a polite and caring way, even if the definitions of politeness vary across cultures. Handshaking Promotes Cooperative Dealmaking by Juliana Schroeder, Jane Risen, Francesca Gino, and Michael I. Norton says humans use subtle sources of information—like nonverbal behavior—to determine whether to act cooperatively or antagonistically when they negotiate. Handshakes are particularly consequential nonverbal gestures in negotiations because people feel comfortable initiating negotiations with them and believe they signal cooperation (Study 1). We show that handshakes increase cooperative behaviors, affecting outcomes for integrative and distributive negotiations. In two studies with MBA students, pairs who shook hands before integrative negotiations obtained higher joint outcomes (Studies 2a and 2b). Pairs randomly assigned to shake hands were more likely to openly reveal their preferences on trade-off issues, which improved joint outcomes (Study 3). In a fourth study using a distributive negotiation, pairs of executives assigned to shake hands were less likely to lie about their preferences and crafted agreements that split the bargaining zone more equally. Together, these studies show that handshaking promotes the adoption of cooperative strategies and influences negotiation outcomes. A simple handshake can have large consequences for a negotiation. In this paper the authors suggest that handshakes before negotiations—or the lack thereof—serve as subtle but critical indicators of negotiators' social motives. In particular, handshakes signal willingness to act cooperatively during negotiations. The authors propose and show through experiments that handshakes increase cooperative behaviors at the bargaining table and, as a result, influence outcomes in both integrative and distributive negotiations. Integrative negotiations are those in which parties' interests are neither completely opposed nor completely compatible, allowing negotiators to mutually benefit by making efficient trades. In contrast, distributive or "zero-sum" negotiations—in which the parties' interests are completely opposed—are characterized by a different set of strategies such as appearing firm and even lying about one's interests. Further the article Conflict management and effectiveness in virtual teams By Pilar pazos (Department of Engineering Management and Systems Engineering, Old Dominion University, Norfolk, Virginia, USA) explored the role of goal‐oriented attitudes and behaviors as antecedents of conflict management and the subsequent impact of conflict management on team outcomes in virtual teams. Of particular interest is the role of “commitment to team goals” as a predictor of successful conflict management and the subsequent impact of conflict management on team outcomes. He described the results from a quasi‐experimental study examining the relationships among commitment to team goals, conflict management and team outcomes in virtual teams. First, it provides an in depth review of relevant empirical findings. Next, it describes a study examining the relationships between three sets of variables: commitment to team goals; conflict management; and team outcomes (performance and attitudinal) in the context of virtual teams. Data were collected from 141 students grouped in 39 teams’ size 3 to 4 that were part of four cohorts of an Engineering Management course. The results provide some preliminary evidence that conflict management mediated the relationships between goal commitment and team outcomes. Results suggest that commitment to team goals is a significant predictor of successful conflict management. Findings also suggest that teams that are more actively involved in preventing and solving their conflict experience a significant increase in the relationship between commitment to team goals and team performance, suggesting that use of effective conflict management can support team effectiveness in the context of virtual teams. Finally, limitations and suggestions for future research are presented. Superiors' Conflict Management Strategies and Subordinate Outcomes by Deborah Weider-Hatfield and John D. Hatfield summarized the extant research investigating the relationships between managers' conflict management strategies and subordinate outcomes and reports the results of a study investigating relationships between a manager's use of collaborating, forcing, and accommodating and four types of rewards (system, job, performance, and interpersonal) subordinates might experience at work. The results show significant positive relationships between a manager's collaborating strategies and subordinates' experiencing interpersonal and performance rewards and significant negative relationships between a manager's forcing strategies and those same outcomes. No relationship was found between a manager's accommodating strategies and subordinates' perceived rewards or between any of the strategies and system rewards. Pakistan Institute of Medical Sciences Islamabad Overview: Pakistan Institute of Medical Sciences (PIMS) is a research oriented health sciences institute located in Islamabad, Pakistan. It is one of the region’s leading tertiary level hospitals which includes 22 medical and surgical specialist centers. It provides medical training through the Quaid-e-Azam Postgraduate Medical College which was established in 1st February 1989. Since its opening in 1985, P.I.M.S. has been expanding its services and equipment to meet the growing healthcare needs of the human community. Objectives of P.I.M.S. are to provide a tertiary level patient care and serve as referral hospital also to conduct teaching/ training of doctors and other health workers at various level in the field of medicine and surgery. The establishment of the Pakistan Institute of Medical Sciences (P.I.M.S) in Islamabad heralds a bright new era for the citizens of Pakistan, especially the residents of the Federal Capital. The plan, conceived in the sixties (1960s), has finally been implemented. Initially named as the Islamabad Hospital Complex (IHC), the original site was located within the premises of the National Institute of Health but was shifted in favor of the present site due to its central position. In 1975, the Capital Development Authority (CDA), outlined a plan for the construction of an inpatients block. Pakistani engineers prepared a master plan by 1978, envisaging ample room for future alteration and expansion. Apart from providing medical facilities to the resident of Rawalpindi-Islamabad and surrounding areas, the PIMS will function as a National Reference Centre for providing specialized diagnostic and curative services to the patients referred by other hospitals/institution. When fully functional the Pakistan Institute of medical Sciences will be a centre of excellence and a model of medical education and research. Conflict in Teams: Conflict is an expressed struggle between at least two people who perceive the situation differently and are experiencing interference from the other person in achieving their goals. In the workplace, a simple disagreement between team members, if unresolved, may escalate into avoidance, inability to work together, verbal assaults, and resentment. In the worst cases, it may also lead to hostility and eventual separation from the organization. Therefore, it is important that the conflict be resolved as soon as possible. Conflict arises from a multitude of sources that reflect the differences in personality, values, ideologies, religion, culture, race, and behavior. It also arises from simple misunderstandings. The key issue in dealing with team conflict is for the team to realize that the focus is not on conflict itself, but how it is managed. The consequences of poorly handled team conflict result lowering of team energy, disruption of healthy relationships, and the prevention of job accomplishment. Certain causes for team conflict include, perceived breach of faith; unresolved disagreement, miscommunication, personality clashes, differences in acquired values, underlying stress and tension, ego problems, etc. Certain curing measures for the resolution of conflicts are improved communication skills, team counseling, relinquishing, accommodating, collaborating, listening, responding, understanding, etc. Key guidelines for avoiding or resolving team conflicts include, reaching consensus through collaboration, controlling emotional outburst, enhance self-esteem, preserve individual dignity, listen carefully and with empathy, be honest about concerns, get individual ego out of management style, etc. Valuable suggestions to resolve conflicts are: Training on the human dynamics of working Together, gain alignment around core team processes, develop a conflict resolution process, keep Disagreement from escalating into conflict, develop a relationship with difficult team members, etc. Conflict pervades the core of team processes, and, if un-addressed, conflict serves to stunt the development of a team. Causes of Team Conflict: Conflict begins due to poor communication, seeking power, dissatisfaction with management style, weak leadership, lack of openness, and change in leadership (N.S.B.A. 2007).Conflict may stem from a variety of causes, and understanding them is the first step in dealing with it effectively. Following are the most common reasons for conflict. 1. Perceived breach of faith and trust: There is a perceived breach of faith and trust between individuals. When one puts faith and trust in another, and that confidence is broken, it can create an emotional response that elevates to conflict. 2. Unresolved disagreements: Disagreements are normal. When they are left unresolved, however, the associated feelings and emotions will remain in force, at least at some level. When another situation brings this disagreement back to the forefront, these suppressed emotions can erupt with force, usually far in excess of those associated with the original disagreement. Therefore, it is critically important to resolve disagreements as soon as possible and not let them continue. 3. Miscommunication: The ability to communicate is one of our most commonly used skills. We sometimes use words to communicate do not always clearly state the picture in our minds. When this occurs, errors often result that lead to frustration. Depending on a multitude of factors (stress level for one), the error sometimes results in conflict if neither person is willing to accept responsibility for it. 4. Personality clashes: We are all different. Experts say that our personalities are genetically determined resulting in different sets of preferred behaviors. These natural sets of differences are some of our greatest strengths as individuals and teams; however, they are also sources of conflict. 5. Differences in acquired values: Our values are the beliefs we hold that help us to make decisions about what is right or wrong, good or bad, and normal or not normal. Our values come from parents, siblings, friends, mentors, coaches, teachers, books, churches, movies, television, music and life in general. No two people ever have the same life experience, so we ultimately have different sets of values and beliefs that guide our decisions and behavior. So, value system is a strong driver of behavior and a frequent source of conflict in our lives and in our teams. 6. Underlying stress and tension: Our lives today place enormous demands on our time and energy. But frequently those demands exceed our capacity to deal with them. Never the less, we come to work and attempt to function normally with our team members. Too often, however, this underlying stress surfaces at the slightest provocation, and we find ourselves in conflict. 7. Ego problems: Ego is another strong driver of human behavior and decisions. Ego wants us to be right and moves people into defending their position, sometimes unreasonably. One of the quickest ways to diffuse an argument or conflict is to admit one’s mistakes. At a minimum, move out of ego and attempt to see the situation from the other person’s point of view. 8. Combinations of the above: Conflict situations are rarely clear-cut, single-source events. Usually, they are a combination of the factors listed. One may have a disagreement that’s stemmed from a miscommunication. Problem Statement Conflict in inter professional primary health care teams (PIMS). Three main themes in inter professional conflict revealed are: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Examining Teamconflict and Inter professional conflict at PIMS Three main themes in inter professional conflict revealed in the study are: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Sources of team conflict included: role boundary issues; scope of practice; and accountability. Barriers to conflict resolution were: lack of time and workload; people in less powerful positions; lack of recognition or motivation to address conflict; and avoiding confrontation for fear of causing emotional discomfort. Team strategies for conflict resolution included interventions by team leaders and the development of conflict management protocols. Individual strategies included: open and direct communication; a willingness to find solutions; showing respect; and humility. Conflict is inherent in teamwork. Dr. Ghazalla elaborated that while the issues of lack of time and workload cannot be eliminated, they can be addressed through creative strategies collectively designed by the team and endorsed by the overall organization. Participants (doctors at PIMS) identified how individuals in less powerful positions could be a barrier to conflict resolution. While nurses may have achieved more equality in the team environment, other team members with less status remain vulnerable as evidenced in this study. The participants viewed conflict avoidance as intentional, and while it may have been at the expense of team effectiveness, it appears to have been utilized to spare a breach in team. Conflict avoidance can lead to alliances and behaviors which are ultimately detrimental to overall team building and sustainment. In contrast, conflicts which are more instrumental or procedural maybe less threatening and more amenable. An important team strategy described by participants in addressing for conflict was the development and active use of conflict resolution protocols. Positions of leadership, as reported by the participants, were frequently filled by family physicians on PHCT. Leaders or in this case senior doctors must understand the essential elements of conflict in order to apply conflict resolution strategies. In addition, the participants identified specific characteristics of leaders as facilitating conflict resolution such as being accessible, non-judgmental, and employing good-listening skills. At an individual level, participants highlighted open and direct communication, a willingness to find solutions, showing respect, and the practice of humility. Perhaps, humility is the foundation on which good communication transpires and respect is enacted. Collectively these strategies support individuals, and teams as a whole, as they engage in seeking solutions to conflictual situations. Finally, this study did not examine the specific developmental stage of the teams in relation to conflict and conflict resolution. In summary, conflict is inherent in team work. However, armed with an understanding of the potential barriers to conflict resolution Professional Health Care Teams can be assisted in developing strategies to resolve conflict in a timely fashion and therefore improve both team functioning and patient care. A total of 30 Participants who are doctors at PIMS with different specializations participated in the study by filling out the Questionnaire designed during the study. Participants reported their perceptions on conflict in teams or inter professional conflict, conflict management strategies used, and the productivity of conflict, using scales developed for this study in the Questionnaire. Discussions were being held with doctor “Ghazalla Mahmud” regarding her perception about the inter-professional conflict which may have persisted during her experience, how do she and other doctors perceive the conflict in team and how do they counter it? People use varying styles in responding to conflict. Avoidance is failure to confront or attempt to resolve conflict. This demonstrates low concern for the outcomes of either party. Conflict should be addressed and managed timely. Nurse Managers deal with conflicts daily. The Compromising mode was found to be the most frequent mode in use by head nurses in conflict management and Collaborating was found second most frequent. However, head nurses, with many years in position, who gain confidence, feel freer, than others, to use Collaborating as strategy in conflict management, as was found in the present study. Another result of this study indicate that approximately half of the respondents use only one mode in conflict management, i.e. their behavior characteristics in one conflict area characterized it in others. They did not adjust their choices to specific conditions and therefore may have not handle the conflict effectively. A leader should recognize which conflict management qualities and skills or solutions strategy is most appropriate for each situation. The study emphasizes the importance that individuals and/or groups avoid becoming chronically committed to any one strategy, instead remaining skilled at each of them, particularly when trying to achieve enhanced environment or personal power. The main purpose in this study was to examine specific conflict resolution strategies in teams and between inter professionals to better understand their potential effects on performance and satisfaction. These individuals in this research are performing the same task assignments and evaluation criteria. Our research’s overall goals would be to oversee: 1. The research gives a good overall view about the working of Senior doctors (in management) what really is team conflict, inter professional conflict, and conflict management. 2. Causes of conflict Specific research hypotheses are also being drawn for this research. The research hypotheses would be empirically tested in a study involving 30 doctors of PIMS. Finally, the results of hypothesis testing would be presented and discussed. Hypothesis: Our hypothesis suggest that Hypothesis 1: Trust within a team promotes team performance. . Our hypothesis suggest that Hypothesis 2: Team cooperative conflict management promotes Methodology: A Quantitative research is proposed for this study. Quantitative research is used because it is easier to compile the data onto a chart or graph because of the numbers that are made available. Another reason for using quantitative research is that the research can be conducted on a large scale and gives a lot more information as far as value and statistics. We have used the following options in our questionnaire: • Once a day • Once a week • Once a month • Extreme • Moderate • Not at all • More often • Once a blue moon • less often Open ended questions were not used in the questionnaire. Sampling Area The research was conducted from the doctors of PIMS Islamabad. Data Collection and Analysis A questionnaire consisting of 20 questions was prepared. 30 Questionnaires were filled by doctors at PIMS randomly. All published information regarding team conflict, inter-professional conflict and organization was collected from available authentic source i.e. Journals, articles, company websites etc. The data after collection was tested to verify the hypothesis of the research. For every component of the questionnaire Line graphs or bar graphs were be made to represent the survey report. Responses from each question of the questionnaire will be analyzed so that an insight is developed. The data is interpreted through bar graphs and pie charts showing the results of each question. The data was collected through the thirty questionnaires, out of 30 participants 13 said there is conflict among the colleagues at least once a week, 7 said once a day and 10 participants said that there is conflict among the colleagues once a month. 47% of the sample believed that the personality conflict is witnessed more often. 13% indicated that the personality conflict is witnessed once a blue in PIMS while 40% said it is experienced less often. The participants agreed that there exists tension between the colleagues and teams, 10 participants agreed that there is tension between colleagues once a day, 10 responded that its once a week and another 10 responded that its once a month. 54% of the sample responded that there exists emotional conflict among the colleagues more often,43% said there is less emotional conflict among the colleagues while 3% said there is emotional conflict once a blue moon. 16 participants said there are conflicts about ideas in work unit more often.3 participants said once a blue moon while 11 participants said its less often. 17 participants said more often they and their colleagues in a team disagree about opinions regarding the work being done.4 said once a blue moon while 9 said less often. 15 participants said that they have conflict about reasons and solutions of work-related problems in a team once a week while 10 said its once a day. 67% of the sample believed there exists moderate differences of opinion in work unit while 17% there is no difference of opinion at all and 16% believed there is extreme difference of opinions. 14 participants believed there are disagreements at least once a month about who should do what in team.12 said its once a week while 4 believed its once a day. 43% of the sample said that they disagree about resource allocation in team once a month, 23% said once a day and 34% said its once a week. There are disagreements more often about how work has to be done in team said 11 participants,13 participants said its less often while 6 participants it happens once a blue moon. 22 participants believed there is more conflict in group about task responsibilities, 4 participants believed there is less conflict about task responsibilities and 4 participants believed there is no conflict at all. 15 participants indicated that they feel less nervous during or directly after a conflict with colleagues, 7 participants said that they are more nervous while 8 participants said they do not feel nervous at all. 37% of the sample said that they become upset more often during or directly after a conflict with colleagues,40% said they are upset less often after a conflict while 23% said they are upset once a blue moon. 14 participants indicated that once a blue moon the stress in a conflict with colleagues increase to such high levels that they cannot let go of it.9 participants indicated its more often while 7 participants said its less often. 15 participants believed that they feel tension more often during or directly after a conflict with colleagues, 9 participants said its once a blue moon while 6 participants believed its less often. 60% of the participants said that they have a sharing working relationship. They can freely share ideas, feelings, and hopes, can talk freely to other teammates about difficulties.17% of the participants believed they feel a sense of loss if one of them was transferred and could no longer work together.23% believed that they respond constructively and caringly in teams. 47% believe their teammates approach their jobs with professionalism and dedication.17% said they see no reason to doubt their team mates competence and preparation for job.3% said they can rely on my teammates.20% said they trust and respect co -workers.13% said that other work associates are trustworthy. Participants were asked to describe how they feel when their group members handle disagreements.20% indicated that team encourages "we are in it together" attitude. 23% believed team seeks solution that will be good for all of us.23% indicated team treats conflict as a mutual problem to solve.20% said that the team works so that to the extent possible they all get what they really want.14% said team combines the best of positions to make an effective decision. Participants were asked to describe what they do in a conflict situation.40% believed teams encourage "we are in it together" attitude.50% indicated that the teams seek a solution that will be good for all teams. 3% believed that the teams treat conflict as a win-lose contest. While 7% said that the teams overstate their position to get their way. Graphical Representation of Results: The data was collected through the thirty questionnaires, out of 30 participants 13 said there is conflict among the colleagues at least once a week, 7 said once a day and 10 participants said that there is conflict among the colleagues once a month. 47% of the sample believed that the personality conflict is witnessed more often. 13% indicated that the personality conflict is witnessed once a blue in PIMS while 40% said it is experienced less often. The participants agreed that there exists tension between the colleagues and teams, 10 participants agreed that there is tension between colleagues once a day, 10 responded that its once a week and another 10 responded that its once a month. 54% of the sample responded that there exists emotional conflict among the colleagues more often,43% said there is less emotional conflict among the colleagues while 3% said there is emotional conflict once a blue moon. 16 participants said there are conflicts about ideas in work unit more often.3 participants said once a blue moon while 11 participants said its less often. 17 participants said more often they and their colleagues in a team disagree about opinions regarding the work being done.4 said once a blue moon while 9 said less often. 15 participants said that they have conflict about reasons and solutions of work-related problems in a team once a week while 10 said its once a day. 67% of the sample believed there exists moderate differences of opinion in work unit while 17% there is no difference of opinion at all and 16% believed there is extreme difference of opinions. 14 participants believed there are disagreements at least once a month about who should do what in team.12 said its once a week while 4 believed its once a day. 43% of the sample said that they disagree about resource allocation in team once a month, 23% said once a day and 34% said its once a week. There are disagreements more often about how work has to be done in team said 11 participants,13 participants said its less often while 6 participants it happens once a blue moon. 22 participants believed there is more conflict in group about task responsibilities, 4 participants believed there is less conflict about task responsibilities and 4 participants believed there is no conflict at all. 15 participants indicated that they feel less nervous during or directly after a conflict with colleagues, 7 participants said that they are more nervous while 8 participants said they do not feel nervous at all. 37% of the sample said that they become upset more often during or directly after a conflict with colleagues,40% said they are upset less often after a conflict while 23% said they are upset once a blue moon. 14 participants indicated that once a blue moon the stress in a conflict with colleagues increase to such high levels that they cannot let go of it.9 participants indicated its more often while 7 participants said its less often. 15 participants believed that they feel tension more often during or directly after a conflict with colleagues, 9 participants said its once a blue moon while 6 participants believed its less often. 60% of the participants said that they have a sharing working relationship. They can freely share ideas, feelings, and hopes, can talk freely to other teammates about difficulties.17% of the participants believed they feel a sense of loss if one of them was transferred and could no longer work together.23% believed that they respond constructively and caringly in teams. 47% believe their teammates approach their jobs with professionalism and dedication.17% said they see no reason to doubt their team mates competence and preparation for job.3% said they can rely on my teammates.20% said they trust and respect co -workers.13% said that other work associates are trustworthy. Participants were asked to describe how they feel when their group members handle disagreements.20% indicated that team encourages "we are in it together" attitude. 23% believed team seeks solution that will be good for all of us.23% indicated team treats conflict as a mutual problem to solve.20% said that the team works so that to the extent possible they all get what they really want.14% said team combines the best of positions to make an effective decision. Participants were asked to describe what they do in a conflict situation.40% believed teams encourage "we are in it together" attitude.50% indicated that the teams seek a solution that will be good for all teams. 3% believed that the teams treat conflict as a win-lose contest. While 7% said that the teams overstate their position to get their way. What situations generate conflict? (Causes) Personality Differences Incompatibilities between and amongst persons can include “personality clashes, tension and annoyance. Individuals have unique personalities and vary in attitudes, opinion, beliefs, culture emotional stability, maturity, education, gender, language, etc. Therefore, their reactions to specific stimuli also differ. These differences cause some individuals to perceive some matters as undermining their positions or refuting their worldviews or values. Oftentimes, individual differences can adopt moral and/or emotional undertones, turning a disagreement over who is factually right or wrong into a bitter squabble over who is morally correct. Value Differences Dr. Ghazalla said Physician-nurse conflict arose when a nurse refused to follow a physician-prescribed order to administer a potent sedative to a 47-year-old patient. The physician, the patient and the patient’s wife had earlier agreed to initiate controlled sedation to the patient, who was seeking to hasten death. A nurse who worked during the previous shift felt uncomfortable with the order as well because it seemed excessive at that point in the patient’s disease progression. Health care workers are able to refuse patient care assignments when they are “ethically or morally opposed to interventions or procedures in a particular case. The polarity of values on the hospice unit created conflict among the physician, the nurses, the patient, and the patient’s family. Blurred Boundaries Multiple scholars reveal that conflicts among interdependent health care workers may occur from discrepancies about which professional is responsible for performing certain roles or making treatment decisions rather than disagreement over the procedure plan chosen (Jameson, 2003). Blurred boundaries between nurses and physicians lead to conflict when senior-level nurses, who are experts in their specialties, “frequently fail to observe the formal boundaries of nursing practice” The advancement of the nursing field creates inter-professional conflict between nurses and physicians who are unwilling to accept the evolution of the nurse practitioner profession. Many nurses today hold equal or increased academic qualifications as physician. Findings: It was seen that there were more respondents who faced conflicts once a week in a team as compared to other options and the conflicts were due to different leadership and personality styles. The ideas were not heard much. There was less often disagreement in opinions during a team discussion. The disagreements on some issue were monthly because everyone knows their duties so there was not much confusion about who should do what. Everyone is confident so there is no one nervous during the conflict (doctors). They are used to take pressure so they can manage stress during a conflict. It is very rare if they cannot. They freely share ideas and respond constructively to each other so there were very few who feel lost. Everyone is professional and dedicated and do not rely on teammates. Overall the doctors have a positive attitude. According to the literature review understanding the other party cultural characteristics and strategies can help negotiators plan how to focus on information exchange and deal with unusual power strategies that they may encounter. On the other hand interpersonal conflict between leader and employee negatively affect satisfaction and this relationship is buffered by high amounts of charismatic transactional and autocratic leadership. Collectively these strategies support individuals, and teams as a whole, as they engage in seeking solutions to conflictual situations. Finally, this study did not examine the specific developmental stage of the teams in relation to conflict and conflict resolution. In summary, conflict is inherent in team work. However, armed with an understanding of the potential barriers to conflict resolution Professional Health Care Teams can be assisted in developing strategies to resolve conflict in a timely fashion and therefore improve both team functioning and patient care. Comparison of the results: Three main themes in inter professional conflict revealed in the study are: sources of team conflict; barriers to conflict resolution; and strategies for conflict resolution. Sources of team conflict included: role boundary issues; scope of practice; and accountability. Barriers to conflict resolution were: lack of time and workload; people in less powerful positions; lack of recognition or motivation to address conflict; and avoiding confrontation for fear of causing emotional discomfort. Team strategies for conflict resolution included interventions by team leaders and the development of conflict management protocols. Individual strategies included: open and direct communication; a willingness to find solutions; showing respect; and humility. Conflict is inherent in teamwork. Dr Ghazalla elaborated that while the issues of lack of time and workload cannot be eliminated, they can be addressed through creative strategies collectively designed by the team and endorsed by the overall organization. Participants (doctors at PIMS) identified how individuals in less powerful positions could be a barrier to conflict resolution. While nurses may have achieved more equality in the team environment, other team members with less status remain vulnerable as evidenced in this study. Conflict avoidance can lead to alliances and behaviors which are ultimately detrimental to overall team building and sustainment. In contrast, conflicts which are more instrumental or procedural maybe less threatening and more amenable. An important team strategy described by participants in addressing for conflict was the development and active use of conflict resolution protocols. According to the article the conflict is related to the performance and trust in a team. Teams adopting a cooperative approach to resolve conflicts reported higher levels of affect-based trust, although there do not appear to be any performance consequences of this. The competitive, win-lose, approach to conflict was negatively associated with cognition-based trust that reduced team performance. On the other hand an employee’s perceptions of how a leader has behaved as a third party to a conflict can amplify as well as buffer the employee’s experience of stress due to workplace conflict. These are important findings because dealing with conflicts is a major task of organizational leaders. Based on our results, leaders should be aware of the effects their behavior can have on employees’ conflict-related stress. Specifically, forcing and avoiding behavior need to be used cautiously. Problem-solving behavior, particularly in relationship conflict, can help alleviate the stress experienced by colleagues in conflict. Therefore this is similar to our findings but where there is a conflict it should be solved as soon as possible. Questionnaire used: Q1.How often is there conflict among colleagues in your work team? Once a day Once a week Once a month Q2.How often are personality conflicts evident among colleagues in your work team? More often Once a blue moon Less often Q3.How often is there tension among colleagues in your work team? Once a day Once a week Once a month Q4.How often are there emotional conflicts among colleagues in your team? More often Once a blue moon Less often Q5.How frequently are there conflicts about ideas in your work unit? More often Once a blue moon Less often Q6.How often do you and your colleagues in your team disagree about opinions regarding the work being done? More often Once a blue moon Less often Q7.How frequently do you and your colleagues in your team have conflict about reasons and solutions of work-related problems? Once a day Once a week Once a month Q8.To what extent are there differences of opinion in your work unit? Extreme Moderate Not at all Q9.How often are there disagreements about who should do what in your team? Once a day Once a week Once a month Q10.How often do you disagree about resource allocation in your team? Once a day Once a week Once a month Q11.How often are there disagreements about how work has to be done in your team? More often Once a blue moon Less often Q12.How much conflict is there in your group about task responsibilities? More Less Not at all Q13.How often do you feel nervous during or directly after a conflict with colleagues? More Less Not at all Q14.How often do you become upset during or directly after a conflict with your colleagues? More often Once a blue moon Less often Q15.How often does the stress in a conflict with colleagues increase to such high levels that you cannot let go of it? More often Once a blue moon Less often Q16.How often do you feel tension during or directly after a conflict with colleagues? More often Once a blue moon Less often Q17.Please describe working relationships in your team: We have a sharing relationship. We can freely share our ideas, feelings, and hope, can talk freely to other teammates about difficulties I am having at work and know that they will want to listen. We would all feel a sense of loss if one of use was transferred and we could no longer work together. If I share my problems with other teammates, I know they would respond constructively and caringly. Q18.Please describe working relationships in your team: My teammates approach their jobs with professionalism and dedication. Given my teammates' track record, I see no reason to doubt their competence and preparation for our job. I can rely on my teammates not to make my job more difficult by careless work. Most people, even those who aren't close friends of my teammates, trust and respect them as co- workers. Other work associates who must interact with my teammates consider them to be trustworthy. Q19.Please describe how you feel when your group members handle disagreements: Our team encourages "we are in it together" attitude. Our team seeks solution that will be good for all of us. Our team treats conflict as a mutual problem to solve. Our team works so that to the extent possible they all get what they really want. Our team combines the best of positions to make an effective decision. Q20 What do you do in a conflict situation? Teams encourage "we are in it together" attitude. Teams seek a solution that will be good for all teams. Teams treat conflict as a win-lose contest. Teams overstate their position to get their way References www.jstor.org www.google.com www.library.bahria.edu.pk www.pims.gov.pk 28 | Page