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住院医师行为与托马斯-基尔曼冲突模式工具之间的关联

The Associations Between Residents' Behavior and the Thomas-Kilmann Conflict MODE Instrument.

作者信息

Ogunyemi Dotun, Fong Susie, Elmore Geoff, Korwin Devra, Azziz Ricardo

出版信息

J Grad Med Educ. 2010 Mar;2(1):118-25. doi: 10.4300/JGME-D-09-00048.1.

Abstract

OBJECTIVE

To assess if the Thomas-Kilmann Conflict MODE Instrument predicts residents' performance.

STUDY DESIGN

Nineteen residents were assessed on the Thomas-Kilmann conflict modes of competing, collaborating, compromising, accommodating, and avoiding. Residents were classified as contributors (n  =  6) if they had administrative duties or as concerning (n  =  6) if they were on remediation for academic performance and/or professionalism. Data were compared to faculty evaluations on the Accreditation Council for Graduate Medical Education (ACGME) competencies. P value of < .05 was considered significant.

RESULTS

Contributors had significantly higher competing scores (58% versus 17%; P  =  .01), with lower accommodating (50% versus 81%; P 5 .01) and avoiding (32% versus 84%; P  =  .01) scores; while concerning residents had significantly lower collaborating scores (10% versus 31%; P  =  .01), with higher avoiding (90% versus 57%; P  =  .006) and accommodating (86% versus 65%; P  =  .03) scores. There were significant positive correlations between residents' collaborating scores with faculty ACGME competency evaluations of medical knowledge, communication skills, problem-based learning, system-based practice, and professionalism. There were also positive significant correlations between compromising scores and faculty evaluations of problem-based learning and professionalism with negative significant correlations between avoiding scores and faculty evaluations of problem-based learning, communication skills and professionalism.

CONCLUSIONS

Residents who successfully execute administrative duties are likely to have a Thomas-Kilmann profile high in collaborating and competing but low in avoiding and accommodating. Residents who have problems adjusting are likely to have the opposite profile. The profile seems to predict faculty evaluation on the ACGME competencies.

摘要

目的

评估托马斯 - 基尔曼冲突模式工具能否预测住院医师的表现。

研究设计

对19名住院医师的竞争、合作、妥协、迁就和回避等托马斯 - 基尔曼冲突模式进行评估。若住院医师承担行政职责,则被归类为贡献者(n = 6);若因学业表现和/或职业素养问题而接受辅导,则被归类为有问题者(n = 6)。将这些数据与教师对毕业后医学教育认证委员会(ACGME)能力的评估进行比较。P值<0.05被认为具有统计学意义。

结果

贡献者的竞争得分显著更高(58%对17%;P = 0.01),迁就得分较低(50%对81%;P<0.01),回避得分较低(32%对84%;P = 0.01);而有问题的住院医师合作得分显著较低(10%对31%;P = 0.01),回避得分较高(90%对57%;P = 0.006),迁就得分较高(86%对65%;P = 0.03)。住院医师的合作得分与教师对ACGME医学知识、沟通技能、基于问题的学习、基于系统的实践和职业素养等能力的评估之间存在显著正相关。妥协得分与教师对基于问题的学习和职业素养的评估之间也存在显著正相关,而回避得分与教师对基于问题的学习、沟通技能和职业素养的评估之间存在显著负相关。

结论

成功履行行政职责的住院医师可能具有托马斯 - 基尔曼模式,即合作和竞争得分高,但回避和迁就得分低。难以适应的住院医师可能具有相反的模式。这种模式似乎可以预测教师对ACGME能力的评估。

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