Isbouts Lisa N, Muijtjens Arno M M, van Mook Walther N K A, Busari Jamiu O
Department of Pediatrics, Radboud University Medical Centre, Nijmegen, the Netherlands.
Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
Int J Med Educ. 2019 Feb 28;10:45-53. doi: 10.5116/ijme.5c6c.3430.
This study explores the optimal focus for negotiation skills development training by investigating how often medical residents negotiate in practice, and how they perceive the effectiveness of their negotiation capabilities.
An exploratory study was performed using a questionnaire regarding the medical residents' working environment, negotiation frequency, knowledge and skills using a 5-point Likert scale, multiple choice questions and open questions. Exploratory factor analysis with principal component analysis, varimax rotation, reliability analysis, and content analysis were used to reduce the number of variables. Descriptive and interferential statistics and multiple regression analysis were used to analyze the data.
We analyzed the responses of 60 medical residents. The findings showed that the perceived development of their negotiation knowledge (M=3.06, SD=0.83) was less than their negotiation skills (M=3.69, SD=0.47). Their attitude during negotiations, especially females, differed substantially in the interactions with nurses than with their supervisors. Medical residents with more working experience, better negotiation skills or who worked in hierarchical environments negotiated more frequently with their supervisors. Medical residents with better collaboration skills and negotiation knowledge demonstrated better negotiation skills.
This study underlines medical residents' need for negotiation training. In addition to the basic negotiation knowledge and skills, training programs in negotiation should focus on the medical residents' awareness of their attitudes during negotiations, combining the assertiveness shown in interactions with supervisors with the empathy and emotional engagement present in interactions with nurses. Furthermore, attention should be paid to the influence of the environmental hierarchy on negotiation skill development.
本研究通过调查住院医师在实际工作中进行谈判的频率，以及他们对自身谈判能力有效性的认知，探索谈判技巧发展培训的最佳重点。
采用问卷调查法进行探索性研究，问卷涉及住院医师的工作环境、谈判频率、知识和技能（采用5点李克特量表、多项选择题和开放式问题）。运用主成分分析、方差最大旋转的探索性因子分析、信度分析和内容分析来减少变量数量。使用描述性和推断性统计以及多元回归分析来分析数据。
我们分析了60名住院医师的回复。结果显示，他们认为自己谈判知识的发展程度（M = 3.06，标准差 = 0.83）低于谈判技能（M = 3.69，标准差 = 0.47）。他们在谈判中的态度，尤其是女性，在与护士的互动中与与上级的互动中有很大差异。工作经验更丰富、谈判技能更好或在等级森严环境中工作的住院医师与上级谈判更频繁。协作技能和谈判知识更好的住院医师表现出更好的谈判技能。
本研究强调了住院医师对谈判培训的需求。除了基本的谈判知识和技能外，谈判培训项目应关注住院医师在谈判过程中的态度意识，将与上级互动中表现出的坚定与与护士互动中体现的同理心和情感投入相结合。此外，应关注环境等级制度对谈判技能发展的影响。
