Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Institute of Sociological Research, University of Geneva, Geneva, Switzerland.
Med Educ. 2019 Aug;53(8):799-807. doi: 10.1111/medu.13881. Epub 2019 Apr 15.
In the clinical environment, health care professionals self-categorise into different groups towards which they develop positive attitudes, whereas they view other groups less favourably. Social identity theory purports that these attitudes influence group processes and may foster conflicts that impede collaborative practice, although this relationship is poorly understood. This study used concepts from social identity theory to examine the interplay between group processes and conflicts, as well as the consequences of these conflicts, with the goal of identifying educational strategies to favour teamwork.
Semi-structured interviews with 82 randomly selected physicians and nursing professionals working at a Swiss academic medical centre explored participants' experiences of conflicts. Data analysis was informed by social identity theory and focused on interviews where group processes were highlighted by participants. The analysis sought to uncover how group processes were intertwined with conflicts and how they affected health care professionals.
A total of 42 participants out of the initial pool of 82 interviews shared 52 stories of conflicts involving group processes. Most of these stories were shared by physicians and involved groups of physicians at different hierarchical levels. Conflicts and group processes were linked in two ways: (i) through processes of group membership when individuals struggled to join a relevant group, and (ii) through intergroup boundaries, such as when participants perceived that power differentials disadvantaged their own groups. Conflicts could lead to difficult experiences for clinicians who questioned their abilities, became disillusioned with their professional ideals and developed negative perceptions of other groups.
This study suggests that conflicts involving group processes may lead to stronger intergroup boundaries, challenging current educational efforts to favour teamwork in health care. Taking steps to create more inclusive groups and to encourage perspective taking may help manage intergroup conflict.
在临床环境中，医疗保健专业人员会自我分类为不同的群体，对某些群体持积极态度，而对其他群体的看法则不太有利。社会认同理论认为，这些态度会影响群体过程，并可能助长阻碍合作实践的冲突，尽管这种关系尚未得到充分理解。本研究使用社会认同理论的概念来检验群体过程和冲突之间的相互作用，以及这些冲突的后果，目的是确定有利于团队合作的教育策略。
对瑞士学术医疗中心的 82 名随机选择的医生和护理专业人员进行半结构化访谈，以探讨参与者的冲突经历。数据分析以社会认同理论为依据，并侧重于参与者强调群体过程的访谈。分析旨在揭示群体过程如何与冲突交织在一起，以及它们如何影响医疗保健专业人员。
在最初的 82 次访谈中，共有 42 名参与者分享了 52 个涉及群体过程的冲突故事。这些故事大多是由医生分享的，涉及不同层级的医生群体。冲突和群体过程以两种方式联系在一起：（i）当个体努力加入一个相关群体时，通过群体成员身份的过程；（ii）通过群体之间的界限，例如当参与者认为权力差异使他们自己的群体处于不利地位时。冲突可能会给临床医生带来困难的经历，他们会质疑自己的能力，对自己的职业理想感到幻灭，并对其他群体产生负面看法。
本研究表明，涉及群体过程的冲突可能会导致更强烈的群体间界限，挑战当前促进医疗保健团队合作的教育努力。采取措施创建更具包容性的群体并鼓励换位思考可能有助于管理群体间冲突。
