Thrum Leadership Ltd, Oxford, UK
London School of Hygiene and Tropical Medicine, London, UK.
BMJ Paediatr Open. 2024 Nov 28;8(1):e003047. doi: 10.1136/bmjpo-2024-003047.
Conflict is prevalent across healthcare settings but is especially common in paediatrics, where high emotional stakes and parental expectations often intensify disagreements. Conflict can lead to negative outcomes for hospitals, staff and patients. Effective conflict management training can mitigate these impacts, but evaluating such training programmes remains challenging due to a lack of standardised tools and best practices.
This qualitative study aimed to explore healthcare decision-makers' perspectives on what key areas should be evaluated in conflict management training programmes in paediatric healthcare settings, employing Patton's utilisation-focused evaluation approach. Semi-structured interviews were conducted with 13 healthcare decision-makers and key stakeholders from various healthcare and charitable organisations. Interviews were analysed using reflexive thematic analysis by Braun and Clarke to identify key themes for evaluation.
Four primary themes were generated regarding the key areas that healthcare decision-makers believe should be evaluated in conflict management training. These were experience of training sessions, staff competency and well-being, patient/family experiences of conflict and impact on staff time and on clinical resources. Interviewees identified that the evaluation of training sessions should focus on participant engagement and satisfaction. Codes relating to staff competency and well-being included the acquisition and long-term retention of conflict management skills. Codes relating to patient/family experience focused on the quality of communication and support during conflicts. The theme of resource utilisation included codes relating to the time and cost implications of conflict.
The study identified essential evaluation areas that align with and expand on Kirkpatrick's framework, suggesting the need for both qualitative and quantitative data and long-term follow-up. Tailoring evaluation frameworks to specific programme contexts can enhance their relevance and utility, contributing to improved conflict management in both paediatric and wider healthcare settings.
冲突普遍存在于医疗保健环境中，但在儿科尤其常见，因为高情感风险和父母的期望往往会加剧分歧。冲突会给医院、员工和患者带来负面后果。有效的冲突管理培训可以减轻这些影响，但由于缺乏标准化工具和最佳实践，评估此类培训计划仍然具有挑战性。
本定性研究旨在探讨医疗保健决策者对儿科医疗保健环境中冲突管理培训计划应评估哪些关键领域的看法，采用了 Patton 的以利用为中心的评估方法。对来自各种医疗保健和慈善组织的 13 名医疗保健决策者和主要利益相关者进行了半结构化访谈。使用 Braun 和 Clarke 的反思性主题分析对访谈进行了分析，以确定评估的关键主题。
确定了医疗保健决策者认为在冲突管理培训中应评估的四个主要领域。这些领域是培训课程的经验、员工能力和福祉、患者/家庭对冲突的体验以及对员工时间和临床资源的影响。受访者认为，培训课程的评估应侧重于参与者的参与度和满意度。与员工能力和福祉相关的代码包括冲突管理技能的获得和长期保留。与患者/家庭体验相关的代码侧重于冲突期间的沟通和支持质量。资源利用主题包括与冲突相关的时间和成本影响的代码。
该研究确定了与 Kirkpatrick 框架一致且扩展的必要评估领域，这表明需要定性和定量数据以及长期随访。根据特定计划背景定制评估框架可以提高其相关性和实用性，有助于改善儿科和更广泛的医疗保健环境中的冲突管理。
