847 Conflict Resolution in Surgery

Aim Evidence from academic and public inquiries suggest that patient safety is threatened when interpersonal communication and professional behaviour breaks down within surgical multidisciplinary teams. Despite this available evidence, undergraduate and postgraduate curricula place a strong emphasis on the development of surgical knowledge and skill, with limited focus on optimal team working and the management of interpersonal conflict. The increasingly diverse surgical workforce will induce a commensurate diversity of personality types, and so an assessment of the evidence base defining the effects of interpersonal conflict and evaluating mitigating interventions, may inform future curricula. Method A systematic interrogation of relevant databases was undertaken. Keywords included “conflict resolution”, “surgery”, “healthcare professionals” and further related terms. The authors analysed the identified studies in line with PRISMA guidelines to assess relevance. Inconsistencies were resolved through discussion between the reviewers. Results Sixty-three studies emerged from the analysis. Interpersonal conflict negatively impacted healthcare professionals (HCPs), inducing stress, burnout, and job dissatisfaction, and threatened team effectiveness and patient safety. Common causes of conflict were categorised into systemic and interpersonal factors. Conflict resolution interventions focussed on communication skills training, team-building workshops, and debriefing sessions. Although studies recognised the value of conflict resolution, strategies varied across surgical specialties. Conclusions This systematic review defines conflict within surgical teams as a threat to patient safety and HCP wellbeing. There is strategic heterogeneity within the educational interventions reported in the literature. We argue that formalised teamworking and conflict resolution training is a neglected component of surgical curricula.