Development and validation of a conflict management competencies assessment questionnaire for surgical residents in the operating room

Conflict is an unavoidable aspect of clinical practice, especially within demanding settings such as surgical departments. This study aimed to develop and validate a specialized tool for assessing surgical residents’ conflict management skills in the Operating Room (OR). A sequential exploratory mixed-method design was conducted in four phases. First, a scoping review following the PRISMA-ScR guideline identified essential concepts of conflict management in clinical practice. Second, qualitative interviews with 20 surgical education experts were analyzed using Graneheim and Lundman’s conventional content analysis to uncover underlying dimensions. Third, the Questionnaire for Surgical Residents was developed based on the model proposed by Jenn (2006), resulting in a 42-item instrument—the Interprofessional Conflict Management Questionnaire for Surgical Residents. Fourth, a cross-sectional survey was conducted with 400 surgical residents from multiple teaching hospitals across different surgical specialties. Content validity was evaluated using Content Validity Ratio (CVR) and Content Validity Index (CVI) with input from 10 experts. Exploratory factor analysis (EFA) with Varimax rotation was performed to determine the latent structure. After validation, two items with CVR values below 0.62 were removed, resulting in a 40-item final questionnaire. The EFA revealed a seven-factor structure encompassing intrapersonal, interpersonal, and intergroup competencies, explaining 59.55% of the total variance. All factor loadings exceeded 0.40, confirming acceptable construct representation. Cronbach’s alpha values for the subscales ranged from 0.76 to 0.94, with overall reliability at 0.83. The developed instrument demonstrated acceptable and promising psychometric properties and cultural relevance for evaluating conflict management competencies among surgical residents in Iran. It offers a valid and preliminary framework for assessing residents’ ability to manage interpersonal and organizational conflicts in clinical contexts.