Diagnosing conflict in clerkship: insights from medical students' experiences.

Abstract

Introduction: Conflict is an inevitable part of clinical training and often arises from differences in opinions or misunderstandings. Most studies around healthcare conflict focus on perspectives of physicians and nurses, overlooking medical students' unique perspectives. This study explores medical students' experiences with conflicts during clerkship, examining types, triggers, and conflict management styles.

Methods: An educational session introduced medical students to conflict types, conflict management modes, and triggers. A total of 167 students wrote reflections about conflicts experienced or observed during their rotations. Both quantitative and qualitative elements were analysed using thematic content analysis.

Results: Conflicts most frequently occurred during surgery (n=49, 32.9%) and internal medicine (n=41, 27.5%) rotations, often involving residents (n=110, 44.7%) and attendings (n=55, 22.4%). Task-related conflicts were most common (n=113, 53.8%), with students primarily using an avoiding (n=91, 60.3%) mode, while others were perceived as using a competing (n=122, 65.2%) mode. Most conflicts were reported as being handled poorly (n=107, 64.8%). Students described five main conflict triggers: (1) conflicts stemming from unclear expectations; (2) hostile or false communication as a conflict driver; (3) unsafe environments reinforced by hierarchy and power; (4) mistrust in team relationships and (5) resident stress impacting student experiences.

Discussion: Identifying conflict characteristics from a student perspective can guide curricular improvements to better prepare students for clerkships and professional practice. Awareness of conflict management styles, types and triggers enables proactive conflict resolution, fostering growth or constructive outcomes. Findings emphasise the importance of setting clear expectations, maintaining effective communication, building psychologically safe environments, reducing stress and establishing trust between students and residents. Based on medical students' reflections, these patterns may extend to other health professions, offering a broader relevance for training and research in conflict management across clinical settings.