A dynamic systems theory of intrateam conflict contagion.

Recognizing the challenges that conflict poses, organizational researchers have invested considerable energy toward investigating the processes by which conflict occurs and spreads within a team. However, current theoretical frameworks of conflict contagion posit a static growth trajectory in which members become engaged in conflict and stay in conflict. While this trajectory is certainly possible, the broader conflict literature outside of the organizational sciences has shown evidence for a more varied set of potential trajectories of conflict contagion. To advance theory on team conflict, we integrate conflict research from micro-level (interpersonal) to macro-level (interstate) perspectives into a formal theory of intrateam conflict contagion. Drawing from conflict stage and social contagion theory, we theorize that team members move through three stages of conflict (disengaged, at-risk, engaged) at rates determined by four process mechanisms (faultlines, forgiveness, frustration, integration) such that disengaged individuals become at-risk of engaging in conflict, engage in conflict, then disengage, only to potentially become at risk of reengaging at a later point in time. Using computational modeling, we demonstrate the generative sufficiency of our theory to account for conflict trajectories observed in the broader conflict literature. To facilitate the interpretation of such trajectories, we present a typology of contagion trajectories, discuss the dynamic properties of these trajectories (e.g., stability, bifurcations), and provide implications for future theory building and practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The dynamic nature of interpersonal conflict and psychological strain in extreme work settings.

Humanity will mount interplanetary exploration missions within the next two decades, supported by a growing workforce operating in isolated, confined, and extreme (ICE) conditions of space. How will future space workers fare in a closed social world while subjected to persistent stressors? Using a sample of 32 participants operating in ICE conditions over the course of 30-45 days, we developed and tested a dynamic model of conflict and strain. Drawing on conservation of resources (COR) theory, we investigated reciprocal relationships between different forms (i.e., task and relationship) of conflict, and between conflict and strain. Results demonstrated evidence for a resource threat feedback loop as current-day task conflict predicted next-day relationship conflict and current-day relationship conflict predicted next-day task conflict. Additionally, results indicated support for a resource loss feedback loop as current-day relationship conflict predicted next-day strain, and current-day strain predicted next-day relationship conflict. Moreover, we found that job conditions affected these associations as current-day relationship conflict was more associated with next-day task conflict when next-day workload was high, but not when next-day workload was low. Similarly, current-day relationship conflict was more associated with next-day strain when next-day workload was high; however, this association decreased when next-day workload was low. Therefore, the results suggest that workload plays a critical role in weakening the effect of these spirals over time, and suggests that targeted interventions (e.g., recovery days) can help buffer against the negative impact of relationship conflict on strain and decrease the extent that relationship conflict spills over into task disputes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does team leader gender matter? A Bayesian reconciliation of leadership and patient care during trauma resuscitations.

OBJECTIVE: Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians. METHODS: We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma activation criteria. Two video-recorded observations for each participant were coded for team leadership quality and patient care by 2 sets of raters. Raters were balanced with regard to gender and were blinded to study hypotheses. We used Bayesian regression to determine whether our data supported gender-based advantages in team leadership. RESULTS: A total of 60 participants and 120 video recorded observations were included. The modal relationship between gender and team leadership (ß = 0.94, 95% highest density interval [HDI], -.68 to 2.52) and gender and patient care (ß = 2.42, 95% HDI, -2.03 to 6.78) revealed a weak positive effect for female leaders on both outcomes. Gender-based advantages to team leadership and clinical care were not conclusively supported or refuted, with the exception of rejecting a strong male advantage to team leadership. CONCLUSIONS: We prospectively measured team leadership and clinical care during patient care. Our findings do not support differences in trauma resuscitation team leadership or clinical care based on the gender of the team leader.

Simulation-Based Team Leadership Training Improves Team Leadership During Actual Trauma Resuscitations: A Randomized Controlled Trial.

OBJECTIVES: Trauma resuscitations are complex critical care events that present patient safety-related risk. Simulation-based leadership training is thought to improve trauma care; however, there is no robust evidence supporting the impact of leadership training on clinical performance. The objective of this study was to assess the clinical impact of simulation-based leadership training on team leadership and patient care during actual trauma resuscitations. DESIGN: Randomized controlled trial. SETTING: Harborview Medical Center (level 1 trauma center). SUBJECTS: Seventy-nine second- and third-year residents were randomized and 360 resuscitations were analyzed. INTERVENTIONS: Subjects were randomized to a 4-hour simulation-based leadership training (intervention) or standard orientation (control) condition. MEASUREMENTS AND MAIN RESULTS: Participant-led actual trauma resuscitations were video recorded and coded for leadership behaviors and patient care. We used random coefficient modeling to account for the nesting effect of multiple observations within residents and to test for post-training group differences in leadership behaviors while controlling for pre-training behaviors, Injury Severity Score, postgraduate training year, and days since training occurred. Sixty participants completed the study. There was a significant difference in post-training leadership behaviors between the intervention and control conditions (b1 = 4.06, t (55) = 6.11, p < 0.001; intervention M = 11.29, SE = 0.66, 95% CI, 9.99-12.59 vs control M = 7.23, SE = 0.46, 95% CI, 6.33-8.13, d = 0.92). Although patient care was similar between conditions (b = 2.00, t (55) = 0.99, p = 0.325; predicted means intervention M = 62.38, SE = 2.01, 95% CI, 58.43-66.33 vs control M = 60.38, SE = 1.37, 95% CI, 57.69-63.07, d = 0.15), a test of the mediation effect between training and patient care suggests leadership behaviors mediate an effect of training on patient care with a significant indirect effect (b = 3.44, 95% CI, 1.43-5.80). Across all trauma resuscitations leadership was significantly related to patient care (b1 = 0.61, SE = 0.15, t (273) = 3.64, p < 0.001). CONCLUSIONS: Leadership training resulted in the transfer of complex skills to the clinical environment and may have an indirect effect on patient care through better team leadership.