Intra Team Conflict

Teams ultimately consist of a collection of individuals and it is vital to consider individuals when considering conflict. It is equally true that not all conflict is conflict on teams. Teams naturally go through stages of development which may or may not feel like conflict depending on your own individual wiring, drivers and preferences.

The Forming – Storming – Norming – Performing framework is a model of group development, first proposed by Bruce Tuckman in 1965, who maintained that these phases are all necessary and inevitable in order for the team to grow, to face up to challenges, to tackle problems, to find solutions, to plan work, and to deliver results.

Forming

In the first stages of team building, the forming of the team takes place. The team meets and learns about the opportunity and challenges, and then agrees on goals and begins to tackle the tasks. Team members tend to behave quite independently. They may be motivated but are usually relatively uninformed of the issues and objectives of the team. Team members are usually on their best behavior but very focused on themselves. Mature team members begin to model appropriate behavior even at this early phase. Supervisors of the team tend to need to be directive during this phase.

The forming stage of any team is important because in this stage the members of the team get to know one another, exchange some personal information, and make new friends. This is also a good opportunity to see how each member of the team works as an individual and how they respond to pressure.

Our experience is that many teams in healthcare simply form or evolve over time without ever really taking the trouble or having the time to explore each other at an individual level. Denied of this important developmental opportunity, conflict can develop and prevent progression through other stages. Equally, it is vital to consider the impact of the leader under these circumstances. A good leader will understand the stages and ensure the team’s safe passage through the earlier ones by providing the highest quality of direction and support, both individually and at a team level.

Sharing the knowledge of the concept of "Teams - Forming, Storming, Norming, Performing" is extremely helpful to the team and assists in conflict prevention.

Storming

Every group will then enter the storming stage in which different ideas compete for consideration. The team addresses issues such as what problems they are really supposed to solve, how they will function independently and together and what leadership model they will accept. Team members open up to each other and confront each other's ideas and perspectives. In some cases storming can be resolved quickly. In others, the team never leaves this stage. The maturity of some team members usually determines whether the team will ever move out of this stage. Some team members will focus on minutiae to evade real issues.

The storming stage is necessary to the growth of the team. It can be contentious, unpleasant and even painful to members of the team who are averse to conflict. Tolerance of each team member and their differences needs to be emphasized. Without tolerance and patience the team will fail. This phase can become destructive to the team and will lower motivation if allowed to get out of control.

Supervisors of the team during this phase may be more accessible but tend to still need to be directive in their guidance of decision-making and professional behavior. The groups will therefore resolve their differences and group members will be able to participate with one another more comfortably and they won't feel that they are being judged in any way and will therefore share their own opinions and views.

Norming

At some point, the team may enter the norming stage. Team members adjust their behavior to each other as they develop work habits that make teamwork seem more natural and fluid. Team members often work through this stage by agreeing on rules, values, professional behavior, shared methods, working tools and even taboos. During this phase, team members begin to trust each other. Motivation increases as the team gets more acquainted with the project.

Teams in this phase may lose their creativity if the norming behaviors become too strong and begin to stifle healthy dissent and the team begins to exhibit groupthink.

Supervisors of the team during this phase tend to be participative more than in the earlier stages. The team members can be expected to take more responsibility for making decisions and for their professional behavior.

As team members get to know each other better, their views of each other begin to change. The team feels a sense of achievement for getting so far, however some members can begin to feel threatened by the amount of responsibility they have been given. They would try to resist the pressure and revert to storming again.

Performing

Some teams will reach the performing stage. These high-performing teams are able to function as a unit as they find ways to get the job done smoothly and effectively without inappropriate conflict or the need for external supervision. Team members have become interdependent. By this time they are motivated and knowledgeable. The team members are now competent, autonomous and able to handle the decision-making process without supervision. Dissent is expected and allowed as long as it is channeled through means acceptable to the team.

Supervisors of the team during this phase are almost always participative. The team will make most of the necessary decisions. Even the most high-performing teams will revert to earlier stages in certain circumstances. Many long-standing teams will go through these cycles many times as they react to changing circumstances. For example, a change in leadership may cause the team to revert to storming as the new people challenge the existing norms and dynamics of the team.

The roots of team conflict

Tuckman’s model is helpful to us in a number of ways. Firstly, it provides a perspective on inevitable stages that a team will go through and secondly many clues to both the cause and resolution of conflict in the team environment. I truth, many of us find that we inherit a team situation i.e. feel that we have not gone through or been part of a ‘forming’ stage and that the stage we now enter at is ‘storming’. In healthcare at the moment, whilst we re-design how it all works, new teams are forming constantly and, inevitably, formerly high performing teams retract to forming and storming stages with less productivity.

The antecedents to conflict are:

Motivation & Morale

Motivation and morale are directly linked to team performance AND conflict. This can be a particular issue at the present time, with teams undergoing significant change, increased pressure from targets and ever increasing expectation and a whole new level of market and financial risk that clinical teams in particular are just not experienced in dealing with. Equally, many team members either don’t understand or have very differing opinions in their understanding of what it happening in health. This gives rise to considerable conflict where it previously didn’t exist.

It is vital for team leaders to ensure that team members understand their environment and what it takes to be successful in it. If team leaders themselves don’t understand the evolving healthcare landscape then this has to be an imperative for development. Every aspect of teamwork and healthcare delivery is impacted by the evolution currently underway in the NHS and what it took to be successful before is very different from what it will take to be successful going forward.

Simple Steps

The basic steps in conflict resolution in team situations are the following:

Resolving Intra Team Conflict & Long Term Prevention

Good leaders understand the importance of maintaining high performance, morale and motivation in teams and in creating the conditions where performance, creativity, innovation and harmony flourish. The following are helpful solutions to consider:

The Medicology team will be able to advise you on the best overall approach. In the first instance, contact Andrew Vincent, Managing Director and Head of Team Performance Centre of Excellence on 07775 646947 or


Morale Testing

With morale being such a strong indicator of performance and conflict, we strongly advocate assessing morale and examining just what is contributing to good or poor morale in different individuals, groups or departments. To facilitate this Medicology has developed a highly sensitive, immensely informative Morale Testing Instrument (Medicology MTI) to assist Trusts with this vital aspect of performance and conflict management.

For more information visit www.medicologyMTI.co.uk