Training Modules

MGL offers EIGHT training modules that all contribute to preparing health care professionals to improve communication and develop conflict transformation skills to deal with high stakes conflict in health care settings. All of the modules are tailored to meet the unique requirements of the health care organization. In some instances elements of each of the modules can be combined in specific ways to be most relevant to the participants in training.

Many of our training materials can be adapted to cater for training-the-trainer. This enables us to help build the capacity of health care organizations by offering new materials to their internal health care consultants and trainers.

Contact MGL for the pricing of each of the modules. Fees are calculated on the basis of the number of participants, the level of specialty, whether it is on-line or face-to-face training, the location and the scope of the training arrangement.

Module 1: Understanding Conflict in Health Care

This module is designed for all health care professionals who work in situations where high stakes conflict occurs. The purpose of this module is to educate nurses, physicians and other health care professionals about the unique factors that produce high-stakes conflict and the steps that can be taken to productively manage conflict in the health care arena. A portion of the module can be completed online and introduces participants to the multi-dimensioned, complex nature of conflict. The module reviews why people stay in conflict and why they escalate it. Furthermore, this module investigates the optimal conditions under which conflict is best addressed. We also examine the physiological effects of fight-flight symptoms and how they shape human behavior amidst conflict.

The module discusses common dynamics that escalate conflict such as generalizations, projection, policy speak, sarcasm, and flooding which leads to high intensity conflict. The module also focuses on defensive strategies which inhibit conflict resolution such as surrendering behavior, withdrawal or flight and counter attack.

Participants evaluate themselves on a conflict styles assessment tool and identify dominant patterns of relating to challenging interactions. This includes the styles of avoiding, compromising, collaborating, competing and accommodating in multiple work and home circumstances. As our health care systems shift from the linear hierarchical delivery of health care services to a multi-disciplinary team delivery of services, they create unique communication challenges and conflictual obstacles. The module concludes by studying these unique contexts that both contribute to the escalation and de-escalation of conflict. This instructional module outlines specific strategies that will address these challenges. The face-to-face module is completed in one day over an eight-hour period.

Module 1: Understanding Conflict in Health Care

Who is this training for? 
For all senior health care professionals who work in high stakes conflict situations.

What do you learn?
The unique factors that produce high-stakes conflict and the steps that can be taken to productively manage conflict in the health care arena.

How long does it take?
8 hours

Are there other modules that are pre-requisites?
No

Trainers: 
Gerald Monk, Mary Gomez, Bev Lauck.

Detailed description

Module 2a: Conflict Transformation Skills

The module is designed for health care professionals who deal with high stakes conflict on a regular basis. The first part of this module can be completed online (eight hours). It is tailored to meet the needs of three major health care professional groups: physicians, nurses, health care leaders (administration, risk, patient safety & patient relations, med-legal). The remainder of the module is delivered in a face-to-face workshop format offered over a two-day (16hr) period. The module can be delivered all face-to-face over a three-day period (24 hrs).

Health care professionals are trained in powerful conflict transformation strategies using (an MGL acronym for working through conflict); SHAPES IT [Use of Space, Heartfelt acknowledgment, Acknowledging feelings, Paraphrasing, understanding Effects, Summarizing, identifying Interests and Translating them into action. This module begins with a review of the research on what factors drive patients’ and families’ distress and rage; two emotions which most often escalate conflict to the point that these same patients and families report suffering and harm at the hands of health care professionals. A specific model is reviewed that shows how the normal result of communication is at least a partial misunderstanding between the communicator and listener. Ineffective listening habits are identified. The importance of quality listening is emphasized and the training in the SHAPES IT techniques are modeled. These are also rehearsed in role-play in the face-to-face training. Specific and relevant problem-based scenarios are reviewed in the workshops. Participants complete the module knowing how to deliver conflict transformation skills within their own professional contexts. Participants also are equipped to apply the basics in non-defensive responding and de-escalating difficult conversations.

Module 2b: Conflict Transformation Skills

Module 2b is delivered using video-feedback for a three-day workshop for groups limited to 24 people.

Module 2: Conflict Transformation Skills

Who is this training for?
Tailored to meet the needs of three major health care professional groups: physicians, nurses, health care leaders.

What do you learn?
A range of specific conflict transformation skills that are practiced in a problem based learning format using role-play with real professionally relevant conflict scenarios.

How long does it take?
24 hours

Are there other modules that are pre-requisites?
Yes, Module 1

Trainers:
Gerald Monk, Bev Lauck, Mary Gomez. 

Detailed description

Module 3: Transparency, Apology & Recovery Following Adverse Outcomes and Medical Error

This module covers a range of topics and caters for health care professionals who are directly and indirectly involved in responding to patients and families when there has been a breach in the standard of care or alternatively where the standard of care is met but its delivery was clumsy and unexpectedly adverse. Participants are provided with a range of powerful strategies to use with patients and families following adverse outcomes. The module is delivered in a range of formats from a four-hour (1/2 day) training to a 24-hour training (three day).

The workshop is organized around two strategies when adverse outcomes have occurred with patients. The first strategy employed is when adverse outcomes occur and appropriate care was carried out and the acronym EASE is used.

Express heartfelt acknowledgment and apology (inadmissible)
Anticipate strong emotions - panic, anxiety, anger
Slow down and listen empathically
Explain the facts non-defensively and keep listening

In the second strategy, when the standard of care is breached the acronym RESTORE is used:

Respond with heartfelt acknowledgment immediately
Explore effects of the adverse event on patient and family
System-wide accountability response with formal apology when complete findings available
Transparency and truth as part of all deliberations
Ongoing communication with patient and family after adverse event
Recovery and restoration with exemplary medical and practical care
Emotional support to patient and family weeks and months later

The module begins by noting how adverse outcomes escalate when there has been a failure in communication following a breakdown in care or when systems or equipment malfunction. The training emphasizes the shift from the “Deny & Defend Strategies” of health care professionals to appropriate disclosure, enhanced communication, and the promotion of improved physician/patient and family relationships. Disclosure principles are reviewed including determining patient/family readiness and ability to participate in disclosure meetings, understand the use of medical terms, as well as the physician or health care provider’s ability to manage expected outcomes. Participants focus on how to correct misperceptions, allow time to process information, focus on how to review medical records and provide documentation for families. A review of how to document a disclosure in a medical record is included. Participants are trained in using these multiple opportunities to ameliorate the impact of adverse events after they have occurred. The workshop has a strong emphasis on setting the stage for apology meetings and facilitating apology conversations and this approach is interwoven throughout the module. Training in appropriate consultations with relevant health care specialists is discussed.

Module 3: Transparency, Apology & Recovery Following Adverse Outcomes and Medical Error

Who is this training for?
This module covers a range of topics and caters for health care professionals who are directly and indirectly involved in responding to patients and families when there has been a breach in the standard of care or alternatively where the standard of care is met but its delivery was clumsy and unexpectedly adverse.

What do you learn?
The training emphasizes the shift from the “Deny & Defend Strategies” of health care professionals to appropriate disclosure, enhanced communication, and the promotion of improved physician/patient and family relationships.

How long does it take?
Between 4-24 hours depending upon the skill level required in each professional health care group category.

Are there other modules that are pre-requisites?
Yes, preferably Module 1 & 2 for more comprehensive delivery.

Trainers:
Mary Gomez, Bev Lauck, Gerald Monk.

Detailed description

Module 4: Caring for Professionals following the Aftermath of Unanticipated Adverse Outcomes

This module is designed for frontline physicians who are dealing with the aftermath of high stakes conflicts, which includes challenging communications with patients, their families and colleagues. Many physicians suffer the negative consequences of unanticipated adverse outcomes in silence. Adverse outcomes often produce a destructive emotional wake that leaves many physicians alone, isolated and with damaging personal negative evaluations. MGL conducts a one-day workshop designed for those who personally suffer the consequences of adverse outcomes even when the standard of care has been successfully provided. The workshop also caters to senior health care leaders who support those frontline physicians traumatized by the destructive wake following aversive health care outcomes. In the first instance, the workshop addresses the nature of trauma and its pervasiveness associated with what the literature describes as the second victim. Assessment tools and observational guidelines are presented including identifying physical and psychological factors, which help health care leaders recognize second victims. Factors exacerbating the effects of adverse outcomes are presented to participants to help manage the difficult negative personalizing evaluations. Strategies are laid out for participants to move through the stages of recovery from the stressful events and possible trauma associated with adverse health events.

Module 4: Caring for Professionals following the Aftermath of Unanticipated Adverse Outcomes

Who is this training for?
For frontline physicians and senior health care leaders who are responsible for managing the aftermath of high stakes conflicts following catastrophic and adverse outcomes.

What do you learn?
Strategies are laid out for participants to move through the stages of recovery following the precipitating stressful event and the possible trauma associated with the aftermath of an adverse event.

How long does it take?
8 hours

Are there other modules that are pre-requisites?
No

Trainers:
Gerald Monk, Bev Lauck, Mary Gomez.

Detailed description

Module 5: Difficult Conversations and Courageous Feedback to Subordinates, Peers, & Colleagues

This module prepares health care professionals at all levels of a health care organization to give and receive feedback and to engage in courageous dialogue designed to enhance people’s abilities to work more effectively in their distinctive health care settings. Modules are exclusively tailored for specific health care professionals such as health care leaders, physicians and nurses. There are two versions of this module. One model is exclusively designed for a Train-the-Trainers module offered over a 15-hour period across a two-day period. Another model is a direct delivery of feedback training in half-day formats. The optimal model for improving professional’s abilities to both give and receive productive feedback incorporates strategies used in high stakes conflict management and techniques used in difficult conversations and cutting edge feedback literature. Participants are guided through a process that addresses the affective and cognitive domains of communication and challenging reflective feedback. The module emphasizes the value of face-to-face accountability discussions where problem situations are dealt with directly. Decision-making trees to address conflict are explored. Role-play is used to prepare participants for difficult conversations while learning to confront others with safety. 

Module 5: Difficult Conversations and Courageous Feedback to Subordinates, Peers, & Colleagues

Who is this training for?
Senior health care professionals.

What do you learn?
Preparation to give and receive feedback, and to engage in courageous dialogue designed to enhance people’s abilities to work more effectively in their distinctive health care settings.

How long does it take?
15 hours

Are there other modules that are pre-requisites?
No

Trainers:
Gerald Monk, Bev Lauck, Mary Gomez.

Detailed description

Module 6: High Conflict Personality Styles

This module caters for all health care professionals who deal with high stakes conflict on a regular basis in their health care role. This module prepares health care professionals to deal with patients, family members and colleagues that exhibit high conflict personality styles, which cause excessive conflictual dynamics. These conflictual styles can create serious challenges for both professionals and consumers in the workplace. Normally participants in the training will have completed module 2 in conflict transformation skills before enrolling in this module specialized module. The key elements of the module are covered over a four-hour or one half-day training. The module begins by reviewing four kinds of personality disorders, which are strongly linked with high intensity conflict. The module considers some of the causal factors that lead to high conflict dynamics in order to better prepare practitioners to manage the negative emotional wake produced by those who exhibit extreme conflictual patterns of relating. Behavioral characteristics of high conflict people are identified as well as the strategies they can employ to form relations with others that enable and encourage inappropriate behavioral responses. The remainder of the module concentrates on strategies to contain and de-escalate high conflict dynamics that include structuring relationships, bonding, emotional containment and reality testing.

Module 6: High Conflict Personality Styles

Who is this training for?
All health care professionals who deal with high stakes conflict on a regular basis in their health care role.

What do you learn?
Preparation to deal with patients, family members and colleagues that exhibit high conflict personality styles which cause excessive conflictual dynamics.

How long does it take?
4 hours

Are there other modules that are pre-requisites?
Yes, preferably Module 1 & 2 for more comprehensive delivery.

Trainers:
Gerald Monk, Bev Lauck, Mary Gomez.

Detailed description

Module 7: Mediation in Health Care Contexts

The mediation training offered in this module is uniquely tailored for health care professionals. The mediation philosophy is built upon the narrative mediation approach that has been successfully applied in health care settings for the last decade. Participants study the principles and practices of mediation in health care over a three and a half day period for a total of 30 hours. The module begins with an overview of mediation models including interest-based and transformative approaches. The training reviews the role that health care culture interfaces with the cultural expectations of patients and their families. The largest proportion of the training is dedicated to a problem-based learning approach where participants work experientially with conflict scenarios that are typical of conflictual disputes in health care settings. Considerable opportunity is given to role-play practice with regular feedback from instructors on performance. This mediation module is typically completed following the Conflict Transformation Skills module 2. 

 

 

Module 7: Mediation in Health Care Contexts

Who is this training for?
All health care professionals who deal with high stakes conflict on a regular basis in their health care role.

What do you learn?
The principles and practices of narrative mediation as applied in health care.

How long does it take?
30 hours

Are there other modules that are pre-requisites?
Yes, the completion of Module 1 & 2 is necessary.

Trainers:
Gerald Monk, Bev Lauck, Mary Gomez.

Detailed description

Module 8: Burnout & Compassion Fatigue

This module is designed for senior health care leaders who are interested in learning more about compassion fatigue and burnout or are potentially at risk for suffering from these consequences from overwork. The distinctions between burnout and compassion fatigue need to be clarified. Burnout is associated with stress and hassles involved in your work; it is very cumulative, is relatively predictable and frequently a vacation or change of job helps a great deal. Compassion Fatigue is very different than the effects of burnout. Compassion Fatigue is a state of tension and preoccupation with the cumulative trauma of patients as manifested by re-experiencing of traumatic events, avoidance or numbness associated with reminders of traumatic events, and persistent distress. Participants review 12 phases of burnout, burnout syndrome, and practices in burnout prevention. Individual and organizational changes are viewed as the best approaches to diminish burnout. A combination of organizational change processes and educative processes for individuals are reviewed. Developing a supportive community to reduce burnout is examined by focusing on the engagement of health care leadership. Stress management training and stress interventions can be added as additional resources to this module.

In addition to the focus on burnout, the factors that cause compassion fatigue are studied. This includes both reviewing the physical and emotional symptoms of compassion fatigue as well as its prevalence and costs. The central focus of the training is on implementing the ways to combat compassion fatigue, while examining the barriers that have to be overcome for health professionals to get help. The training is offered in a variety of formats. One approach is to offer training in both burnout and compassion fatigue separately in two half-days. A more comprehensive approach in delivering this module is to offer it over a two-day period. 

 

Module 8: Burnout & Compassion Fatigue

Who is this training for?
Senior health care leaders who are interested in learning more about compassion fatigue and burnout or for health care leaders potentially at risk for suffering from these consequences from overwork.

What do you learn?
Phases of burnout, burnout syndrome, and practices in burnout prevention. In addition, the training is on implementing the ways to combat compassion fatigue, while examining the barriers that have to be overcome for health professionals to get help.

How long does it take?
4-8 hours

Are there other modules that are pre-requisites?
No

Trainers:
Gerald Monk, Bev Lauck, Mary Gomez.

Detailed description
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