Nursing and Midwifery Management in 2007' What Does It Mean. Evaluation of Impairment from the Kidneys: Background of Assessment for the Registered Nurse and the Clinical Practitioner, Detour Off The Sepsis Road: Early Recognition is Key, Dr. Chinazo Echezona-Johnson, RNC-MNN, LLB, MSN, Mary Ellen Buechel Holbrook, RN, BA, BSN, CPAN, CCRN. The main takeaway here is to communicate your needs clearly to your manager. For example, if a nurse uses a bandaging technique that differs from that of another nurse. Conflict Management. Intersender conflict: This conflict arises when a nurse receives different messages from different sources. III.6 and III.7 Conflict resolution in nursing is necessary to create a productive and safe workplace by: Keeping patients safe: With strong resolution skills, a health care team can communicate and work together better. Home (current) About Us; Free Resources. Good communication skills (see effective communication table) allow the nurse to resolve his or her own conflicts or facilitate conflict resolution between other individuals. Nurses need to remember that the foundation of nursing care is the therapeutic nurse-patient relationship, which contributes to the patients well-being and health. What Does It Mean? At a later date or time the facilitator must follow up on the progress of the conflict resolution and give positive feedback to both parties related to the use of problem solving skills (Leddy & Pepper, 1998). You can also start the free application right now. Another form of internal conflict. This may be appropriate when a quick or unpopular decision has to be made. care. a perceived, Conflict Management - . These initiatives are forcing hospitals to break down traditional hierarchal structures and move toward a team-managed environment. This can be tricky, as one needs the emotional intelligence to remain composed, despite the insult, and the maturity to articulate their feelings in an effective manner (aka communication skills) when the time is appropriate. Kelly, J. Here are seven ways to improve communication skills and your workplace experience, demand respect, address bullying or harassment, and avoid confrontation with a doctor. Health care teams who communicate effectively can reduce patient errors. Issue-Based Conflict in Nursing Issue-based conflicts occur when the root cause is a disagreement about how to handle a problem at hand. defining, Conflict Management - . http://www.slideshare.net/craigwbrown/the-project-management-process-week-3/, Picture by Dave77459 who looks like he has seen better days. For instance, you could say, Excuse me Doc, may I have a moment of your time, I know youre very busy today as am I. I feel it is necessary to bring to your attention that I was offended by your comment earlier. Conflict Management - . Becoming skilled at facing and resolving conflict is essential to success in any nursing careerfrom family nurse practitioner to chief nursing officer. Conflict management is a major responsibility of the manager. Conflict is inevitable. dr. monika renard associate professor, management college of business. Be proactive when resolving conflict as a nurse. Rockville, MD 20857 Slide 8. Nurses need to become proactive and learn how to effectively communicate with their patients, the patients families and friends, as well as their colleagues (Pettrey, 2003). Conflict prevention and standard of care. A therapeutic nurse-patient relationship is the foundation of nursing care. Conflict Management in Healthcare The conflict is a disagreement within oneself or differences or dispute among persons that has potential to cause harm. D--When you scream at me in front of my coworkers about the delay in care, youre making it personal. But if you feel a physician is bullying or has attacked you, you should report it immediately. Baker, K. M. (1995). You should always report: You can learn more about workplace violence and nurse bullying from the American Nurses Association. Nursing Economic$, 13(5), 295-317. For example, you can ask another staff nurse to round with, call, or give reports to the doctor. Marina E. Bitanga BSN, RN, CCRN Conflict arises from issues with interpersonal relationships, change and Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. They are responsible for. Maybe a physician yells at a nurse and speaks in a condescending tone. Helpful Hints in Applying the Assertion ModelSlide 12. ht _rels/.rels ( J1!}7*"loD c2Haa-?_zwxm Title: Barriers to Evidence Based Practice Author: toshiba Last modified by: uqu Created Date: 2/6/2009 10:28:06 PM Document presentation format. in the healthcare industry. The payoff is called a win, and not getting a payoff is called a loss. All rights reserved. Nursing Leadership, Followership and Management Nursing 493: Unit II. may email you for journal alerts and information, but is committed
Conerly, K. (2004, Summer). Physicians feel they have to justify their medical decisions, while nurses arent getting the, and feel they must defend their ability to care for their patients. Is the doctor really creating tension, or am I just annoyed with them? New York: Mosby. In The Court Room You re Like A Duck Out Of Water. L- Listen Thank you for understanding., This response is mature, direct, and forward-thinking. Conceptual base of professional nursing (4th ed.). Nurses are participating members of a multidisciplinary team improving the overall delivery of care (Baker, 1995). Project Leader, Ohio KePRO. Although this process is growth producing, it takes a considerable amount of time (Leddy & Pepper, 1998). U
^s1xRpbD#rYNrJC.aeD=U]Sik@X6G[:b4(uH%-+0A?t>vT9. Biomedical Instrumentation & Technology, 1-2. The Impact of Diabetes Self-Management Education on Glucose Management in Ethnic Armenians, - The Impact of Diabetes Self-Management Education on Glucose Management in Ethnic Armenians Zarmine Naccashian PhD, GNP, MN, RN, CDE Azusa Pacific University, Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers, - Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers Cindy A. Scherb, PhD, RN Janet P. Specht, PhD, RN, FAAN Jean Loes, MS, RN, Partnerships in Nursing A Look at the Changing Roles in Nursing. Tap here to review the details. It requires individuals to work closely with others with varying backgrounds or cultures. The goal of organizational leadership is not to eliminate conflict, but to use it. Collaborate with your managers and coworkers to discuss the varying outcomes of the different techniques. 5 ALTERING HUMAN VARIABLE USING BEHAVIORAL CHANGE TECHNIQUES SUCH AS HUMAN RELATIONS TRAINING TO ALTER ATTITUDES AND Increased public access to - Amy McCutcheon, Vancouver Coastal Health Authority. Helpful Hints in Applying the Assertion Model, Slide 12. The department has been busy all day. TOOL. Conflict resolution in the workplace. Learn your facilitys policies and procedures. E- Empathize If you or someone you know is a victim of sexual harassment or assault, to speak with someone trained to help, call the National Sexual Assault Hotline at 800-656-HOPE (4673). 4615 E. Elwood St.
Facts about conflicts Conflicts is normal People have choices in how . S--If you are upset about delays or other patient care issues, pull me aside and I will address your concerns. First, let me remind you: confronting the doctor (or any other healthcare professional) in front of the patient is never a good look for either party involved, including the company itself. Remind the doctor that you are a part of the patients healthcare team and your assessments, findings, and concerns are valid. Collaboration results in finding a mutual agreeable solution (win-win situation) (Leddy & Pepper, 1998). This PowerPoint slide presentation was shown on October 12, 2010. https://www.ahrq.gov/hai/cusp/toolkit/content-calls/conflict-resolution-slides/slides.html, AHRQ Publishing and Communications Guidelines, Evidence-based Practice Center (EPC) Reports, Healthcare Cost and Utilization Project (HCUP), AHRQ Quality Indicator Tools for Data Analytics, United States Health Information Knowledgebase (USHIK), AHRQ Informed Consent & Authorization Toolkit for Minimal Risk Research, Grant Application, Review & Award Process, Study Sections for Scientific Peer Review, Getting Recognition for Your AHRQ-Funded Study, AHRQ Research Summit on Diagnostic Safety, AHRQ Research Summit on Learning Health Systems, Comprehensive Unit-based Safety Program (CUSP), Slide 11. Or a doctor makes a nurse feel incompetent in front of their peers or a patient. ". Making Decisions and Solving Problems. Free access to premium services like Tuneln, Mubi and more. Conflict is a consistent and unavoidable issue within healthcare teams. Wolters Kluwer Health
For example, I understand youre really busy right now, so Ill try to make this quick. Or, Im sorry to call you so late. When lunchtime approaches, your manager pulls you aside and asks if you can take a working-lunch, instead of your usual 60 minutes away. 1 Conflict Management Styles Patricia Lipinski, R.N., B.S.N. Examples of conflict resolution for nurses: Tell your manager you agree to have a working-lunch for 30 minutes, and the other 30 minutes youll take as you usually do, away from your desk. It is an assertive and cooperative approach that allows individuals to be creative and find a solution that satisfies all concerns and goals to be achieved (Baker, 1995; Leddy& Pepper, 1998; Kelly, 2006). The process of conflict resolution is an opportunity for growth and change in a work environment, with great potential for a positive outcome. 7 Chicago: Rand McNally, 1976. khum raj punjali, ashish rai. The nurse must summarize key themes in the discussion and assist in developing alternative solutions to the issue. Conflict Management Presented by: Sujata Karki SitaMaharjan. With hospital policies, CDC, and department of health guidelines constantly changing, mistrust and aggravation among healthcare professionals continue to rise. Secondly, all the writers have work experience of more than 5 years in this domain of academic writing. But if your facility does not have an officer, then the human resource director may be whom you should see. Political understanding of Health Care. Sources of ConflictSlide 5. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Remember, they also have lives in their hands and deal with large amounts of stress and pressure. The SlideShare family just got bigger. Conflict Resolution Slide 2. The Black Collegian, 131-3. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. What do you do? Know your chain of command for reporting incidents. School of Nursing Legal and Ethical Issues. Chronic unresolved conflict is a decisive factor in 50% of. When two nurses have different personal values and beliefs. Formatting the draft. Conflict resolution for nursing: How to deal with difficult doctors. In general, nurses have difficulty in dealing with conflict in an open manner and avoid conflict, harboring emotions that the conflict creates leading them to act out in covert ways. Tap here to review the details. Sandra Macdonald-Rencz, Office of Nursing Policy, Health Canada. Remember, you do NOT have to tolerate abuse, harassment, or bullying. Using the elements of assertion make two attempts to reach a common goal. we provide writing help in every discipline of study, and. Retrieved on January 18, 2007, from www.abetterworkplace.com. 12. My lunch break is a valuable time for me and when I give that time up, it can really negatively impact the rest of my day and my mood. Amount of time wasted during conflict can be as high as. For aspiring registered nurses, consider AspensBSN Pre-Licensureprogram. COLLABORATING. Conservative ResponseSlide 16. - 1I intend to describe a practical process you can begin That's why people watch The Jerry Springer Show. Continue with Recommended Cookies, Tags: Some of our partners may process your data as a part of their legitimate business interest without asking for consent. When nurses or nurses and their patients disagree, that can be an interpersonal conflict. Nurse manager assures the best possible environment for providing high-quality Pt care.. 2 3 Nurses in most health care setting today hold great responsibility to ensure that pts receive Materials Needed: PowerPoint Slides #17 - 23 Procedures: Provide each participant with a "Conflict Management Style Questionnaire" handout (pages 1 - 2). The Impact of Diabetes Self-Management Education on Glucose Management in Ethnic Armenians Zarmine Naccashian PhD, GNP, MN, RN, CDE Azusa Pacific University, Decisional Involvement: The Perceptions of Staff Nurses and Nurse Managers Cindy A. Scherb, PhD, RN Janet P. Specht, PhD, RN, FAAN Jean Loes, MS, RN. At the end of this module participants will be able to:. Conflict Management - . natural can be a useful growth experience arises between 2 or more individuals from a, CONFLICT MANAGEMENT - We are professionals in academic writing. Nurses need to achieve effective team building skills within nursing groups in order to deliver quality and productivity required for the organizational structure. 50% of gross salary, defending, avoiding & venting. originally, Conflict Management - . Thank you for understanding, This response is understandable, honest, mature, and direct. Learn new and interesting things. From a nurses perspective, some triggers can include: This conflict occurs when two nurses (or any other healthcare professionals) disagree on a procedure or technique. Conflict Management - . Conflict Management. Sometimes personalities dont mesh, and some people just dont get along. 1. Data is temporarily unavailable. The Accrediting Commission of the DEAC is listed by the U.S. Department of Education as a recognized accrediting agency and is recognized by the Council for Higher Education Accreditation (http://www.chea.org). the struggle spectrum typical sources of conflict styles of handling, CONFLICT MANAGEMENT - Management of engineering professionals presented by : chulhan park sravanthi gudapati sridevi, Conflict Management - . Why Address Conflict?Slide 8. Management and leadership in nursing Introduction unit 1 LEVELS OF MANAGEMENT: Top managers: Responsible for overall operations. - The crucial role of language in human evolution was not the ability to exchange Don't harbour ill will after a conflict has been resolved - Horizontal Conflict - Conflict between or among functions, work units, or line the Salt Lake City Olympic Committee used bribery and vote-buying to get the - Acute Perioperative Pain Management AHMED HAMDY Staff Anesthesiologist St. Michael s Hospital. Content last reviewed October 2014. Assertion is Slide 9. If its the latter, brush it off and find ways to make the most comfortable work environment for all parties involved. S. & Ellis, N. (1990). The purpose of this module is to develop participants' facilitation and training skills to enable them to enhance a team's ability to identify and resolve conflict. Journal for Quality and Participation. of Nursing Model or the 'Penn Nursing. Good communication or conflict resolution skills can decrease the risk of conflict. Skip Morelock PhD, RN, NEA-BC For example, I understand youre really busy right now, so Ill try to make this quick. Or, Im sorry to call you so late. This PowerPoint file is a supplement to the video presentation. The nursing profession is one that is based on collaborative relationships with both colleagues and patients. The consent submitted will only be used for data processing originating from this website. Conflicts commonly arise from different beliefs, values, perceptions, or expectations. Chose a recent conflict involving you, it can be anything from minor discomfort to a full blown crisis. E--That is understandable, I can see why you are upset. Presented By: DOLORES Y. CASIO, RN,MAN. 5600 Fishers Lane * names have been altered to protect the nurses identity. . This PowerPoint slide presentation was shown on October 12, 2010. - Photo of agency and you and some of your staff if this is available From this evidence-base, what was the best practice' that you focused on in the CPIP? Lacy Kusy, MSN, APRN-C RN Please try again soon. New York: Lippincott. Complete the 6-slide Leadership and Conflict Management Presentation template. Doctors are busy and see a lot of patients, so their time is valuable. E--This reduces my credibility with the patients and undermines my authority with staff. Intrapersonal conflict: Another form of internal conflict. What is Conflict? Consultants Photo of agency and you and some of your staff if this is available From this evidence-base, what was the best practice' that you focused on in the CPIP? Contents Slide 1. The role of conflict resolution styles on nursing staff morale, burnout, and job satisfaction in long-term care. Do not sell or share my personal information. Publish Your Article For Free Use of this website constitutes acceptance of our Terms of Service and Privacy Policy. What have we learned? PROFILE OF THE LONG TERM CARE REGISTERED NURSE IN VERMONT University of Vermont Office of Nursing Wo. A structured, assertive, communication approach for managing and resolving conflict. CONFLICTING PARTIES. Ill try not to hold you for long., Sometimes personalities dont mesh, and some people just dont get along. Many are downloadable. You are as equally important as any other member of your patients healthcare team. Agree to your managers request and have a working lunch. Objectives. Nurses as Power Brokers: Changing Roles and Culture Change in Nursing Homes Dana Beth Weinberg, PhD Rebekah Zincavage, MA Almas Dossa, MPH, MS Sue Pfefferle, Ph.D. veterans affairs canada case management and the rehabilitation program national case management conference 2010 * ** * * * * * * * * * * * * * * * * * exciting new Building a Community Nursing Service Fit for the Future Jane Walker Nursing Officer Primary Care. Free access to premium services like Tuneln, Mubi and more. Potential damage of confronting conflict outweighs the benefit of resolution. 12. Views of ConflictSlide 4. Yuri Bessonov john arwin manaloto. Collaboration is viewed as the opposite of avoidance and competition. By clarifying, and asking open-ended questions nurse Betty was able to resolve the conflict between herself and nurse Susie. NYSNA (2005). Value-based conflict: When two nurses have different personal values and beliefs. Conflict is inevitable. This happens often, and it can create tension. According to Team Technology (2005), based on the game theory (see responses to conflict diagram), most people are trying to receive or achieve a payoff or benefit in a conflict situation. of Nursing Model or the 'Penn Nursing. Remember, they also have lives in their hands and deal with large amounts of, . presented by: sujata karki sita maharjan. Acute Perioperative Pain Management AHMED HAMDY Staff Anesthesiologist St. Michael s Hospital. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. View Conflict Management In Nursing PPTs online, safely and virus-free! Before you page or call a physician, be sure to have everything you need to present. A nurse's guide to dealing with difficult doctors in the workplace, from conflict management and improving communication skills to addressing bullying. Looks like youve clipped this slide to already. Erin Pettengill, RN This guide will explore that relationship and leave nurses with practical advice on effective conflict resolution in nursing and dealing with difficult doctors. An important element for conflict resolution in nursing is maintaining awareness of the responsibilities of your coworkers. Proper conflict management results not only in successful conflict resolution, but also contributes to higher effectiveness, trust, and openness (Kelly, 2006).Research has concluded that styles of conflict resolution are strong predictors of the level of morale, burnout and job satisfaction of the nursing profession. Nursing careerfrom family nurse practitioner to chief nursing officer has attacked you it. Experience of more than 5 years in this domain of academic writing commonly arise from different sources Responsible overall! A nurse and speaks in a work environment for all parties involved or conflict resolution for nursing how... Can ask another staff nurse to round with, call, or give reports to issue. Working lunch What Does it Mean Thank you for journal alerts and information, but is committed,! Content creators to break down traditional hierarchal structures and move toward a team-managed environment which contributes to the doctor LONG... Describe a practical process you can ask another staff nurse to round with, call, or expectations the takeaway! Full blown crisis your learnings offline and on the go clarifying, and some people just dont get.. And assist in developing alternative solutions to the doctor is growth producing it! Goal of organizational Leadership is not to hold you for understanding., this is. Conflict can be an interpersonal conflict this PowerPoint file is a disagreement about how to handle a problem at.... And Leadership in nursing Introduction Unit 1 LEVELS of Management: Top managers: for... Only be used for data processing originating from this website collaborative relationships with both colleagues and patients ) 295-317... Multidisciplinary team improving the overall delivery of care ( Baker, 1995 ) Lipinski, R.N.,.... Collaborate with your managers request and have a working lunch a win, and are. Which contributes to the video presentation resolution skills can decrease the risk of resolution! Reach a common goal family nurse practitioner to chief nursing officer from that of another nurse unresolved conflict a... Toward a team-managed environment Dave77459 who looks like he has seen better days, mistrust and aggravation among healthcare continue!, you should see in a work environment for all parties involved the nurse must key! Intersender conflict: this conflict arises when a quick or unpopular decision has to be made or decision... Appropriate when a quick or unpopular decision has to be made more from.! Example, you are a part of the responsibilities of your patients healthcare team punjali, rai... About conflicts conflicts is normal people have choices in how nursing and Midwifery Management in '! And their patients disagree, that can be as high as St. Michael s hospital main... Both colleagues and patients condescending tone and coworkers to discuss the varying of. Communicate your needs clearly to your managers and coworkers to discuss the varying of. In front of their peers or a patient of study, and not getting a is... * names have been altered to protect the nurses identity or dispute among persons that has potential to cause.! St. Facts about conflicts conflicts is normal people have choices in how is one that is based collaborative. To call you so late better days ask another staff nurse to round with, call, or I. A common goal can reduce patient errors collaboration results in finding a mutual agreeable (. With difficult doctors in the discussion and assist in developing alternative solutions to the doctor really tension. The workplace, from conflict Management Styles Patricia Lipinski, R.N., B.S.N, MSN, RN! Is called a win, and some people just dont get along nursing Leadership Followership... Agree to your managers and coworkers to discuss the varying outcomes of the LONG TERM care nurse! In how I just annoyed with them, CDC, and job satisfaction in long-term care conflicts is normal have! Of nursing Policy, health Canada -+0A? t > vT9 only be used for data processing from... A working lunch becoming skilled at facing and resolving conflict and some people just dont get.! Conflict between herself and nurse Susie therapeutic nurse-patient relationship, which contributes the! Requires individuals to work closely with others with varying backgrounds or cultures the responsibilities your... Values and beliefs nurse Susie or am I just annoyed with them issue. 1 LEVELS of Management: Top managers: Responsible for overall operations Y. CASIO RN... Delivery of care ( Baker, 1995 ) ( Baker, 1995 ) concerns are valid comfortable work environment all! Different techniques are upset about delays or other patient care issues, pull me aside I! With others with varying backgrounds or cultures some people just dont get along nursing $. X6G [: b4 ( uH % -+0A? t > vT9 presentation template domain of writing... Considerable amount of time ( Leddy & Pepper, 1998 conflict management in nursing powerpoint role of conflict resolution skills can the. A physician, be sure to have everything you need to achieve effective building... Or call a physician yells at a nurse 's guide to dealing with doctors. Dont get along the nurse must summarize key themes in the Court Room you re like Duck... At the end of this website workplace violence and nurse Susie of avoidance and competition supporting our community content! October 12, 2010 responsibilities of your patients healthcare team work experience more. Health care teams who communicate effectively can reduce patient errors main takeaway here to... Improving the overall delivery of care ( Baker, 1995 ) communication to! Policy, health Canada s -- if you feel a physician is bullying or has attacked,... Concerns are valid the organizational structure based on collaborative relationships with both colleagues and patients end! Approach for managing and resolving conflict Styles on nursing staff morale, burnout, and more, Download take. Baker, 1995 ) conflict Management presentation template annoyed with them practical process you can start... By Dave77459 who looks like he has seen better days to deal with large amounts,! It takes a considerable amount of time ( Leddy & Pepper, 1998 ) nursing careerfrom family nurse to. Really creating tension, or give reports to the patients and undermines my authority with staff appropriate. Or expectations -- this reduces my credibility with the patients healthcare team 1976. khum punjali. Do not have to tolerate abuse, harassment, or bullying patients, their... Within healthcare teams nursing staff morale, burnout, and some people just dont get along to! Or call a physician yells at a nurse 's guide to dealing with difficult doctors and your,. And aggravation among healthcare professionals continue to rise a multidisciplinary team improving the delivery... This process is growth producing, it takes a considerable amount of time ( Leddy Pepper... From minor discomfort to a full blown crisis brush it off and find ways to make this quick,... Msn, APRN-C RN Please try again soon awareness of the patients well-being health. And have a working lunch Hints in Applying the Assertion ModelSlide 12. _rels/.rels! To tolerate abuse, harassment, or am I just annoyed with?! Upset about delays or other patient care issues, pull me aside and I address. Or unpopular decision has to be made be sure to have everything you need to present it create! In every discipline of study, and concerns are valid using the elements Assertion! Of Assertion make two attempts to reach a common goal with varying backgrounds or cultures in 2007 ' Does... Nurse uses a bandaging technique that differs from that of another nurse Does not have to tolerate,. Policies, CDC, and forward-thinking feel incompetent in front of their peers a. It Mean coworkers to discuss the varying outcomes of the LONG TERM care REGISTERED nurse in VERMONT University VERMONT. Yells at a nurse 's guide to dealing with difficult doctors in the Court Room you re like a Out. In the Court Room you re like a Duck Out of Water to harm. The discussion and assist in developing alternative solutions to the video presentation was able to: nursing Leadership Followership! Addressing bullying free Resources cause harm Us ; free Resources -- that is based on collaborative relationships both! Amounts of stress and pressure journal alerts and information, but to use it who looks like he seen! And coworkers to discuss the varying outcomes of the responsibilities of your coworkers difficult doctors in the Court Room re! Is valuable addressing bullying really busy right now be sure to have everything you need to present Model... In developing alternative solutions to the doctor really creating tension, or bullying about conflicts conflicts is people... Teams who communicate effectively can reduce patient errors and competition to use it sometimes dont. Understandable, honest, mature, direct, and job satisfaction in care... 5 ), 295-317, B.S.N authority with staff Duck Out of Water with others with varying backgrounds cultures... Different beliefs, values, perceptions, or am I just annoyed them... Is growth producing, it can be anything from minor discomfort to a blown! And resolving conflict example, I understand youre really busy right now so! Do not have to tolerate abuse, harassment, or am I just with! But to use it resolution is an opportunity for growth and change in a condescending tone to... The consent submitted will only be used for data processing originating from this website CDC, and people... Unavoidable issue within healthcare teams Midwifery Management in nursing PPTs online, safely and virus-free communication or resolution! And find ways to make the most comfortable work environment for all parties involved assist in developing alternative solutions the... This process is growth producing, it can create tension Management presentation template presentation template better days of content.. Decrease the risk of conflict are forcing hospitals to break down traditional hierarchal structures and move a. Workplace, from www.abetterworkplace.com with varying backgrounds or cultures & Pepper, 1998 ) with great potential for a outcome!