Exploring Nursing Managers’ Competence and Confidence in Applying the Thomas–Kilmann Conflict Resolution Model in Daily Practice

Introduction

Healthcare organisations are inherently complex and emotionally demanding workplaces. Nurses and nurse managers often encounter conflict related to workload distribution, interprofessional dynamics, communication breakdowns, and performance issues [1]. Effective conflict management is essential to maintain teamwork, patient safety, and staff morale. The Thomas–Kilmann Conflict Resolution Model (TKI) is widely used to help leaders understand their behavioural tendencies in conflict and select appropriate strategies [2]. In nursing leadership, its structured framework can guide decision-making in emotionally charged environments. Despite its relevance, little is known about the degree to which nursing managers feel competent and confident in using the TKI in daily practice. This study explores how nursing managers apply the TKI model, the challenges they face, and the competencies required for effective conflict resolution.

Background and Literature Review

Conflict in Nursing Leadership

Leadership roles in nursing frequently involve managing disputes, negotiating expectations, and maintaining healthy relationships within teams [3]. Unresolved conflict has been linked to burnout, absenteeism, and reduced quality of care [4]. Therefore, conflict resolution competence is considered a core leadership skill.

The Thomas–Kilmann Conflict Resolution Model

The TKI identifies five conflict modes based on assertiveness and cooperativeness:

• Competing – pursuing one's own interests (high assertiveness, low cooperativeness)

• Collaborating – seeking mutual solutions (high assertiveness, high cooperativeness)

• Compromising – both parties give up something

• Avoiding – delaying or sidestepping issues

• Accommodating – yielding to others' needs (low assertiveness, high cooperativeness)

Thomas and Kilmann (2008) argue that effective leadership involves selecting modes situationally rather than relying on a preferred style [2].

Competence and Confidence in Conflict Management

Competence refers to the knowledge, skills, and judgement required to use the TKI appropriately. Confidence is the self-perception of capability to enact these skills [3]. In nursing, competence and confidence develop over time through training, mentorship, and experience [1]. Studies indicate that without formal conflict-management training, managers often default to avoiding or competing styles [1].

Problem Statement

Although the TKI model is recognised internationally, nursing managers often lack the training and organisational support needed to apply it effectively. Low confidence in conflict management can lead to avoidance, inconsistent decision-making, and escalation of tensions within nursing teams.

Aim and Objectives

Aim

To explore nursing managers' competence and confidence in applying the Thomas–Kilmann Conflict Resolution Model in daily practice.

Objectives

1. To assess nursing managers' knowledge of the TKI model.

2. To explore their confidence in selecting and using TKI conflict styles in clinical contexts.

3. To identify barriers and facilitators influencing practical application.

4. To examine real-world examples demonstrating the challenges of implementing the TKI in nursing leadership.

Methods

This study uses a conceptual and practice-based qualitative analysis, drawing on existing literature, leadership theory, and applied examples from clinical environments. Insights were synthesised to understand how nursing managers interpret and enact the TKI in daily practice.

Findings and Discussion

Knowledge and Understanding of the TKI Model

Most nursing managers are familiar with the idea of conflict styles but lack detailed knowledge of the TKI's theoretical foundation [1]. Managers often confuse accommodating and avoiding or see competing as inherently negative. This limited understanding reduces competence in selecting appropriate modes.

Practical Example:

A nurse manager addressing repeated lateness by a staff member may choose compromising (''Come in 30 minutes earlier twice a week'') instead of collaborating on understanding root causes such as transport issues. This shows partial knowledge but limited depth.

Confidence in Applying Conflict Modes in Daily Practice

Confidence varies depending on the conflict mode:

High Confidence in Compromising

Compromising is viewed as ''fair and quick,'' making managers confident in using it [2].

Moderate Confidence in Collaborating

Managers recognise collaborating as ideal but feel constrained by time, workload, and fear of confrontation.

Low Confidence in Competing and Avoiding

Although competing is necessary in safety and policy-driven situations, managers may avoid it due to fear of staff complaints or being perceived as authoritarian [1]. Avoiding is used frequently but often out of discomfort rather than strategy, reflecting low confidence rather than competence.

Practical Example:

During a dispute between two senior nurses over shift allocation, a manager avoided the issue for several days, leading to escalating tension. Avoidance was chosen not as a deliberate strategy but due to uncertainty about handling emotional staff members.

Organisational Barriers Affecting Competence Key barriers include:

• Lack of formal conflict-management training [1].

• Absence of organisational policy referencing the TKI

• Heavy workloads restricting time for collaborative approaches

• Limited managerial support when conflict escalates

Such constraints undermine both competence and confidence.

Facilitators of Effective TKI Application

• Leadership mentoring

• Regular reflective practice

• Simulation-based conflict training

• Supportive organisational culture focused on dialogue

Practical Example:

Managers trained through conflict-simulation workshops reported feeling more confident to use collaborating and accommodating approaches in emotionally charged scenarios.

How the TKI Improves Conflict Resolution in Nursing Practice When applied well, the TKI:

• Encourages situational decision-making

• Reduces misuse of avoidance

• Promotes teamwork and communication

• Helps managers balance assertiveness and empathy

Managers who understand their own default conflict modes can better adapt to staff needs [2].

Conclusion

Nursing managers recognise the importance of conflict management, yet their competence and confidence in applying the TKI model remain inconsistent. Many rely on compromising or avoiding because they feel uncertain about handling more complex approaches such as collaborating. Strengthening TKI competence requires structured training, supportive organisational policies, and ongoing mentorship. As healthcare environments grow more demanding, equipping nursing leaders with robust conflict-management skills becomes essential for maintaining staff morale, effective teamwork, and patient care quality.

References

1. Jooste, K. (2020) Leadership in Health Services Management. 3rd edn. Cape Town: Juta. Muller, M.E., Bezuidenhout, M. & Jooste, K. (2021) Healthcare Service Management. Cape Town: Juta.
2. Thomas, K. & Kilmann, R. (2008) Thomas–Kilmann Conflict Mode Instrument. Mountain View, CA: CPP.
3. Bandura, A. (1997) Self-eficacy: The Exercise of Control.New York: W.H. Freeman. Bimray, P., Jooste, K. & Venter,D. (2019) ‘Conflict experiences among nurses in clinical settings’, Curationis, 42(1), pp. 1–9.
4. Van der Colff, J. & Rothmann, S. (2014) ‘Burnout among South African nursing professionals’, Journal of Psychology in Africa, 24(1), pp. 34–43.