Are you skillful at arguing and debating, at standing your ground, and at using your rank, position, or influence when dealing with conflict? Or are you better in conflict situations with forgoing your desires, yielding to others, and acting with selflessness? According to the Thomas-Kilmann Conflict Mode Instrument (TKI), your conflict-handling style would be either “competing” or “accommodating,” respectively. And if you had certain other dominant skills, your most natural conflict mode might be “collaborating,” “compromising,” or “avoiding.” No one of the five conflict-handling styles is necessarily good or bad, said Yuya Hagiwara, MD, at AMDA – the Society for Post-Acute and Long-Term Care Medicine’s Annual Conference. “All are good if used appropriately,” he said. The point is that conflict management skills are essential for the interdisciplinary practice of post-acute and long-term care, and “we want to be more aware of our own intrinsic conflict management [preferences] and be able to assess what’s appropriate in [each] situation,” he said. Dr. Hagiwara, who practices geriatrics and palliative care medicine at the University of Texas Health Science Center at San Antonio (UT Health San Antonio), led physicians, nurses, and others through the TKI model — a tool developed in 1974 by Kenneth W. Thomas and Ralph H. Kilmann to measure an individual’s response to conflict situations. The five conflict-handling styles defined in the TKI model are described in terms of two basic characteristics: assertiveness and cooperativeness. Each style, or mode, has different levels of these two dimensions. The “competing mode” is high in assertiveness and low in cooperativeness, for instance, while the “accommodating” mode is high in cooperativeness and low in assertiveness. Each of the modes can be overused or underused to one’s detriment, Dr. Hagiwara explained. A “competing” style might be appropriate when you need to take quick action, make unpopular decisions, stand up for vital issues, or protect yourself. “Like when you need to send someone from the nursing home to the emergency room,” he said. If the style is underused, “you can end up having restricted influence,” whereas its overuse can result in indecision and delayed action — if “you’re always in the competing mode, you might not get feedback, and in the end you might be surrounded only by ‘yes people’,” he said. Or take the “collaborating” mode — this style is usually appropriate for committee meetings and other instances when you’re trying to integrate solutions, merge perspectives, gain commitment, or improve relationships. Yet if it’s overused, “you might spend too much time on trivial matters, which can lead to work overload,” he said. “Or there might be people who try to take advantage.” Underuse, on the other hand, may lead to lack of commitment, low empowerment, and loss of innovation. Neela Patel, MD, MPH, CMD, chief of the division of geriatrics and palliative care at UT Health San Antonio and medical director of UT Health Geriatrics & Palliative Care, said she became familiar with the TKI tool when she was a resident. Today, her colleagues find it useful as well, she told Caring. “We work in the clinic, the hospital, and the nursing home … and with hospice,” she said. Developing effective conflict resolution skills is important “for getting results across different settings, getting everyone on the same page, and trying to stay person-centered.” Christine Kilgore is a freelance writer in Falls Church, VA.
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