The Associations Between Residents' Behavior and the Thomas-Kilmann Conflict MODE Instrument

Abstract

Objective To assess if the Thomas-Kilmann Conflict MODE Instrument predicts residents’ performance. Study Design Nineteen residents were assessed on the Thomas-Kilmann conflict modes of competing, collaborating, compromising, accommodating, and avoiding. Residents were classified as contributors (n = 6) if they had administrative duties or as concerning (n = 6) if they were on remediation for academic performance and/or professionalism. Data were compared to faculty evaluations on the Accreditation Council for Graduate Medical Education (ACGME) competencies. P value of < .05 was considered significant. Results Contributors had significantly higher competing scores (58% versus 17%; P = .01), with lower accommodating (50% versus 81%; P 5 .01) and avoiding (32% versus 84%; P = .01) scores; while concerning residents had significantly lower collaborating scores (10% versus 31%; P = .01), with higher avoiding (90% versus 57%; P = .006) and accommodating (86% versus 65%; P = .03) scores. There were significant positive correlations between residents’ collaborating scores with faculty ACGME competency evaluations of medical knowledge, communication skills, problem-based learning, system-based practice, and professionalism. There were also positive significant correlations between compromising scores and faculty evaluations of problem-based learning and professionalism with negative significant correlations between avoiding scores and faculty evaluations of problem-based learning, communication skills and professionalism. Conclusions Residents who successfully execute administrative duties are likely to have a Thomas-Kilmann profile high in collaborating and competing but low in avoiding and accommodating. Residents who have problems adjusting are likely to have the opposite profile. The profile seems to predict faculty evaluation on the ACGME competencies.

A Systematic Review of Physician Leadership and Emotional Intelligence

“…127,128 Another training program reported positive results in training residents 129 and attributed the program's success to a longitudinal and skill-based structure that supported the residents in their leadership paths to advocate for children's health. Another small study showed that the Thomas-Kilmann Conflict Mode Instrument predicted Accreditation Council for Graduate Medical Education (ACGME) evaluations of residents, 129 suggesting the relevance of EI evaluation to ACGME competencies. In contrast, other studies have not shown a benefit from incorporating EI training into graduate medical education training.…”

Evaluating Professionalism, Practice-Based Learning and Improvement, and Systems-Based Practice: Utilization of a Compliance Form and Correlation with Conflict Styles

“…This is in support of our previous observation that residents who successfully execute administrative duties are likely to have a TKI profile that is high in collaborating and competing but low in avoiding and accommodating, and residents who have problems adjusting are likely to have the opposite profile. 12 Faculty evaluation using ACGME competencies and CREOG in-service scores did not correlate with compliance scores, suggesting that these tools measure different parameters. Our findings support the ACGME mandate that assessments by multiple observers using multiple tools at multiple time points are needed to provide a holistic assessment of residents in the 6 competencies.…”

Leadership Development for Program Directors

“…For administratively successful residents, a Collaborative or Competing mode may be more productive. 6 One possible concern was that a few program directors preferred the Avoiding or Accommodating modes. These 2 modes are clearly appropriate in specific contexts but may not be helpful if used predominantly to handle conflict.…”

“…instrument also has been used to differentiate among residents who have problems adjusting versus those who succeed in an administrative role during residency. 6 The Hersey-Blanchard Situational Leadership (HBSL) model, developed in the late 1960s, focuses on leaders' assessment of their followers' needs and their adoption of the most appropriate leadership style. 7 Followers may have variable degrees of competence and/or commitment (eg, a group of new interns may have little knowledge of systemsbased practice tools and little motivation to learn them).…”