• aged care;
  • importance-performance-analysis;
  • leadership;
  • middle manager;
  • managerial skills


This study examined the importance and performance of middle managers' skills to provide a starting point for a sector-wide leadership and management framework.


There is an increasing consensus that the quality of management, leadership and performance of any organisation is directly linked to the capabilities of its middle managers and the preparation and on-going training they receive.


A total of 199 middle managers from three aged care organisations in Australia participated in a questionnaire conducted during 2010–2011.


This study found that middle managers perceived the need to develop their communication skills, self-awareness, change management, conflict resolution and leadership skills.


Middle managers perceive a discrepancy between performance and importance of various managerial skills. This study demonstrated that provision of training needs to go beyond clinical skills development and further investigation into managers' needs is necessary, particularly considering the diversity of this critical group in organisations.

Implications for nursing management

Future training opportunities provided to middle managers need to address the ‘softer’ skills (e.g. communication) rather than ‘technical’ skills (e.g. clinical skills). The provision of training in these skills may improve their performance, which may also lead to increased job satisfaction, continuity in leadership and management and ultimately improvements in the quality of care provided.