Which Leadership Style Works Best? What Research Says About Servant Leadership and Team Trust

What does good leadership performance look like?

In the research, well-led teams share five markers. People stay, and the intent to leave drops. Burnout drops. People bring problems forward early, while they are still small, instead of hiding them until they are expensive. Discretionary effort goes up, meaning the right things get done without being policed. And job satisfaction rises.

In healthcare this is not a soft outcome. A systematic review by Wong and colleagues (2013) linked relational leadership styles to higher patient satisfaction and to lower mortality, fewer medication errors, less restraint use, and decreased hospital-acquired infections. How the team is led reaches patient outcomes.

Notice that compliance is not on this list. Any leadership style can get people to do what the person in charge says, at least for a while. But compliance is not the same as staying, speaking up early, or giving the extra effort nobody required. If your team does what you say but tells you nothing, covers nothing voluntarily, and quietly updates their resumes, you do not have performance. You have compliance standing where performance used to be. And from the top, the two look the same, which is why so many leaders find out the difference on the day the resignations start.

The real question is not which style feels right. It is which style produces those five markers.

Picture the same morning four ways. A callout leaves the team short, and the work is stacking up. What happens next depends less on the problem than on the style of the person in charge.

The four leadership styles, in one scenario

1. Laissez-faire leadership: the absent leader. They hope the problem sorts itself out. No decision gets made, so everyone makes their own, and those decisions certainly conflict. The team learns that nobody is steering. Over time they stop bringing problems forward and start working around leadership instead of with it. Research consistently ranks laissez-faire leadership as the worst-performing style, and now you can see why: it fails all five markers at once. Doing nothing performs worse than almost anything else a leader can do.

The skill to learn: clarity. Ambiguity creates conflict. Most of the disputes on this leader's team are not people problems, they are unanswered questions, assumed expectations, and a story around what "should" be. Be clear about who does what and what success looks like. Set everyone, including yourself, up to win.

2. Reactive leadership: the crisis decider. These leaders decide fast, from frustration, and announce it. Sometimes it is even the right call. But the team learns something else along the way: pressure sets policy here. So, they comply today, push back tomorrow, and wait to see whether the next crisis reverses the decision.

The skill to learn: the pause. When we are triggered, the emotional brain moves faster than the thinking brain, and the reactive decision is almost always made inside a story we have not checked. Pause before responding and ask whether the story you are telling yourself about what happened is true.

3. Task-focused leadership: managing the work, not the people. The schedule gets fixed. The staff feels like widgets. The room gets colder. The work gets done and trust gets thinner, and nobody can point to the exact moment it happened.

The skill to learn: the emotional deposit. This leader is not doing anything wrong. They are only making withdrawals: every contact with the team is a correction. Relationships need roughly five positive interactions for every negative one to stay healthy. Notice something specific that is working and say so.

4. Servant leadership: the leader who asks first. They ask the team what they need to get through the day, listen, then decide. It may be the same decision the reactive leader would have made. The difference is what the team learns: our leader is for us. And that lesson compounds.

The skill in use: this leader is already practicing conflict management. Asking whether someone needs listening or help before offering either. Acknowledging what people say before deciding, not deciding for them. These are learnable behaviors, not personality traits.

When a leader is two of these at once

These four are postures, not personality types, and most leaders move between them. A combination I see often in my practice is the absent leader and the reactive one living in the same person. This leader is invisible on the ordinary days, and everywhere the moment something breaks. The team never experiences steady leadership. They experience weather. Calm means nobody is watching. Storm means someone is in trouble.

Notice what that combination teaches. The only way to get leadership's attention is to have a problem. So, problems become the communication channel, and some teams learn to manufacture urgency just to get a decision made. It also means every single interaction this leader has with the team is a withdrawal, because they only show up for corrections and crises.

The fix is not a better crisis response. It is a presence that exists outside of crisis. A leader who shows up on the ordinary days can be sharply decisive when the storm comes, and the team reads it as leadership. The same decisiveness from a leader nobody has seen in two weeks reads as an ambush. The difference between those two moments is not the decision. It is everything you did on the ordinary days before it.

What is servant leadership?

Servant leadership flips the usual question. Instead of asking, how do I get my team to perform, the servant leader asks, what does my team need from me to perform, and treats answering that question as the job. The idea comes from Robert Greenleaf in the 1970s, and the research since defines it by where the leader's attention goes: to each person's needs, to their growth, and outward to the team and the people the team serves.

Two things it is not. Servant leadership is not consensus. The leader in the scenario above asked, listened, and then decided. Asking first does not mean everyone votes. And it is not softness. Servant leaders still hold standards, still correct, and still make the hard call. What changes is the order of operations: understand first, then act.

If you work in healthcare, you already know how to do this. Assess what the person in front of you needs. Ask questions to be sure your assessment is correct and to find out what you might be missing. Then act on it, making decisions collaboratively when possible. That is nursing. Servant leadership is the same assessment, aimed at your team.

What does the research say about leadership styles?

The five markers at the top of this piece are not my opinion. Two large bodies of evidence sit behind them, and one comes straight from healthcare.

Cummings and colleagues reviewed more than one hundred studies of nursing leadership in the International Journal of Nursing Studies (2018). The pattern was consistent. Relational leadership styles, the ones that invest in people and not just tasks, were associated with higher job satisfaction, better retention, lower burnout, and healthier work environments. Task-only styles were associated with the opposite, and laissez-faire leadership performed worst of all.

Eva and colleagues reviewed 285 studies spanning twenty years of servant leadership research in The Leadership Quarterly (2019). Teams led by servant leaders show higher trust in the leader, stronger team effectiveness, and more organizational citizenship behavior, which is the research term for people doing the right thing without being policed.

Why does servant leadership work? Trust is the mechanism

Both reviews point to the same mechanism: trust. People who believe their leader is for them can hear hard feedback without reading it as an attack. People who do not believe that will experience even a gentle correction as one more strike. The words matter less than the trust behind them.

The emotional bank account: leadership as a ratio

I learned about the emotional bank account from research by John Gottman on relationships. Evidence suggests that people need roughly five positive interactions for every negative one to stay relationally healthy. Appreciation, acknowledgment, humor, connection, and encouragement are examples of deposits. Corrections and criticism are withdrawals.

Necessary withdrawals are fine. Every leader has to make them. The trouble starts when the only contact a team has with their leader is a withdrawal. You cannot withdraw from an empty account, and most teams that seem resistant to feedback are not being difficult. They are overdrawn.

This is what the leadership research looks like at ground level. Servant leadership is not a personality type you either have or lack. It is a set of skills you learn. It is a mission and a purpose. It comes from being purposeful in the experience you want to cause, for yourself, your teams and your organization. It's a ratio that is built one interaction at a time.

What does servant leadership cost, and what does it save?

I want to acknowledge the cost for taking the time to lead well, because there is one. Asking before deciding adds a beat to decisions that used to be instant. The deposits take attention you could spend elsewhere. Listening to what your team needs takes minutes on days when you do not have minutes. That is the whole bill: some time, some attention, and the discipline to ask before acting.

Now the other side of the ledger. The 2026 NSI National Health Care Retention and RN Staffing Report puts the average cost of replacing one bedside RN at $60,090, and each one percent change in RN turnover costs or saves the average hospital about $295,000 a year. The leadership styles that keep people, per Cummings, are the relational ones. One nurse who stays because her leader was for her pays for a great many minutes of asking first.

And that is only the number you can put on an invoice. The daily savings are harder to count and larger: problems surfaced while they are still small, corrections that do not spiral into conflict, effort nobody had to police, and the meetings you never had to have about the conflict that never happened. Servant leadership costs minutes. The alternatives cost people.

Like many "right" things to do, the real choice is between paying up front and saving time, money and frustration on the back end, or rushing through and paying, sometimes more than we can afford, on the back end.

The fastest way leaders destroy trust: talking about people who are not in the room

One behavior drains the account faster than any correction: leaders talking about each other, or about team members, to the team.

Every leadership style runs on one belief, that the leader is trustworthy when you are not in the room. When people hear leadership talk about someone who is absent, the lesson they take is not about the absent person. It is about themselves: if leaders talk this way about each other, they talk this way about me. No leadership style survives that lesson, because the mechanism every style depends on is gone.

The fix is daily, not complicated. Speak only to the people involved. When someone brings you talk about a third person, ask if they have spoken to that person directly. The conversation being avoided by talking to you is usually the conversation that needs to happen.

Leadership skills are conflict management skills

Look back at the four mornings and notice what the skills were. Clarity about expectations. Pausing before reacting. Checking the story you are telling yourself. Making deposits before withdrawals. Speaking only to the people involved. None of these are leadership techniques in the org-chart sense. They are conflict management skills, and the research on leadership styles is research on which leaders have them.

That is good news, because it means the difference between the four leaders above is not personality. There are no people problems here, only skills gaps, and skills can be learned.

People do more of what they see you do

Being a manager is complicated. The people you lead have whole lives you cannot see, and sometimes your best intended words do not land the way you hoped. That is not failure. That is what leading people is like.

So here is the hard part, offered with care: if you are struggling with your team, look in the mirror first. People will do far more of what they see you do than what you tell them to do. If the team gossips, ask where they learned that it is how things work here. If nobody admits mistakes, ask what happens when you make one. You are modeling constantly, whether you mean to be or not. The only choice is what you model.

And sometimes what needs modeling is humility. An apology. Owning a mistake out loud, in front of the people who watched you make it. Nothing builds trust faster, because nothing is harder to fake.

Leveling up: start with one skill this week

It's no more possible to be a manager without learning how. than to be anything without learning how. Too often, managers are doing the best they can without any training. The UK's Chartered Management Institute found that 82% of managers are what they call accidental managers, promoted with no formal leadership training at all. In nursing it is the standard path: clinical nurses are regularly promoted into leadership based on clinical skill and experience, with little or no training in leading people (Warshawsky and Cramer, 2019). One study of clinical nurse managers found most had no preparation before entering the role, and the phrase that kept coming up was "I learned by myself day by day" (Buck and colleagues, 2023).

If that is you, nothing is wrong with you. You were the best clinician on the floor, someone handed you a team, and you likely had no idea what you were signing up for. You are leveling up. It is a different skill set, and to do it well, you need the training for it.

So here is the reframe. Deciding is the first step, and it counts. The next step is developing, one practiced behavior at a time. That is what leveling up means: not becoming a different person, just adding skills to the person you already are, the same way you added clinical skills year by year.

Start with one. This week, make at least one deposit with each person on your team. Notice something specific and say it. Not flattery, evidence. Then watch what happens the next time you have to make a withdrawal.

And know that the learning itself is doing work. A leader visibly building a skill is modeling something the team badly needs to see: willingness to learn, to be vulnerable, to try and maybe not get it right, and to try again. On a team where nobody admits to being unfinished, that demonstration may matter more than the skill.

This is exactly what the Best Conflict Conversation Cards were built for: fifty skills, one card at a time, to learn on your own and to practice with your team while you learn them. Model plus learn. Your team builds the skill alongside you, and they watch you building it, which teaches more than the card does.

Leadership is not about having the answers. It is about building the kind of trust that lets a team find its own way through the hard mornings. The research says so. So does every team that has ever had a leader who was for them.

Kimberly Best, RN, MA, spent decades as a critical care nurse before becoming a mediator and conflict management consultant. She is the owner of Best Conflict Solutions, LLC and creator of the Best Conflict Conversation Cards, practical tools for building these skills one week at a time. Learn more at www.bestconflictsolutions.com.

Sources: 

Buck, C. K., Dorrell, J. J., & Winslow, S. A. (2023). Leadership development recommendations for clinical nurse managers to bolster the postpandemic workforce. Nursing Administration Quarterly, 47(3), E27-E33.

Chartered Management Institute. (2023). Taking Responsibility: Why UK PLC Needs Better Managers. CMI/YouGov.

Cummings, G. G., et al. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60.

Eva, N., Robin, M., Sendjaya, S., van Dierendonck, D., & Liden, R. C. (2019). Servant leadership: A systematic review and call for future research. The Leadership Quarterly, 30(1), 111-132.

Gottman, J. M. (1994). Why Marriages Succeed or Fail. Simon & Schuster.

NSI Nursing Solutions, Inc. (2026). 2026 NSI National Health Care Retention & RN Staffing Report.

Warshawsky, N. E., & Cramer, E. (2019). Describing nurse manager role preparation and competency: Findings from a national study. JONA: The Journal of Nursing Administration, 49(5), 249-255.

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709-724.