<p>Active nematic models can explain the topological defects and flow patterns observed in epithelial tissues, but the nature of active stress—whether it is extensile or contractile, a key parameter of the theory—is not well established experimentally. Individual cells are contractile, yet tissue-level behaviour often resembles extensile nematics. Here we use a continuum theory with two tensor order parameters that distinguishes cell shape from active stress to address this discrepancy. We show that correlating cell shape and flow, whether in coherent flows in channels, near topological defects, or at rigid boundaries, cannot unambiguously determine the type of active stress. Our results demonstrate that simultaneous measurements of stress and cell shape are essential to fully interpret experiments investigating the nature of the physical forces acting within epithelial cell layers.</p><p></p>