Development and psychometric validation of a core competency scale for military nurses in high-altitude extreme...

With the ongoing evolution of military operations, future high-altitude missions are expected to present significant challenges due to extreme environmental and geographical conditions. As essential members of the medical support system, military nurses play a crucial role in various combat rescue operations-particularly in casualty care under special environmental conditions-where their competency directly influences the effectiveness of medical support. Evaluating casualty care capabilities in extreme settings not only reflects the overall performance of rescue personnel but also provides a foundation for capability development and training. This study developed a core competency scale for high-altitude extreme environment rescue among military nurses (HA-MNCS) and examined its reliability and validity, offering a practical tool for use in training and assessment by managers.

Based on a literature review and semi-structured interviews, an initial item pool was constructed. The scale was refined through expert consultation, group discussions, and a pilot survey. Using convenience sampling, 220 active-duty or civilian nurses from two hospitals in China were recruited. Item analysis, reliability, and validity tests were conducted on the collected questionnaire data.

The final version of the scale consists of 36 items across four dimensions: theoretical knowledge, professional skill, comprehensive ability, and personal trait. The item-content validity index (I-CVI) ranged from 0.833 to 1.000, and the scale-content validity index (S-CVI) was 0.978. Exploratory factor analysis (EFA) revealed that Bartlett's sphericity test χ ² value was 3217.183 (p < 0.001), the KMO coefficient was 0.839, and the cumulative variance explained by the four common factors was 70.040%. The results of confirmatory factor analysis (CFA) indicated that the root mean square error of approximation (RMSEA) was <0.08, the root mean square residual (RMR) was <0.05, and the incremental fit index (IFI) and comparative fit index (CFI) were both >0.9. The Cronbach's α coefficient of the scale was 0.948, the split-half reliability was 0.810, and the test-retest reliability was 0.962.

The HA-MNCS demonstrates good reliability and validity and can serve as an effective tool for evaluating the core competency of military nurses in high-altitude extreme environment rescue operations. It provides a valuable reference for improving assessment systems and optimizing training programs.