Development and Preliminary Validation of an Oral Health Multidisciplinary Team Nurse Competency Scale

Oral health multidisciplinary team (OHMDT) care places nurses in a coordinating role across specialties, but the absence of a context-specific assessment tool limits training evaluation, competency benchmarking, and quality improvement. This study aimed to develop and preliminarily validate an OHMDT nurse competency scale.

We conducted a mixed-methods instrument-development study with two phases. First, an item pool derived from a systematic literature review was refined through two Delphi rounds with a multidisciplinary expert panel (n = 16). Second, a cross-sectional survey was administered to OHMDT nurses from three hospitals of different levels in Guizhou, China (September-December 2025). The final analytic sample included 120 nurses, and 25 completed a 2-week retest. Psychometric evaluation included content validity, item analysis, exploratory factor analysis using principal axis factoring with promax rotation, internal consistency, test-retest reliability, floor and ceiling effects, and known-groups validity.

The final scale contained 23 items. Content validity was high (S-CVI/Ave = 0.93). Exploratory factor analysis supported a four-factor structure (KMO = 0.87; Bartlett's χ² [253] = 824.63, p <0.001) explaining 47.3% of total variance. The total scale showed high internal consistency (Cronbach's alpha = 0.895) and good 2-week stability (ICC[3,1] = 0.884; 95% CI: 0.756-0.947). No floor or ceiling effects were observed. Total scores were higher among nurses with longer OHMDT experience (t[69] = -9.59, p <0.001, Cohen's d = 2.32) and differed significantly across professional titles (F[3,116] = 41.01, p <0.001, η²= 0.515).

The OHMDT Nurse Competency Scale showed promising reliability and preliminary validity in this single-province sample. At the current stage, it is best used for research, baseline assessment, or preliminary clinical screening rather than high-stakes standalone decisions. Larger multicenter studies with confirmatory factor analysis and criterion validation are needed.