Construction of an entry-to-practice competency evaluation index system for public health nurses in China: A Delphi...

Public health nurses (PHNs) play a key role in health promotion, infectious disease control, policy development, and emergency response. In China, specialized PHN training has not yet been established, highlighting the need for a competency evaluation system.

To construct a competency evaluation index system for PHNs to guide future training and assessment in China.

A two-round Delphi study based on the Iceberg Competency Model.

A panel of 27 experts (associate senior level or above) in community nursing practice, management, education, or public health was recruited from seven cities across China.

A preliminary indicator system was developed through literature review and semi-structured interviews with 17 community nurses and 15 public health physicians. Two Delphi rounds were then conducted with the 27 experts, who rated indicator importance and provided revision suggestions. Indicators were retained if importance mean > 3.5 and coefficient of variation <0.25.

Both rounds achieved a 100% effective response rate, with an expert authority coefficient of 0.90. Kendall's W coefficients were 0.518 for the first round and 0.628 for the second (both P < 0.001). The final system comprised 4 first-level, 19 second-level, and 80 third-level indicators.

The PHN competency evaluation index system is structured around four overarching domains, namely professional knowledge, professional skills, professional competence, and professional qualities. It demonstrates methodological rigor, thereby offering a standardized and actionable framework for competency assessment, personnel training, and workforce development in China, and ultimately contributing to enhanced public health service quality.