Development and Validation of the Nurse Unit Manager Competency Scale (NUM-CS): A Multicenter Study

To develop and validate the Nurse Unit Manager Competency Scale (NUM-CS) and to examine the stability of its factor structure across hospital settings in China.

Nurse Unit Managers (NUMs) play a central role in clinical governance and care delivery. In China, NUM appointments are commonly based on seniority rather than formal competency assessment. Existing international frameworks provide useful reference points but do not fully reflect the demands of specialized and high-risk hospital contexts. A context-sensitive and psychometrically robust instrument is, therefore, needed to support competency-based nursing management.

A multiphase methodological study was conducted between May and December 2025. Items were generated from a prior qualitative study and refined through two rounds of Delphi consultation. Psychometric testing was performed using two independent samples: a specialized hospital sample (n = 151) for exploratory factor analysis (EFA) and a cross-setting sample (n = 212) for confirmatory factor (CFA) analysis. Reliability, construct validity, and criterion-related validity were examined.

The final NUM-CS consisted of 33 self-report items across six competency domains. EFA showed excellent sampling adequacy (KMO = 0.953; Bartlett's χ² = 5248.363, p < 0.001), accounting for 74.28% of the total variance. CFA supported the six-factor model across hospital settings. Internal consistency was high across all domains. Total NUM-CS scores were positively correlated with the 12-item situational judgment test score (r = 0.312, p < 0.001).

The NUM-CS is a preliminarily validated, practice-oriented tool for identifying and developing NUM reserve candidates across diverse hospital settings in China.

The NUM-CS offers a structured tool to support competency-based identification, development, and formative assessment of NUM reserve candidates, particularly in specialized and high-risk clinical environments.