Development and Validation of a Competency Assessment Tool for Community Health Management among Nursing Graduates

Abstract

In the context of an increasingly complex and dynamic primary healthcare system, nursing graduates are required to possess comprehensive competencies in community health management that integrate knowledge, skills, and attitudes. However, there is currently no standardized instrument available to assess such competencies in the Thai context. This study aimed (1) to synthesize the components and develop an assessment tool for community health management competencies of nursing graduates, and (2) to assess the community health management competencies of nursing graduates in the affiliated colleges of the Praboromarajchanok Institute under the Ministry of Public Health. A mixed-methods design was employed. In Phase 1, the components of community health management competencies were synthesized through literature review, concept analysis, and in-depth interviews with nursing graduates and practicing community nurses, and then used to develop a behavioral competency assessment tool. Construct validity was examined using exploratory factor analysis (EFA), and internal consistency was determined using Cronbach’s alpha. In Phase 2, data were collected from 552 fourth-year nursing students to assess their competency levels using the developed instrument.

The results showed that the developed instrument demonstrated high internal consistency (Cronbach’s alpha = .972) and comprised nine core components: (1) community health management analysis and design, (2) cultural and belief-based community communication and management, (3) data and information technology use for community health, (4) community health monitoring, evaluation, and development, (5) action research and network collaboration, (6) community engagement and participatory planning, (7) field implementation, (8) leadership and resource management, and (9) evidence-based and academic knowledge application. Component 1 explained the largest portion of variance (38.39%), while the remaining components each explained 0.9–3.8%; the total explained variance of the entire instrument was 50.04%. The overall mean score of the nine components indicated a high level of competence (Mean = 3.38, SD = 0.11), with component means ranging from 3.23 to 3.60.

These findings suggest that the developed instrument is a valid and reliable tool for assessing and categorizing the community health management competencies of nursing graduates. It can serve as a standardized instrument to support curriculum development and guide the preparation of nursing graduates to effectively meet the demands of the primary healthcare system.