New Self-Assessment Tool Measures Nurses’ Perceived Delegation Competence

Nurses delegate tasks every day, yet few validated tools exist to measure how competent they feel doing it. Researchers in Flanders, Belgium, have now developed and content-validated the Nursing Delegation Competence Scan, a concise self-assessment instrument designed to capture nurses’ perceived delegation competence. The study, published in BMC Nursing, describes a multi-phase methodological instrument development and content validation process with preliminary pilot testing, and reports strong item-level validity alongside early feasibility and consistency data from a student sample.

The team built the instrument on the premise that delegation is a core component of professional nursing practice whose importance has grown in healthcare systems marked by workforce shortages, rising care complexity and expanded skill-mix models. Rather than treating delegation as a single skill, the researchers framed it as a multidimensional competence encompassing accountability, communication, clinical judgement, supervision and reflective practice. Because validated instruments assessing nurses’ perceived delegation competence through self-assessment remained limited, the study aimed to develop a theoretically grounded measure and to evaluate its content validity and preliminary measurement characteristics.

Development began with a literature review combined with a structured expert consensus meeting involving academic and clinical experts. This phase produced a preliminary 17-item instrument organised across four theoretically derived domains. The structure was then stress-tested through an iterative three-round Delphi technique with experts in nursing practice, leadership and delegation. Panel participation was anonymous, and only items requiring re-evaluation progressed to subsequent rounds, a design choice intended to focus expert scrutiny on the weakest components rather than re-litigating every item.

The Delphi process trimmed the instrument to a final 16 items arranged in four domains: legal and ethical accountability, communication and feedback, clinical decision-making and supervision, and reflective practice and lifelong learning. Item-level agreement was strong. Final item-level content validity index values ranged from 0.86 to 1.00, and modified kappa coefficients ranged from 0.85 to 1.00, indicating strong item-level validity. Across the iterative Delphi process, the aggregate scale-level content validity index averaged 0.95, a figure the authors interpret as support for the content validity of the instrument.

Next came pilot testing among third-year nursing students, a population chosen to examine feasibility, preliminary internal consistency and preliminary interpretability. Forty-seven participants completed the scan. The median completion time was 3 minutes and 4 seconds, with an interquartile range of 2 minutes 28 seconds to 6 minutes 5 seconds, and the researchers observed minimal missing data. Taken together, these results indicate good completion feasibility among respondents, an important practical property for a tool intended for routine self-assessment.

The preliminary psychometric picture from the pilot was also consistent. The total scale showed high interrelatedness, with Cronbach’s alpha of 0.93 (95% confidence interval 0.89 to 0.95) and McDonald’s omega of 0.93 (95% bootstrap confidence interval 0.79 to 0.97). Corrected item-total correlations ranged from 0.33 to 0.78, and no substantial floor or ceiling effects were observed at the scale level, suggesting that the response scale was neither too easy nor too difficult for this sample to differentiate respondents.

The authors are careful about what these numbers do and do not establish. The findings support the content validity of the Nursing Delegation Competence Scan and provide preliminary evidence regarding feasibility, item interrelatedness and score interpretability in a student pilot sample. They do not yet demonstrate the instrument’s dimensional structure, temporal stability or broader construct validity, and the study explicitly calls for further validation in larger samples to examine these properties. The pilot population of third-year nursing students also limits generalisability to practising nurses, whose delegation experiences and competence perceptions may differ.

What makes the instrument notable is its theoretical grounding and its focus on perception. Delegation competence is not only about knowing what may legally be handed over; it spans accountability for the delegated task, clear communication and feedback, clinical judgement about when and to whom to delegate, supervision of the person performing the task, and reflective practice that feeds lifelong learning. By structuring the scan around these four domains, the developers aimed to create a self-assessment that mirrors the multidimensional nature of delegation recognised in the nursing literature.

Methodologically, the study illustrates a standard sequence for instrument development: derive items from theory and expert consensus, refine them through anonymous iterative expert rating, and then pilot the resulting measure in a small sample to check completion burden, internal consistency and score distribution. The reported metrics follow that logic. Content validity indices and modified kappa quantify how far experts agree that each item is relevant and clear, while Cronbach’s alpha and McDonald’s omega estimate how strongly items covary, and corrected item-total correlations flag items that fit poorly with the rest of the scale.

For nursing education and practice, the scan offers a compact way for students and, pending further validation, practising nurses to reflect on their perceived delegation competence across legal, communicative, clinical and reflective dimensions. The authors position it as a concise and theoretically grounded self-assessment instrument, with the current evidence base supporting its content validity and early feasibility. As workforce pressures continue to push skill-mix models forward, tools that make delegation competence visible and measurable are likely to attract attention; this study provides the first structured step toward a validated option, with the caveat that larger-scale validation work remains to be done.

Subject of Research: Development and content validation of a self-assessment instrument measuring perceived delegation competence in nursing

Article Title: Development and content validation of the Nursing Delegation Competence Scan: a self-assessment instrument for perceived delegation competence in nursing

Article References: De Roo, N., Nachtergaele, S., Serraes, B., & Embo, M. (2026). Development and content validation of the Nursing Delegation Competence Scan: a self-assessment instrument for perceived delegation competence in nursing. BMC Nursing. https://doi.org/10.1186/s12912-026-05491-1

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05491-1

Keywords: nursing, delegation competence, self-assessment instrument, content validation, Delphi technique, psychometrics, pilot testing, BMC Nursing, nursing education, instrument development, Development, content