Implementation and Validation of Competency-Based Spiritual Care Education using the EPICC Self-Assessment Tool in Undergraduate Nursing Students

• Competency-based spiritual care education is essential but lacks culturally adapted tools. • This study validates the EPICC self-assessment tool for Portuguese nursing students. • Findings support improved curriculum design and assessment in nursing education. The World Health Organization and various healthcare organizations recognize the spiritual dimension as crucial for well-being and health, particularly in person-centered care. The EPICC project developed a consensus-based model for spiritual care education, contributing tools like the EPICC Spiritual Care Competency Self-Assessment Tool to support competency development. To translate, culturally adapt, and validate the EPICC Spiritual Care Competency Self-Assessment Tool for undergraduate nursing students in Portugal. Cross-cultural adaptation followed by Beaton et al.'s method. Reliability and validity were assessed using Kaiser–Meyer–Olkin (KMO) and Bartlett’s tests for factor analysis, with internal consistency measured using Cronbach’s α. Data collected between November 2023 and October 2024 showed 100% agreement and a Content Validity Index (CVI) of 1 among experts. A pretest with 39 students indicated 79.1% agreement and acceptable internal consistency (KR-20 = 0.573). Psychometric properties showed KMO of 0.845, CFI of 0.895, GFI of 0.805, RMSEA of 0.082 and Cronbach’s α of 0.92 ( n = 161 nursing students from a Portuguese higher education institution). The European Portuguese version of the EPICC Spiritual Care Competency Self-Assessment Tool is a valid and reliable instrument for assessing spiritual care competency in nursing and midwifery students. However, some limitations of this study should be addressed in future research to enhance the generalisability of the findings to broader educational contexts.