Development of a competency framework for airport emergency medical personnel: a Delphi and analytic hierarchy process study

INTRODUCTION: Airports, as critical transportation hubs, encounter unpredictable medical emergencies that require specialized competencies from emergency nursing staff, but existing hospital-derived training and assessment tools lack tailored, tiered indicators. This study developed a measurable core competency framework for airport emergency nurses based on the Onion Model. METHODS: A preliminary indicator set was established through a comprehensive literature review, refined through two Delphi rounds with 17 experts (June-September 2025), and weighted using the Analytic Hierarchy Process (AHP). Expert authority and coordination coefficients confirmed the reliability of the results. RESULTS: The final framework was validated by a 100% expert response rate and significant coordination coefficients (P < 0.005), and comprises 4 first-level, 13 s-level, and 56 third-level indicators. CONCLUSIONS: This Onion Model-based framework offers a structured, validated tool for targeted training, performance assessment, and workforce development in airport emergency settings.