Development and psychometric validation of a core competency scale for military nurses in high-altitude extreme environments

Background: With the ongoing evolution of military operations, future high-altitude missions are expected to present significant challenges due to extreme environmental and geographical conditions. As essential members of the medical support system, military nurses play a crucial role in various combat rescue operations-particularly in casualty care under special environmental conditions-where their competency directly influences the effectiveness of medical support. Evaluating casualty care capabilities in extreme settings not only reflects the overall performance of rescue personnel but also provides a foundation for capability development and training. This study developed a core competency scale for high-altitude extreme environment rescue among military nurses (HA-MNCS) and examined its reliability and validity, offering a practical tool for use in training and assessment by managers. Method: Based on a literature review and semi-structured interviews, an initial item pool was constructed. The scale was refined through expert consultation, group discussions, and a pilot survey. Using convenience sampling, 220 active-duty or civilian nurses from two hospitals in China were recruited. Item analysis, reliability, and validity tests were conducted on the collected questionnaire data. Results: coefficient of the scale was 0.948, the split-half reliability was 0.810, and the test-retest reliability was 0.962. Conclusion: The HA-MNCS demonstrates good reliability and validity and can serve as an effective tool for evaluating the core competency of military nurses in high-altitude extreme environment rescue operations. It provides a valuable reference for improving assessment systems and optimizing training programs.