Translation and psychometric validation of instruments assessing healthcare professionals’ digital competence and associated factors – an international multisite study

BACKGROUND: As healthcare systems worldwide become increasingly digitalised, the skills, knowledge, and attitudes of healthcare professionals toward digital technologies are now recognised as essential for both everyday clinical practice and as part of broader competence framework. Previous research has studied digital competence among healthcare professionals through instrument development, yet it has lacked international scope across diverse healthcare settings. The purpose of this study was to conduct a cultural and linguistic validation of the Digital Health Competence (DigiHealthCom) and Aspects Associated with Digital Health Competence (DigiComInf) instruments. The aim was to verify the structure of the factor model in the instruments across 19 different countries and healthcare systems. METHODS: An international multisite instrument translation, content validity assessment and survey data collection on healthcare professionals' self-evaluated digital competence were conducted between March 2022 and September 2024. The data (n = 6440) was analysed with exploratory factor analysis and confirmatory factor analysis to test the factorial structure of the DigiHealthCom and DigiComInf instruments measuring healthcare professionals' digital competence and educational and organisational factors associated. FINDINGS: Scale level content validity ranged from 0.83 to 1.00 in DigiHealthCom and 0.73 to 1.00 in DigiComInf. Minor cultural adjustments were made to the items across healthcare countries. Both instruments showed high internal consistency (α = 0.95 - ω = 0.95) and the items' internal consistency varied between 0.59 and 0.86 in item-to-total correlations. Exploratory factor analysis confirmed the construct validity with five factors in DigiHealthCom and two factors in DigiComInf. Confirmatory factor analysis revealed adequate model fit in the five-factor structure in DigiHealthCom and three factor structure in DigiComInf. INTERPRETATION: The findings provide preliminary support for the reliability and factorial validity of the instruments across diverse healthcare contexts and languages. However, cross-cultural measurement invariance should be established before instrument scores are compared directly between countries.

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Journal
International Journal of Medical Informatics
Published
2026-09-11
DOI
https://doi.org/10.1016/j.ijmedinf.2026.106712
Primary Topic
Telemedicine and Telehealth Implementation
Type
article
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article

Translation and psychometric validation of instruments assessing healthcare professionals’ digital competence and associated factors – an international multisite study

Tove Aminda Hanssen, Segundo Jiménez-García, M. Utsumi, Martín Krause et al.
International Journal of Medical Informatics
Telemedicine and Telehealth Implementation
article

Translation and psychometric validation of instruments assessing healthcare professionals’ digital competence and associated factors – an international multisite study

Tove Aminda Hanssen, Segundo Jiménez-García, M. Utsumi, Martín Krause, Amalie Nilsen Hagen, Marco Tomietto, Megan F. Liu, Dania Comparcini, Petra Mandysová, Erika Jarva, Wilson Tam, Franzisca Domeisen Benedetti, Kristina Mikkonen, Miyae Yamakawa, Janne Kommusaar, Rita Ramos, Giancarlo Cicolini, Jung Jae Lee, Olga Riklikienė, Mari Kangasniemi, Janicke Andersson, André Fringer, María Flores Vizcaya-Moreno, Andrea Egger‐Rainer, Catharina Gillsjö, Brigitte Fong Yeong Woo, John Unsworth, Piret Paal, Wentao Zhou, Xiaoyan Liao, Fen Ye, Anna Stefanowicz-Kocoł, Nele Stock, Paula Macalintal, Aneta Grochowska
article en

Abstract

BACKGROUND: As healthcare systems worldwide become increasingly digitalised, the skills, knowledge, and attitudes of healthcare professionals toward digital technologies are now recognised as essential for both everyday clinical practice and as part of broader competence framework. Previous research has studied digital competence among healthcare professionals through instrument development, yet it has lacked international scope across diverse healthcare settings. The purpose of this study was to conduct a cultural and linguistic validation of the Digital Health Competence (DigiHealthCom) and Aspects Associated with Digital Health Competence (DigiComInf) instruments. The aim was to verify the structure of the factor model in the instruments across 19 different countries and healthcare systems. METHODS: An international multisite instrument translation, content validity assessment and survey data collection on healthcare professionals' self-evaluated digital competence were conducted between March 2022 and September 2024. The data (n = 6440) was analysed with exploratory factor analysis and confirmatory factor analysis to test the factorial structure of the DigiHealthCom and DigiComInf instruments measuring healthcare professionals' digital competence and educational and organisational factors associated. FINDINGS: Scale level content validity ranged from 0.83 to 1.00 in DigiHealthCom and 0.73 to 1.00 in DigiComInf. Minor cultural adjustments were made to the items across healthcare countries. Both instruments showed high internal consistency (α = 0.95 - ω = 0.95) and the items' internal consistency varied between 0.59 and 0.86 in item-to-total correlations. Exploratory factor analysis confirmed the construct validity with five factors in DigiHealthCom and two factors in DigiComInf. Confirmatory factor analysis revealed adequate model fit in the five-factor structure in DigiHealthCom and three factor structure in DigiComInf. INTERPRETATION: The findings provide preliminary support for the reliability and factorial validity of the instruments across diverse healthcare contexts and languages. However, cross-cultural measurement invariance should be established before instrument scores are compared directly between countries.

International Journal of Medical InformaticsVol. 222
University of Alicante (ES), Lithuanian University of Health Sciences (LT), University of Pardubice (CZ), Witten/Herdecke University (DE), National University of Singapore (SG), ZHAW Zurich University of Applied Sciences (CH), University of Skövde (SE), Charles University (CZ), Paracelsus Medical University (AT), Oulu University Hospital (FI), Turku University Hospital (FI), Nord University (NO), Akademia Tarnowska (PL), Northumbria University (GB), University of Chieti-Pescara (IT), Kyoto Prefectural University of Medicine (JP), St. Luke's Medical Center (PH), Hospital General Universitario de Alicante Doctor Balmis (ES), Taipei Medical University (TW), University of Bari Aldo Moro (IT), University of Tartu (EE), Oulu University of Applied Sciences (FI), Halmstad University (SE), UiT The Arctic University of Norway (NO), University of Silesia in Katowice (PL), University of Hong Kong (HK), Guangzhou Medical University (CN), University of the Philippines Open University (PH), The University of Osaka (JP), University of Oulu (FI)
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Openalex Percentile: Top 8%
Telemedicine and Telehealth Implementation
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