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

Delegation is a core component of professional nursing practice and has gained increasing importance in healthcare systems characterised by workforce shortages, rising care complexity and expanded skill-mix models. Delegation is recognised as a multidimensional competence encompassing accountability, communication, clinical judgement, supervision and reflective practice. Despite the relevance, validated instruments assessing nurses’ perceived delegation competence through self-assessment remain limited. This study aimed to develop a theoretically grounded instrument to assess nurses’ perceived delegation competence and to evaluate the content validity and preliminary measurement characteristics. A multi-phase methodological instrument development and content validation study with preliminary pilot testing was conducted in Flanders, Belgium. First, the Nursing Delegation Competence Scan was developed based on a literature review and a structured expert consensus meeting with academic and clinical experts. Second, content validity was assessed using an iterative three-round Delphi technique with experts in nursing practice, leadership and delegation. Only items requiring re-evaluation progressed to subsequent rounds, and panel participation was anonymous. Third, pilot testing was conducted among third-year nursing students to examine feasibility, preliminary internal consistency and preliminary interpretability. The initial development phase resulted in a preliminary 17-item instrument structured across four theoretically derived domains. Following the Delphi process, a final 16-item instrument was established comprising: (A) legal and ethical accountability, (B) communication and feedback, (C) clinical decision-making and supervision, and (D) reflective practice and lifelong learning. Final I-CVI values ranged from 0.86 to 1.00, and modified kappa coefficients ranged from 0.85 to 1.00, indicating strong item-level validity. The aggregate S-CVI/Ave was 0.95 across the iterative Delphi process. Pilot testing included 47 participants. The median completion time was 3 minutes and 4 seconds (IQR 2 minutes 28 seconds − 6 minutes 5 seconds), with minimal missing data, indicating good completion feasibility among respondents. The total scale demonstrated high interrelatedness (Cronbach’s alpha = 0.93; 95% CI 0.89–0.95; McDonald’s omega = 0.93, 95% bootstrap CI 0.79–0.97). Corrected item-total correlations ranged from 0.33 to 0.78, and no substantial floor or ceiling effects were observed at the scale level. The Nursing Delegation Competence Scan is a concise and theoretically grounded self-assessment instrument for perceived delegation competence in nursing. 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. Further validation in larger samples is needed to examine the instrument’s dimensional structure, temporal stability and broader construct validity.