On December 18, 2025, our first publication within the COREtool project was published in the journal BMC Nursing. This systematic review examines self-assessment instruments developed to measure disaster nursing competencies among nurses. The aim was to identify an instrument that could serve as a reference standard for research, education, and workforce development. However, the findings of the study are sobering: none of the instruments can currently be recommended without reservation.
The background of this work lies in the growing importance of the role of nurses in disaster contexts. The number of disasters has increased significantly over recent decades. As the largest professional group in the healthcare system, nurses play a central role in disaster management. In order to promote their competencies in a targeted manner, these competencies must first be measured validly. In practice, this is often done using self-assessment instruments. However, whether these instruments meet scientific quality standards has not yet been systematically examined.
A systematic literature search identified eight instruments from various countries, ranging from Brazil to Iran, Saudi Arabia, China, Turkey, and South Korea. All explicitly refer to the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies . Despite this shared reference, the instruments differ considerably in their psychometric quality.
The evaluation was conducted using the scientific COSMIN standards . These assess key measurement properties such as validity, reliability, and responsiveness, that is, whether an instrument measures what it is intended to measure, how reliably it does so, and whether it can sensitively detect changes over time, as well as the quality of instrument development.
The assessment of validity was particularly critical. Content validity, that is, whether the individual items adequately capture the competency domain in a comprehensive, relevant, and comprehensible manner, was sufficiently demonstrated only for the DNCS from Iran. All other instruments showed deficiencies with regard to relevance, comprehensiveness, or comprehensibility of the items. Structural validity, whether the internal structure of an instrument reflects the theoretically assumed dimensionality, was generally sufficiently supported, with the exception of the DNCS, for which relevant data were lacking. Construct validity, examining whether the results correspond to theoretically expected relationships, was investigated only for two instruments, the NCC-PHE from China and the DNPRCS from South Korea, both with sufficient results. Cross-cultural validity, that is, comparability across languages and cultural contexts, was analyzed only for the CDNMQ from Turkey and was rated as insufficient.
With regard to reliability, the overall picture is somewhat more stable: with the exception of the DNPRCS, for which corresponding data are missing, the reliability of the instruments is generally sufficiently supported. Internal consistency, that is, whether the individual items of an instrument measure the same underlying construct, was also consistently rated as sufficient.
A serious deficit, however, is evident in responsiveness: not a single instrument examined whether it can validly detect changes over time, for example following training or educational interventions. Yet in the context of disaster preparedness and competency development, this property is of central importance.
The methodological quality of the development processes is overall heterogeneous and often insufficiently documented. Although all instruments refer to the ICN competency framework as their theoretical foundation, the structural implementation of this framework varies considerably. Only one instrument, the NDRCAR from Brazil, explicitly aligns with the eight dimensions of the ICN framework, others structure their scales according to phases of the disaster management cycle or thematic categories.
Overall, our findings indicate that the measurement of disaster nursing competencies currently rests on a methodologically weak foundation. For research, education, and practice, this means that statements regarding competency development must be interpreted with caution. If competencies in disaster contexts are to be promoted on an evidence-based basis, an instrument is needed that meets scientific quality standards, is internationally applicable, and can be implemented in routine nursing practice. The development of such an instrument is therefore not only justified but urgently required, and is consequently the objective of the COREtool project.