Revising the TIGER 2018 Health Informatics Competency Framework: Updated Core Competency Areas for Nurses in a Digital Health Era

Background: In 2018, the "TIGER International Recommendation Framework of Core Competencies in Health Informatics for Nurses" was published and used worldwide as a global guidance for educators and students to navigate educational requirements in an increasing digital working environment. Objective: Recent developments in digital health point to the need to revise these recommendations. Methods: This update followed the three-step logic of the 2018 framework development process, comprising (1) a global survey capturing the relevance of 43 core competency areas based on the ratings of 117 experts from all continents, (2) four regional expert workshops, and (3) 21 educational case studies. To ensure comparability with the 2018 framework, the same role-based structure was retained, covering Clinical Nursing, Nursing Management, Quality Management in Nursing, Coordination of Interprofessional Care, and Information Technology IT-Management in Nursing. Results: These recommendations underpin the high relevance level of health informatics for all nursing roles, characterizing each role by an informatics pattern: in Clinical Nursing patient issues, personal skills of working properly in a digital environment and a thorough understanding of the legal and ethical background of one's own work dominate the pattern. In Nursing Management, a similar composition prevails extended by management knowledge. The skill mix for Quality Management emerged as a blend of Clinical Nursing and Nursing Management, whereas Coordination of Interprofessional Care strongly emphasized coordination and teamwork capacities. IT Management in Nursing required basic and specialized computer skills incorporating problem solving, communication, and teamwork. These recommendations strongly suggest artificial intelligence (AI) topics should be addressed in all domains and for all roles of nurses. Conclusion: This updated recommendation framework provides guidance for focusing on areas that gained further priority such as patient safety, electronic health records, making use of its data and AI while retaining a core of invariant components of health informatics education for nurses.