Pre-fieldwork core competencies for mental health occupational therapy students in Taiwan under conditions of volatility, uncertainty, complexity and ambiguity: A Delphi method

Introduction: In mental health occupational therapy (MHOT) fieldwork, the volatility, uncertainty, complexity and ambiguity (VUCA) environment poses challenges for students. The present study, conducted in Taiwan, aimed to identify pre-fieldwork core competencies essential for preparing occupational therapy undergraduates for mental health fieldwork, with a focus on professional readiness and resilience. Methods: A two-round Delphi survey was conducted with MHOT fieldwork instructors across Taiwan. Round 1 included 14 experts (10 completed) and generated preliminary items through qualitative analysis. Round 2 involved 20 experts (16 completed) who rated item appropriateness and agreement. Consensus was evaluated using descriptive statistics and predefined thresholds. Results: Expert consensus confirmed 15 pre-fieldwork core competencies; each meeting established subjective criteria (median, interquartile range, standard deviation). Content validity ratios exceeded 0.49, averaging 0.76. The Percentage of Positive Ratings ranged from 52.94% to 94.12%, averaging 82.75%, surpassing the 70% threshold. Kendall’s W showed moderate agreement for definition appropriateness (0.494, p < 0.000) and overall agreement (0.34, p < 0.000). Metrics for convergence, consensus and stability (0.34–0.85) confirmed strong expert alignment. Conclusions: The framework comprises 11 core and 4 adaptive competencies, organised into 5 domains, and provides a practice-oriented blueprint for early clinical preparation in VUCA-challenged mental health settings.