Psychometric properties of instruments used to measure the competence of operating room nurses: A COSMIN-based systematic review

Abstract Objective: This systematic review aimed to evaluate competence instruments for operating room nurses,in order to provide evidence-based support for selecting the most appropriate instrument for specific populations. Background: The operating room nurses’ competence significantly affects the quality of nursing care, as well as the outcomes of surgical treatments and patient prognosis.Despite the development of various instruments designed to assess the operating room nurses’ competence, a comprehensive and rigorous systematic review that provides an overview and critical appraisal of these instruments is currently lacking. Consequently,a systematic review of the measurement properties of such instruments is essential. Design: Systematic review of measurement properties following the COSMIN guidelines. Methods： Relevant studies were searched on seven English databases and four Chinese databases from inception to October 2025.The eligible studies were reviewed to identify the competence measured by the instruments for operating room nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The COSMIN checklist was used to assess the studies' methodological quality. Results: A total of 16 instruments were included,and included instruments assessed only two to four psychometric properties.No studies report measurement error and responsiveness.The PPCS-R and the SPLINTS were rated as A recommendations, while the remaining instruments were rated as B recommendations. Conclusion: The study identified the PPCS-R and the SPLINTS as appropriate measures for assessing the competence of operating room nurses.Future research should adhere to the COSMIN methodological standards to strengthen the development and validation of competence assessment tools.