CC BY-NC-ND 4.0 · Methods Inf Med 2018; 57(S 01): e30-e42
DOI: 10.3414/ME17-01-0155
Original Articles
Schattauer GmbH

Technology Informatics Guiding Education Reform – TIGER[*]

An International Recommendation Framework of Core Competencies in Health Informatics for Nurses
Ursula Hübner
1  Health Informatics Research Group, University of Applied Sciences Osnabrück, Osnabrück, Germany
Toria Shaw
2  Clinical Informatics, HIMSS North America, Chicago, IL, USA
Johannes Thye
1  Health Informatics Research Group, University of Applied Sciences Osnabrück, Osnabrück, Germany
Nicole Egbert
1  Health Informatics Research Group, University of Applied Sciences Osnabrück, Osnabrück, Germany
Heimar de Fatima Marin
3  Federal University of São Paulo (UNIFESP), São Paulo, Brazil
Polun Chang
4  National Yang-Ming University, Taipei, Taiwan/ROC
Siobhán O’Connor
5  School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
Karen Day
6  School of Population Health, The University of Auckland, Auckland, New Zealand
Michelle Honey
7  School of Nursing, The University of Auckland, Auckland, New Zealand
Rachelle Blake
8  Omni Micro Systems, Omni Med Solutions GmbH, Hamburg, Germany
Evelyn Hovenga
9  eHealth Education Pty Ltd and Global eHealth Collaborative, East Melbourne, Australia
Diane Skiba
10  University of Colorado College of Nursing, Aurora, CO, USA
Marion J. Ball
11  Healthcare Informatics, Center for Computational Health, IBM Research, USA
› Author Affiliations
Funding: This work was supported by the European Commission within Horizon 2020 grant number (Grant Agreement 727552 EUUSEHEALTHWORK), HIMSS North America, the HIMSS Foundation and the Federal Ministry of Education and Research (bmbf) Germany grant number (16OH21026).
Further Information

Publication History

received: 29 December 2017

accepted: 15 March 2018

Publication Date:
20 June 2018 (online)


Background: While health informatics recommendations on competencies and education serve as highly desirable corridors for designing curricula and courses, they cannot show how the content should be situated in a specific and local context. Therefore, global and local perspectives need to be reconciled in a common framework.

Objectives: The primary aim of this study is therefore to empirically define and validate a framework of globally accepted core competency areas in health informatics and to enrich this framework with exemplar information derived from local educational settings.

Methods: To this end, (i) a survey was deployed and yielded insights from 43 nursing experts from 21 countries worldwide to measure the relevance of the core competency areas, (ii) a workshop at the International Nursing Informatics Conference (NI2016) held in June 2016 to provide information about the validation and clustering of these areas and (iii) exemplar case studies were compiled to match these findings with the practice. The survey was designed based on a comprehensive compilation of competencies from the international literature in medical and health informatics.

Results: The resulting recommendation framework consists of 24 core competency areas in health informatics defined for five major nursing roles. These areas were clustered in the domains “data, information, knowledge”, “information exchange and information sharing”, “ethical and legal issues”, “systems life cycle management”, “management” and “biostatistics and medical technology”, all of which showed high reliability values. The core competency areas were ranked by relevance and validated by a different group of experts. Exemplar case studies from Brazil, Germany, New Zealand, Taiwan/China, United Kingdom (Scotland) and the United States of America expanded on the competencies described in the core competency areas.

Conclusions: This international recommendation framework for competencies in health informatics directed at nurses provides a grid of knowledge for teachers and learner alike that is instantiated with knowledge about informatics competencies, professional roles, priorities and practical, local experience. It also provides a methodology for developing frameworks for other professions/disciplines. Finally, this framework lays the foundation of cross-country learning in health informatics education for nurses and other health professionals.

* Supplementary material published on our website