The International TIGER Competencies Synthesis Project: Learn What is Important

Health IT: ever-changing and powerful

Health information and communication technology (health IT) is a fast moving target that changes with technology innovation cycles, legal and political requirements, new knowledge in medicine and healthcare and last not least with its users who have become keen consumers of digital technology outside their working place. The health industry has realised the great opportunities that arise from using health IT – when it is properly implemented and used. There is evidence, however, that unexpected and detrimental consequences can result from introducing the wrong technology for the wrong application in the wrong context. The answer to this problem for nurses and other clinicians is not to blind out informatics but rather to become a major player of this change.

Health IT needs clinicians at the forefront of informatics

In order to conceptualise and design robust, usable and useful systems for clinicians, clinicians themselves must think and speak informatics. They must have a clear vision of what kind of system they need and must communicate their requirements to the technical developers. This has great implications on the education and life long learning of clinicians. They must be familiar with the underlying concepts, models, procedures, constraints and opportunities that shape their digital working environment. The challenge is not to operate a system properly but to design and implement it to the benefit of its users and to exploit it in the best way possible. Academia must therefore be aware of the need to address changes in their curricula and weave informatics skills into the entire fabric of nursing training and education.

Learning priorities

The International TIGER Competencies Synthesis Project aims to investigate the learning priorities for clinicians from an international perspective and to match these priorities with national and local needs and experiences. To this end, an international survey with 43 participants from 21 countries around the globe was conducted and a series of case studies from six countries was compiled. The survey results provided the top priorities of cognitive competencies in health informatics for nurses holding different roles, such as clinical nurse/nurse practitioner, quality manager, coordinator of inter-professional care, nurse manager and nursing informatics specialist. It became clear that nurses in all roles needed broad and profound health informatics competencies. Top priorities covered the competency areas nursing documentation, information and knowledge management, information and communication systems and data protection and security, In addition, they also comprised management related competency areas such as process management, change and stakeholder management and quality management. These results demonstrate the good mixture of competencies related to technical topics, information and knowledge, secure and lawful management of data and competencies that enable the clinicians to define the processes, ensure information quality, foster change and involve the right persons. These are in fact the competency areas that put clinicians into a position to strongly influence the digital workplace.

In-depth learning from case studies

Educators seeking advice how to design the health informatics curricula and courses based on these competency areas can resort to the case studies. They provide the details how to break down the competency areas into competencies, give information on the level and duration of the course and illustrate different didactic styles. The TIGER case studies cover nursing specific and inter-professional courses, at bachelor, masters and continuing educational level, they are addressing different professional roles and yield insight into how the courses were developed.


The more case studies there are the more benefit can be achieved. Therefore, the International TIGER Competencies Synthesis Projects continues compiling case studies from more countries. Aligning with the Horizon2020 project EU*US eHealth Work it aims at amplifying the scope of health informatics competencies to more professions and more roles in healthcare.

Not addressing the change needed, to add these skills into the basic nursing and medical training will be detrimental to preparing the best qualified nurse and doctor in this, the 21st century! We live in an information age and the skills to work successfully in this century, requires essential Informatics competencies not only in the United States but in all countries around the world.

Further reading

  1. MJ Ball, JV Douglas et.al. Nursing Informatics: Where Technology and Caring Meet, 4th Edition, Springer-Verlag, London, 2011.
  2. Hübner U, Ball M, de Fátima Marin H, Chang P, Wilson M, Anderson C. Towards Implementing a Global Competency-Based Nursing and Clinical Informatics Curriculum: Applying the TIGER Initiative. Stud Health Technol Inform. 2016;225:762-4.
  3. Egbert N, Thye J, Liebe J, Schulte G, Hackl W, Ammenwerth E, Hübner U. An iterative methodology for developing national recommendations for nursing informatics curricula. Stud. Health Technol. Inf. 2016;228, 660-664.
  4. Hübner U, Shaw T, Thye J, Egbert N, Marin HF, Ball MJ. Towards an international framework for recommendations of core competencies in nursing and inter-professional informatics: the TIGER competency synthesis project. Stud Health Technol Inform. 2016;228:655-659.