Adequacy of Human Resources in Medical Tourism: Scale Development Study

Aim: This study aims to develop the first validated psychometric scale designed to assess the adequacy of human resources in medical tourism. As a rapidly growing global industry, medical tourism demands competent, communicative, and analytically skilled healthcare professionals. Given its strategic advantages, Türkiye has emerged as a major destination in this field, underscoring the novelty and the necessity of an assessment tool to ensure sustainable service quality. Method: This methodological study reports analyses of the validity and reliability of the Healthcare Workforce Adequacy Scale (MedToue-HHR). Participants were 347 healthcare personnel working in medical tourism at a public hospital in Konya. This study followed the seven-step framework proposed by DeVellis (2014). The item pool was generated through an integrative literature review and expert interviews, which were analyzed using conventional content analysis. Two coders independently reviewed codes and themes (Cohen’s kappa > 0.80). An initial 25-item pool was refined through expert panel review and pilot testing, resulting in a final 17-item scale. Data were collected from 347 healthcare professionals engaged in medical tourism. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and validity and reliability analyses were conducted. Convergent and discriminant validity were assessed through AVE, CR, and Fornell-Larcker criteria. Results: EFA revealed a three-factor solution—Communication and Team Competence (CTC), Technical Competence (TC), and Analytical Competence (AC)—explaining 63.2% of the total variance. Factor loadings ranged between 0.436 and 0.861. CFA confirmed this structure with acceptable fit indices: χ²/df = 3.05, RMSEA = 0.077, SRMR = 0.045, CFI = 0.924, TLI = 0.911. For all constructs, AVE values exceeded 0.50 and CR values surpassed 0.70. The square roots of the AVEs exceeded the inter-construct correlations, confirming discriminant validity. Cronbach’s alpha ranged from 0.819 to 0.895. Conclusion: The MedTour-HHR Scale represents a theoretically informed, empirically validated instrument for assessing healthcare workforce adequacy in medical tourism. Its three-factor structure has practical implications for healthcare institutions and decisionmakers by enabling the identification of skill shortages, supporting the development of training programs, and improving the quality of service delivery in globally competitive environments. Nevertheless, future cross-cultural validation studies are encouraged to further establish the scale’s robustness and generalizability.