Background Culturally responsive nursing extends beyond attitudes to include observable skills and reflective judgment in routine bedside care. In Japan, the lack of a context‐specific cross‐cultural competence measure constrains structured self‐assessment and domain‐targeted education. Aim To develop and psychometrically evaluate a cross‐cultural competence scale tailored to clinical settings. Methods A cross‐cultural competence scale for Japanese clinical nurses was developed in three phases: (1) development of a conceptual framework and item generation, (2) a pilot study for face and content validation, and (3) psychometric analyses. A structured questionnaire was distributed to licensed nurses working in 69 hospitals that actively provide care for foreign patients across Japan. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability testing, and known‐groups analyses were performed ( n = 185). Results After item reduction, EFA supported a 28‐item, five‐factor structure comprising “cultural skills,” “cultural sensitivity,” “cultural knowledge,” “cultural awareness,” and “cultural insight.” Internal consistency was good for all subscales and the total scale (Cronbach’s α = 0.791–0.865; total α = 0.898). CFA provided preliminary support for the five‐factor model, with improved fit after limited theoretically justified modification ( χ 2 /df = 1.99, CFI = 0.874, TLI = 0.856, RMSEA = 0.073, SRMR = 0.077). Known‐groups analyses provided stronger support for prior cross‐cultural healthcare training than for foreign patient care experience. Conclusion The findings provide initial support for the scale as a context‐specific, practice‐relevant measure of cross‐cultural competence among Japanese clinical nurses, including a distinct cultural insight domain. The newly developed scale demonstrated acceptable reliability and validity, capturing both the internal tendencies and external competencies relevant to Japanese clinical nursing practice. It can be applied in education and practice to identify areas for improvement and to guide targeted training.
Xiang et al. (Thu,) studied this question.