Defining competence in health care professions: Peer consensus, credentialing standards, and psychometric rigor

Defining professional competence in health care is critical for ensuring patient safety, public trust, and workforce integrity. This article examines the processes and standards that underpin credentialing in health care professions, emphasizing the interplay between peer consensus, psychometric rigor, and legal compliance. We describe how subject matter experts establish practice standards through systematic job analyses, which form the foundation for competency frameworks and high-stakes credentialing examinations. We discuss best practices in test development and standard-setting methods to demonstrate how validity, reliability, and fairness are achieved in alignment with accreditation standards. Emerging technologies, including artificial intelligence, are also identified for their potential to enhance credentialing processes while introducing new considerations related to fairness, transparency, and governance. Legal frameworks further underscore the necessity of defensibility in credentialing programs. By synthesizing historical context, technical standards, and emerging innovations such as artificial intelligence, this article provides an overview of practices for credentialing in health care that help to ensure credentials reflect genuine competence and uphold public protection.