Electronic healthcare services, also known as eHealth, is defined as the use of information and communication technologies (ICT) in health and healthcare (WHO, 2016). eHealth is dynamic and rapidly evolving in current healthcare services (Aluoch, 2016). The use of technology in healthcare is not new. Before the COVID-19 pandemic, the care delivered through eHealth was estimated to grow at an annual rate of 16.8 %. However, during the pandemic, it increased to 80 % (Rutledge et al., 2021). While the development and deployment of eHealth have continued at a rapid pace, healthcare professionals are expected to keep up and adapt to this digital evolution (Honey and Wright, 2018). A study, using structuration theory and intuitive logics scenario planning methods, showed a shift towards a strong and increasing presence of eHealth in future midwifery practice (Bleijenbergh et al., 2022). The extensive eHealth development provides new contexts for care, with both opportunities and new challenges (Ali et al., 2022). Technological innovations are an opportunity to address the challenges of modern health (i.e. an ageing population and the high prevalence of chronic diseases), but only if accompanied by a behavioral transformation and the engagement of healthcare professionals (Barchielli et al., 2021, Puckett, 2020, van der Zijpp et al., 2018).

Nurses and midwives represent a large group of healthcare professionals and are regarded as important actors in the successful implementation of eHealth. Essentially, their work has a practical hands-on focus in direct contact with patients, instead of a digital one (Honey and Wright, 2018, Ten Hoeve et al., 2017). The digital health transformation has created demands for nurses and midwives to acquire additional skills and competencies. This enables them to engage in eHealth safely and effectively and assist patients in adapting to digital health (Ali et al., 2022). Moreover, professionals would benefit from a learning process on how to use and organize eHealth within healthcare – adapting to digital health. A digital adaptable healthcare professional is flexible between (in)direct patient care and the (simultaneous) use of technology and will consult eHealth as a resource to answer problems and provide care via eHealth, to support or improve care (Bleijenbergh et al., 2023, Puckett, 2020).

Training nurses and midwives on how to be more digitally adaptable might encourage them to engage in eHealth (Risling, 2017, van Houwelingen et al., 2016). To educate these professionals, it is important to critically assess the competencies required to be a digital adaptable healthcare professional (Ahonen et al., 2016, Sharma and Clarke, 2014). A modified three-round e-Delphi study on digital adaptability used expert consensus to identify the necessary competencies to be(come) a digital adaptable healthcare professional, resulting in a set of items representing the competencies of digital adaptability for nurses and midwives. This set contains 29 practice-oriented items providing the first comprehensive description of the relatively new competencies of digital adaptability (Bleijenbergh et al., 2023).

The Belgian eHealth Monitor and the USA National League for Nursing issued a call for further action in preparing (student) healthcare professionals for a technological healthcare future (Bleijenbergh et al., 2023, Risling, 2017, Verhellen et al., 2020). These 29 items are therefore an informative series of skills and other abilities essential to be(come) a digital adaptable healthcare professional. Examining the conceptual structure of digital adaptability makes explicit what properties are relevant, as these form the foundational cognitive operationalization in practice and the education of future nurses and midwives. This study therefore aimed to investigate the underlying constructs between the 29 practice-orientated items of the competencies of digital adaptability.