<![CDATA[Background: Competent graduates from Medical Records and Health Information and Health Information Management (MRHIM-HIM) programs are critical to quality patient care. However, no national standardized assessment currently integrates knowledge, skills, and attitudes in MRHIM-HIM education. Objective: To develop and pilot a competency assessment instrument for MRHIM-HIM education integrating knowledge, skills, and attitudes. Methods: Using Research and Development methodology, this study progressed through exploration, development, and evaluation phases. Participants included MRHIM-HIM faculty, educational association administrators, and medical records stakeholders, selected via criterion-based purposive sampling. Qualitative analysis identified patterns, themes, and meanings from observations, interviews, and document reviews. Results: The instrument demonstrated strong psychometric properties (CVI=0.92, Cronbach's ?=0.94) with representative performance indicators. Pilot testing confirmed comprehensive, contextual competency assessment capability. Students showed strong mastery across technical, managerial, and professional domains consistent with national education standards. Conclusion: This validated instrument effectively measures and enhances MRHIM-HIM graduate competencies and may serve as a national performance-based assessment standard. Digitalization and expanded testing are recommended for broader educational and certification implementation. Keywords: development, pilot testing, instrument, assessment, competency.]]>
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