The purposes of this study were to (1) understand and compare pre and post nursing competence (2) analyze the factors impacting nursing competence. The study was conducted from Dec 1,1999 and ended on Jul. 31, 2001. A total of 321 nurses participated in pre implementation clinical ladder system and 222 nurses took the post-test in a medical center. A 5-point Likert scale was used to test nursing competence. The results showed that (1) the average pre and post nursing competence mean scores were 3.77 and 3.78; (2) the mean pre and post-test scores of six nursing competence areas including caring, communicating, teaching, managing, research, self-growth and professional development ability were 4.04, 4.03; 3.95, 3.95; 3.83, 3.78; 3.69, 3.71; 2.85, 2.98; 3.60, and 3.68; (3) there were no significant difference between these two groups in the six nursing competence areas; (4) there were significant differences in age, working position, marital status, number of children, years of service, attending training, motivation to attend clinical ladder systems, subjective nursing competence classification, objective nursing competence classification (N1, N2, N3, and N4), and importance of work by using ANOVA. Subjective nursing competence classification, boss's leadership, family support, personal motivation, and working years could explain 21.7% of the variance by using stepwise regression. There were 78.3% impact factors not found in this study. The researchers suggested evaluating nursing competence 2 years later continuously in order to use this data to improve teaching and evaluate the quality of nursing care.
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