|| Checking for direct PDF access through Ovid
The purpose of this study was to examine factors affecting the development of nursing competence in the writing of N3 (clinical nurse level III) case reports. A cross-sectional survey was conducted in 13 hospitals in southern Taiwan from July to October, 2002. The subjects included 239 nurses who had passed N3 case report accreditation. The results show that (1) nurses rated their current competence at a fairly good level (5.57 ± 0.74). There was no significant difference between nurses' subjective self-evaluation and supervisors' objective evaluation (5.57 ± 0.74 vs 5.55 ± 0.89; t = 0.162, p = .871). (2) The nurses' self-rating, supervisors', and colleagues' evaluation all indicated moderate progress in nursing competence after writing N3 case reports. The progress scores rated by nurses themselves, supervisors and colleagues were not significantly different (4.89 ± 1.35 vs. 4.84 ± 1.57 vs. 4.84 ± 1.26; F = 0.096, p = .909). This finding reveals that writing N3 case reports has a positive effect on nursing competence. (3) The results also indicate that ‘Attitude toward N3 case report’, ‘Writing difficulty’, ‘Preparation for writing case report’ were the three predicting factors of progress in nursing competence, which accounted for 26.2% of the total variance. Therefore we recommend that N3 advancement education should include guidance in alleviating writing difficulty and emphasis on implementing various types of preparation for writing case reports, as effective ways to improve nursing competence.