護生的護理能力是護理教育界及業界所關心的課題。本研究目的為探討護生綜合實習前後的護理能力和改變，及與實習場所的關係。以輔英技術學院專科部898名護理科五年級學生為樣本，採結構式自答問卷，在實習前一個月及實習後二個月，由學生自行填寫，實習期間共36週。所得資料以平均值、t檢定、重複量數ANOVA等統計方法分析之。結果顯示：(1)護生實習前後的整體護理能力均介於「大部份做到」與「部份做到」間；(2)六分項能力中，前後均以「人際關係／溝通」能力最高，「臨危照顧」能力最低。(3)就全體學生來看，整體護理能力及計劃／評値、敎學／協調、人際／溝通、領導、專業發展等五分項能力實習後有顯著增加，臨危照顧能力沒有改變。(4)就實習醫院而言，實習後有顯著增加：醫學中心組在敎學／協調和人際／溝通方面；區域醫院組在整體性能力及計劃／評値、敎學／協調、人際／溝通、領導等能力；巡迴組除了與區域醫院組相同之各項外，專業發展能力亦顯著增加。醫學中心組的臨危照顧能力。於實習後顯著降低。(5)實習前後能力的改變中，領導一項因實習場所不同而有差異。 The purpose of the study is to analyze senior nursing students' clinical competence pre-and post-clinical practice and its relationship with clinical settings. Yu's questionnaire, the Scale of Nursing Competence, was adopted for data collection and was self-administeredby 898 senior students (4th to 5th year). A total of 798 pre test and 689 post test questionnaires were returned. The results showed: (1) The students' overall competence ranked between "competent" and "some what competent" both pre-and postclinical practice. (2) Among the six sub-scales, interpersonal relationship (IPR)/communication was the highest and critical care the lowest on both pre and post tests. (3) After practice, all students had higher clinical competence score with statistical significance in overall competence, planning/evaluation, teaching/collaboration, IPR/communication, leadership and professional development. (4) The students' practice in medical centers showed improvement in teaching/collaboration and IPR/communication. In regional hospitals there was improvement in overall nursing professional competence, planning/evaluation, teaching/collaboration, IPR/communication and leadership. Students who rotated between hospitals showed improvement in overall competence and in all subscales except critical care. (5) Except for leadership competence,t here were no significant relationship between the competence improvement and the clinical setting.