which is different from the result obtained byJang (2010) and Kim (2006). This result is believed to be because of the individual characteristics of ER nurses. This religion-based difference highlights the effect of philosophy on nursing, through which nurses develop comprehensive perspectives of the human body and mind. This result highlights the need for a nursing philosophy or a vision of individuals, departments, or organizations (Merk & Bu¨ker, 2013). In addition, educating ER nurses on communication resulted in better communication competence. This result is believed to be because of the effect of communication education and is supported by previous studies (Im, 2011; Merk & Bu¨ker, 2013). Thus, communication education program is critical to improving the communication competence of ER nurses