Objectives At Dominican University of California’s nursing program (DUC), a typical pattern would arise where students began each semester with little ability to perform the skills taught in the previous semester. The scale and duration of this problem were significant enough to warrant an intervention. To resolve this problem, the DUC nursing program initiated a large scale semi-annual testing event designed to ensure ongoing competency of appropriate skills each semester. This program change was initiated with the understanding that scheduled tests create great motivation for study and practice. In the process of preparing for testing, the authors also hoped to provide a stimulus for students to perform deliberate practice at regular intervals. While deliberate practice is not a direct requirement of the testing process, as word of mouth from successful students has spread, greater than 95% of the students choose to spend time in the clinical simulation center performing deliberate practice to obtain mastery of the required skills. The objectives of the testing process were to ensure the students were held accountable for maintaining ongoing competency in previously acquired skills. Description The Safe Nursing Skills-Competency Test (SNS-CT) process occurs at the beginning of each semester. Students in all med-surg and preceptorship courses are tested. Four unique testing stations with rich personal narratives provided context. On test day students are randomly assigned a station. SNS-CT rubrics were developed and numerically rated. Students are provided rubrics in advance, allowing for deliberate practice. Students are encouraged to attend open lab in pairs to grade each other during practice. Students voluntarily practice skills at each station. The labs are open for practice sessions extensively during the week prior to testing. The stations use low-fidelity human patient simulators (HPS). Students who do not “pass” are encouraged to attend additional open lab hours until they achieve competency. The goal of the testing process was to have students review previously taught clinical skills ultimately demonstrating competency. After three semesters of competency testing, the program is deemed a success based upon both testing pass rates (> 97%) and extensive student contact hours logged during open lab sessions. The labs in which practice/testing occur were near full capacity for many hours preceding testing. Lab hours were extended to support student demand. Conclusion DUC has experienced success in nursing students’ ongoing competency with clinical skills through implementation of SNS-CT. Requiring students to test at only one of four possible stations has been effective at prompting students to deliberately practice all the required skills. Students demonstrate a strong desire for practice time, and use it effectively. Working in pairs has been particularly popular as an active study technique. Students voluntary preparation for testing has been extensive, requiring the addition of resources in both lab time and materials to meet the needs. This is viewed as a highly positive response by the authors. Testing stations in which rich personal narratives and clinical scenarios encompassing multiple skills have been an effective method for providing context for student decision making and skill recall. Providing extensive open lab hours is resource intensive, but appreciated by the students. Providing additional payment for clinical faculty to be available has been an effective method of ensuring appropriate staffing on test day. Testing of non-senior nursing students has been effective with senior or graduated students resulting in cost savings. Results of surveys are being used for continuous quality improvement.