The FNP program includes a series of clinical courses: Primary Care I, II, and III, with Primary Care III occurring the semester of graduation. Dr. Elizabeth Phenneger and other FNP faculty incorporated a self-evaluation for students taking Primary Care III at the end of the semester and identified gaps in students' competencies. Faculty created an improvement plan tailored to address these deficits that included : (1) a 7-hour in-person clinical skills intensive day incorporating multiple case-based learning activities, standardized patient case simulations, clinical skills practice on task trainers, and unfolding case studies, and (2) a series of physiology cascade assignments threaded throughout the course. Surveys and faculty assessment revealed significant improvement in students' competencies.