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Excelsior College, an educational institution with a strong background in nursing education assessment, partnered with the Commission on Graduates of Foreign Nursing Schools to conduct a study that assessed self-perceptions of nursing knowledge and the clinical needs of international nurses. The Clinical Competency Survey developed for this study was used to measure perceived proficiency in activities related to safe and effective nursing practice. These included conducting physical assessments, planning nursing care, administering medications, performing treatments, managing specific disease conditions, and using technology. Analyses indicate that international nurses perceived themselves to be less proficient in cardiac assessment and interventions and the use of technology and more proficient in wound and skin management and general physical assessments.