The preparation of newly qualified nurses has raised many professional debates and yet the end product of nurse education, the qualified nurse continues to demonstrate knowledge and skill deficits in areas considered essential to patient care. Technological advances in an ever-changing and complex clinical environment mean that certain acute clinical skills have become routine for the qualified nurse and yet few educational institutions and NHS Trusts in the UK have seen the need to address this within the pre-registration nursing curricula. This study, questions whether the pre-registration nursing curricula is failing newly qualified nurses by not adequately preparing them to cope with the complexities of practical skills within the clinical environment. This skill deficit is rectified on qualifying when nurses rapidly equip themselves with skills that are considered essential for practice. Using a constructivist paradigm and a mixed methods research approach, the opinion of key stakeholders in pre-registration nurse education was sought. Focus groups and surveys were conducted with skills teachers to ascertain essential skills. Constructive alignment theory (Biggs 1999) was tested with two student cohorts from a pre-registration nursing programme (n=58). Comparisons were made between an experimental group who acquired certain skills during their pre-registration programme and a control group who had not acquired those additional skills. The programme was evaluated using Stakes (1967) countenance model of evaluation. Data were analysed using SPSS, constant comparative analysis and triangulation. The findings confirmed that nurses should acquire the skills investigated in this study, but differences of opinion were found as to when this was acceptable. Favourable results for the experimental group were demonstrated indicating the need to provide nurses with the additional skills prior to qualifying. The study also identified other like-minded UK nurse educators who had been innovative with their skills curricula. Nursing curricula can be successfully underpinned by an educational theory such as constructive alignment providing added value to the learner and enablingnurses to enter the profession fit for practice and purpose. To further enhance the quality and standard of provision, the following are recommended: strengthening the collaborative relationships between the key stakeholders for nurse education, as well as promoting interprofessional learning and skills development. This will help improve the international credibility for the UK skills curricula