A coronary care training project was established by the Western Pennsylvania Regional Medical Program at the University of Pittsburgh to extend the knowledge, skills, and confidence of nurses caring for cardiac patients. To assess the effectiveness of the four-week course a 120-item multiple-choice examination was developed, which measured the nurse's knowledge as well as her confidence in that knowledge. Nurses were required to give the correct answer to each item as well as to designate whether that answer was certain, a partial guess, or a guess. Posttest results showed that nurses who completed this specialized course performed better and with greater confidence than on the pretest. Whereas only 27.4 per cent of the answers were both correct and given with a high degree of certainty before the course, this figure rose to 66.3 per cent following the course. A six-month follow-up examination of participants showed that knowledge retention of coronary care principles remained high and that 77 per cent of the nurses tested were working in intensive coronary care areas. The ultimate goal of the project was to improve the care of patients in intensive coronary care areas. An ongoing method to assess morbidity and mortality in regional coronary care units was established as a result of this project.