While the curricula of clinical nurse specialist (CNS) programs have proved to be successful in meeting past and current health care needs of specialty populations, the needs of children requiring care by the CNS have changed greatly over the past few years. Because of advanced technology, more children are surviving, although they may have serious physical, developmental, and psychosocial disabilities. At the same time, the educational, health, and social services for these children have become harder to access. A conceptual model, Family-Focused Pediatric Transitional Care (FFPTC), was used to interpret a survey of graduates of a pediatric clinical specialist program and their employers. Recommendations regarding possible changes in pediatric clinical nurse specialist curricula are offered to guide future educational agendas. Advanced skills in clinical decision making and coordinating care across the continuum from the hospital to the community and to the home have become essential role competencies for the clinical nurse specialist.