Purpose: Online learning is growing exponentially across disciplines, including the health professions (Liu, Q., et al. 2016). However, distance learning (DL) encompasses more than just online instruction. Distance learning using video conferencing technology provides an opportunity for instructors to synchronously teach more graduate students than may be accommodated in a traditional classroom, which is especially advantageous where cohorts are located in separate physical sites. This technology allows instructors to interact with students both face-to-face as well as at a distance. A small number of physical therapy (PT) programs operate using this type of DL instruction and there are additional programs looking to expand using this technology. However, little is known about its influence on student learning in entry-level PT programs. The purpose of this investigation was to examine students’ perceptions and experiences of a DL course in a rural PT program, with the intent to guide future studies on the effectiveness of synchronous DL instruction. Methods/Description: A pre- and post-survey on students’ perceptions of DL was administered to students enrolled in a single course over two consecutive years. The students were located at two distinct campuses. The majority of students were at the campus located away from the instructor (n= 76). All participants were provided with 10-questions on a five-point Likert scale questionnaire, including biographical information, administered through Qualtrics.com. Survey questions were purposefully directed using a mixture of positive and negative prompts toward perceptions of DL. Electronic informed consent was provided according to Institutional IRB guidelines. Results/Outcomes: Ninety nine students (93%) completed the survey; first-year DPT (72) and MOT (27) students (21-42 years of age, 53 females and 46 males). Approximately 43% of participants had never experienced a synchronous DL class. Primary analysis was conducted on two specific questions: 1. Does DL require significant changes in the learning process for the student? and 2. Does DL make it difficult to contribute to class discussions? There was little change with the pre/post results regarding question 1. Students’ initial perceptions on whether DL requires significant changes in the learning process was slightly less (46.53%) than the post-test results (47.96%). In addition, fewer students (22.45%) were neutral in the post-test compared to the pre-test (26.73%) following their experiences with DL. There was a greater change in the pre/post results regarding question 2. More students believed that is was more difficult to contribute to class discussion in a DL course in the post survey (61.61% agreed while 16.16% disagreed) compared to the pre survey (47.52% agreed while 21.78% disagreed). Students who were neutral to this question also dropped from 30% in the pre-test to 22.22 % in the post-test. Conclusions/Relevance to the conference theme: Students clearly have a different experience when learning through DL. Instructors who teach with DL using blended learning need to become more learner-centered and actively engage students with effective formal and informal assessment practices that target desired learning outcomes. Such learner-centered assessment may reside in not only what understanding is being measured but also how it is assessed (Lederman, 2019) in order to accurately gather evidence of learning. Even for traditional Face-To-Face delivery, how instructors facilitate the understanding of learning content is critical to achieving desired learning outcomes. For DL environments, it would require active learning strategies that address the object of learning (Lang, 2016). Achieving this objective entails even clearer guidance with purposeful directions for assigned readings (Tolman, 2017). It will also require specific approaches to make targeted connections during class discussion to keep students engaged. Croft, Dalton and Grant (2015) conducted a study on student isolation in a non-ground based program and determined that student isolation from peers was an impediment to their learning, and affected their learning experience negatively. The study also concluded that the lack of interaction between students and instructors was detrimental to student learning. Although student isolation was not a targeted item in this study, the element of participation and interaction is. Relevant to this program is the comprehensive online education national study: Changing Landscape of Online Education (CHLOE 2) report by Legon and Garrett (2017) which concluded that blended learning is the best modality among online, blended and traditional modalities. The use of DL technologies with online learning supplementation is a method of blended learning. Teaching using DL requires a fundamental shift in awareness and preparation on the part of both the faculty and the students in order to benefit from learning with DL technologies. In addition to previous research, the results of this study will facilitate conversations between faculty and students to further our understanding of behaviors that influence learning with DL technology.