Purpose: The purpose of this innovative, 2:1 ICE is to provide peer-to-peer collaborative learning, leadership development, and patient ownership in a non-traditional, low-resource environment. Methods/Description: The adaptive sports ICE is offered to 2nd year DPT students in the 3rd semester of the DPT program. The clients are recruited from the nearby community via word-of-mouth, newspaper advertisement, and clinical contacts. The clients have completed formal physical therapy but, given the chronic nature of their condition, continue to experience deficits in physical ability. The clients have expressed an interest in snow sports, and obtain a physician referral to participate in the PT&SKI program. Working in the 2:1 model, with one client for four weeks, the students complete an initial evaluation, using the ICF model, to develop the plan of care, land and ski goals, interventions, and home exercise program. Each week, a different licensed PT, in the role of the clinical instructor, provides oversight and feedback to the student team. The students alternate "lead PT" for the second 4-week program with a new client. Results/Outcomes: By requiring early independence, creating the complete plan of care, and delivering the case presentation to a different CI weekly, the student develops leadership, teaching skills, clinical creativity, and high level reasoning and responsibility early in the professional program. Students gain access to patients/clients who want to engage in adaptive sports, and use this as the basis for the interventions/goals and to facilitate integration into a community activity. Written and focus-group comments from students are reflective of the challenges and growth during, and after, this adaptive sport clinical opportunities. Developing confidence, being creative in low-resource environments, flexibility in practice, taking on a leadership role, and utilizing feedback from multiple sources are the predominant comments and areas of growth. Conclusions/Relevance to the conference theme: This innovative, unique clinical experience, based on the collaborative 2:1 model of clinical education, in conjunction with an adaptive sports program, develops student leadership, confidence and creativity. The resource-limited, non-traditional clinical was intentionally designed for peer-to-peer collaboration, and teaching to multiple clinical instructors. By engaging with numerous clinicians of varied expertise, and learning/teaching to and from each other, the students report flexibility in learning and creativity in their teaching. This early expectation for full responsibility for patient care appears to develop confidence and leadership skills that may translate directly to creative, flexible future clinical and professional practice.