Purpose: Managing complex conditions without guidance or clinical supervision is one of the entry-level performances expected of student physical therapists in clinical education.1The management is challenging as the complexity in complex patients does not only come from their multiple co-occurring medical conditions but also from their behavioral and psychosocial domains.2To help students succeed in fulfilling this challenging expectation, it is imperative to train them during the didactic curriculum and provide them opportunities to work with and learn from complex patient cases prior to their clinical education experiences. Simulation-based education may be well suited for meeting this training need. In healthcare, simulation refers to “a technique – not a technology – to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner.”3(p.126)It makes use of simulated patients – normal individuals portraying patients, for the evocation or replication. Utilizing simulated patients to portray complex patients may prepare students for achieving the entry-level performance of managing complex conditions. A systematic review on simulated patients in physical therapy education revealed that simulated patients appear to have an effect on developing physical therapy clinical practice competencies at a level comparable to other educational methods.4Allowing students to practice on simulated patients also reduces any unnecessary risks being placed on real patients in the initial training phase.5This benefit of risk reduction may be critical to complex real patients considering their vulnerability.6Despite the possible gains from simulation-based education, its utilization can be limited by the potential high cost in personnel, equipment and facilities.7The purpose of this educational session is to present the development and implementation of a complex patient simulation course, which has shown positive educational outcomes using a budget-friendly and resource conscious approach. Methods and/or Description of Project: In 2018, the primary speaker applied for the Hybrid Learning Course Redesign and Delivery grant, offered by the Office of the Provost at the academic institute she works at. The grant was awarded for the speaker to redesign a course named Complex Medical Conditions. Third-year student physical therapists at the academic institute are required to take the course and pass it prior to their final two clinical education experiences. The timing of the course allows it to prepare students for meeting the high standards expected of them in the terminal clinical affiliations. The speaker transformed the course into a complex patient simulation course. She used the hybrid learning model to maximize the in-class time for training students how to work with complex patients through simulation-based education, with the training focused on students’ clinical reasoning. A total of eight complex patient cases were created through the collaboration between the speaker – an academic educator, and four clinical educators, in a structured and systematic manner. The redesigned course was offered for the first time in the fall of 2018. The simulations took place in a classroom and in a large group setting with one third of the class in each group. Psychological fidelity – “the degree to which the skill or skills in the real tasks are captured,”8(p.23)was emphasized more than the engineering fidelity – “the degree to which the training device or environment replicates the physical characteristics of the real task,”8(p.23)during the simulation experiences. Sixty-five students took the course. Every student was scheduled to work with a complex simulated patient in the role of a physical therapist for one time. When not working as a physical therapist, students were primarily in the role of engaged audience in class with their real-time clinical reasoning being challenged and assessed. Results/Outcomes: Outcome measures of the course were collected at the first two levels of the Kirkpatrick Model – reaction and learning.9The results were positive and encouraging. The primary speaker also adopted a cost model framework for instruction10to review the cost in developing and offering the course. The cost is deemed to be low except during the initial phase, in which the complex patient cases were developed and certain one-time expenditures needed to be made. The two speakers will cover the collaboration between the academic and clinical educators in developing the complex patient cases and provide resources for the session attendees to practice the case development. Attendees will also experience the innovative techniques used during simulations to facilitate students’ real-time clinical reasoning and enhance audience engagement. Technologies used in the course will be introduced to the attendees as well. At the end of the educational session, faculty and curriculum developers will be equipped with information, like those from the outcome measures and the cost model framework, to make informed decisions on the desirability, feasibility and viability of developing and running a complex patient simulation course in their programs. Conclusions/Relevance to the conference theme: In clinical education, student physical therapists are expected to be able to manage complex conditions without guidance or clinical supervision when they have reached the entry level.1To help students succeed in fulfilling this high expectation, it is crucial to provide them opportunities to work with and learn from complex patient cases prior to the clinical education experiences. The primary speaker transformed a didactic course into a simulation-based course full of complex patients in order to provide her students the opportunities. Course outcomes were collected and the results were encouraging. The positive educational outcomes also did not come with a hefty price tag. This educational session will show attendees how to utilize simulation-based learning to chart a new and cost effective complex patient simulation course.