Despite a growing body of evidence that a practice-based approach is the best way to prepare teachers, few studies to date provide tangible insight into how to move toward a clinical model. With the release of Clinically Oriented Teacher Preparation (COTP) in 2015, the National Center for Teacher Residencies (NCTR, formerly UTRU) set out to illustrate what preparation programs actually do as they transition to a clinically oriented approach; what the move toward practice-based preparation looks like; and what can be learned from programs across the nation that are transitioning to clinically oriented teacher preparation. The COTP Case Study Project (CSP) takes an in-depth look at the opportunities and challenges programs face as they instantiate each key shift. Through three case studies, NCTR digs more deeply into the lessons learned from and the struggles inherent in transitioning to a clinical model.