Introduction: Professional practice placements in occupational therapy education can be provided in various ways. Accreditation standards allow up to 200 placement hours of simulation based learning but little is known about the outcomes of simulation compared with traditional placements. Objective: To determine whether occupational therapy students attending a 40hour Simulated Clinical Practice (SCP) attain non-inferior learning outcomes to students attending a 40hour Traditional Clinical Placement (TCP). Methods: This pragmatic, non-inferiority, single blind, multicentre, randomised controlled trial involved students (1st or 2nd year undergraduate, or 1st year graduate entry) from six universities. Power analysis estimated a required sample of 425. Concealed allocation (consenting students, 1:1) was to SCP or TCP in one of three settings: vocational rehabilitation, mental health or physical rehabilitation. SCP material was developed, manualised and staff training provided. TCPs were sought in equivalent settings. Primary outcomes were assessed using the Student Practice Evaluation Form Revised (SPEFR), a standardised examination and unit grades. Logistic regression assessed differences in odds ratios between SCP and TCP on the SPEFR pass/fail rate with sex, age, group allocation, university and placement type as covariates. Analysis of covariance assessed differences between groups on the examination and unit grades. Results: Complete data was collected from 543 students (n=279 SCP; n=265 TCP). Preliminary results indicated that the SCP group achieved non-inferior results compared to the TCP group in professional competency and exam scores. Conclusion: This study will provide evidence about the effectiveness of simulation as part of students' professional practice education in achieving practice competencies in a range of practice areas.