BACKGROUND: Nurse practitioner programs increasingly incorporate distant learning. Challenges establishing workforce preparedness and clinical competency are well documented in distance education literature. An evidence gap exists establishing the efficacy of online course delivery modalities. OBJECTIVE: To determine if an online clinical training program with required residencies is an effective delivery modality in nurse practitioner education. METHODS: This observational, cohort research evaluates distant learning by comparing student cohort outcomes from a successful hybrid family nurse practitioner (FNP) program to student cohort outcomes from an online with residency requirement program. Mixed methods, comparative research examine a convenience sample of 98 FNP students. Quantitative measures include 5 summative simulation based experiences, national certification exam pass rates, and an indirect student survey. Statistical analyses include equivalence tests with Bonferroni corrections for multiple comparisons and Pearson Chi-square test for independence. Qualitative analysis employs a short answer question, open-coded for thematic analysis, to assess curricular model perceptions. RESULTS: Analyses demonstrate no practical difference, broad statistical equivalency across 6 of 7 quantitative measures, and identify qualitative similarities in thematic analyses across cohorts. CONCLUSION: This study supports equivalency in outcomes between hybrid and online with residency course delivery models when curricular and clinical competency assessments are uniformly implemented. This research suggests the impact of curricular delivery modality is low.