Problem: The healthcare environment is dynamic and healthcare professionals must learn to function under unique demands: changing patient needs, multiple interruptions, various distracters, inconsistent resource availability, time-critical needs, and evolving acuity levels. Although the reality of practice is multiple patient assignments, education and orientation processes often focus on the management of one patient at a time to maximize learning and comprehension. This creates a performance gap and may set new nurses up to fail. Educational Intervention: To bridge this gap, a series of four 2-patient simulations were developed and implemented into the final day of a 7 week critical care orientation program. During the program, two patient scenarios occur simultaneously in separate rooms. Scenarios are designed so the “patients” have competing needs requiring participants to consider prioritization, utilization of resources, troubleshooting equipment, and critical thinking. The four simulations (8 patients) incorporate disease processes encountered/discussed during the orientation program. Two participants work as one person to assess and intervene as needed. Different participant pairs are involved with each 2-patient simulation. Result/Outcome: Implementation of 2-patient simulations has resulted in more in-depth discussions of clinical reasoning, prioritization, troubleshooting, resource utilization and use of critical language during the post simulation debriefing session. Participants have said that the experience is more realistic. As a result of the success of this program, multiple patient scenarios have been implemented into Progressive Care Orientation, and nursing student curricula.