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Alternative teacher education programs prepare teacher candidates to offset the K-12 nationwide teacher shortage. However, many alternative teacher candidates work as first-time K-12 teachers while simultaneously pursuing an initial teaching license. Clinical practice-based teacher education may be an instructional approach that helps in-service alternative teacher candidates quickly develop effective instructional practices to strengthen K-12 student learning. This case study examined a clinical practice-based approach to training in-service alternative teacher candidates. Five characteristics of a clinical practice-based approach were identified: (1) intentional course design considerations, (2) purposeful engagement in core teaching practices, (3) encouragement of reflective thinking and instructional reasoning, (4) inspiring a conscious focus on K-6 students’ perspective, and (5) emotional engagement and investment.