Preservice music educators’ (PMEs) experiences teaching students with disabilities (SwD) often occurs through general education coursework. Researchers have examined the effect of content-specific course work on PMEs preparation to teach music to SwD but have not examined if differences in course and clinical settings impact their self-reported feelings of self-efficacy. The purpose of this study was to examine whether differences in the delivery (online or in-person) of music-specific coursework and clinicals affected PMEs confidence to teach music to SwD. Students who participated in an online course reported a significant decrease in their self-efficacy ( t (17) = 3.57, p = .002, d = 0.89), while those who participated in an in-person course reported a significant increase ( t (10) = 7.116, p = .001, d = 2.15). Although no statistical significance was found between groups ( t (28) = 0.976, p = .33, d = 0.36), a comparative analysis of interview data provided nuanced differences. Applications for preservice music educator needs and instruction are discussed.