Purpose/Hypothesis : Many challenges face physical therapy educators attempting to prepare students to handle clinical practice demands. One is the need to prepare practitioners to provide culturally sensitive care with the increasing diversity of the U.S. population. Another lies in facilitating studentsÕ development of occupational identities. Occupational science literature suggests that participation in meaningful activities helps individuals to develop a Òcomposite sense of who one is and wishes to become.Ó (Kielhofner G, 2008) Previous studies suggest service-learning is beneficial for developing cultural competence; however, its impact on the development of occupational identity has not been fully investigated. The purpose of this qualitative study was to explore the experiences of entry-level physical therapist (PT) students participating in an international service-learning (ISL) program in Belize.Number of Subjects : Participants were six entry-level PT students engaged in an ISL program during their final semester in the educational program.Materials/Methods : This study utilized a phenomenological approach while incorporating a unique methodology, using elements of photo-elicitation and photovoice to illuminate information that may remain hidden during standard interviews. Data included: reflective journal entries; student-generated photo portfolios with accompanying narratives; and a focus group utilizing student photos to stimulate discussion. All data was transcribed verbatim, checked for accuracy, and then analyzed using phenomenological procedures. Results were triangulated using multiple data sources and investigators, and validated with member checks.Results : Four themes emerged from the data: 1. cultural immersion and enlightenment; 2. relevance to future practice; 3. internalization of experience for personal understanding and growth; and 4. establishment of meaningful relationships. Students described that immersion opened their eyes to another lifestyle, while also strengthening essential skills for PT practice including creativity, flexibility, and relationship-building. Areas of personal and professional growth emerged for students as they were placed in uncomfortable situations and emotions surfaced relative to their purpose and self-worth.Conclusions : Findings suggest that implementing an ISL experience was meaningful for entry-level PT students. This reinforces studies that have found immersion experiences assist with development of cultural competence and other clinical practice skills. Beyond this, engagement in the ISL experience helped students to shape their occupational identities specific to their purpose, efficacy, value, and self-worth.Clinical Relevance : Educators may wish to consider ISL programs to promote the development of occupational identities as well as cultural competence. In addition, although further research is needed with these visual methods, educators may wish to consider including photos as a visual-elicitation tool to stimulate reflection in the learning process.