Purpose/Hypothesis : Entry-level physical therapists with low knowledge but high knowledge confidence may make mistakes with their patients. Alternatively therapists with high knowledge but low knowledge confidence may be reluctant to act in the clinic. The purpose of this study was to investigate teaching-learning activities in an amputee rehabilitation Ð wound care management course that enhanced or diminished studentsÕ ability to develop high levels of knowledge confidence.Number of Subjects : Twenty-three second-year DPT students participated. All had completed one 8-week full-time internship and 45 hours of integrated clinical experience.Materials/Methods : Participants completed on-line surveys within 48 hours of starting this course, after completing a midcourse written examination and the final examination. Participants rated their knowledge and knowledge confidence regarding selected course objectives on a 10 point Likert scale (1=low, 10=high) and completed weekly journal entries noting what factors promoted or inhibited their knowledge confidence. A small subset (n= 12) participated in a one-hour focus group that was conducted after this course ended. Journal entries and focus group transcripts were analyzed using a constant comparative process with categories, patterns, and themes identified and coded. Change scores from the pre-post Likert scale surveys provided the basis for analyzing these data using dependent t-tests (p < .01). Qualitative data were used to triangulate the quantitative data which informed the qualitative data and description.Results : Students rated their knowledge and knowledge confidence as improved after they completed both halves of this four-week course. The qualitative data indicate that Ôhands onÕ lab work, faculty guided analyses of gait videos, problem based learning activities, independent study time, and review sessions increase studentsÕ confidence in their knowledge. Instructional approaches that seem to inhibit student confidence in their knowledge included long or rushed teaching sessions, too much content in too short of a time span, disorganized teaching, and teaching that was not directly linked to patient care activities.Conclusions : Confidence in oneÕs knowledge is significant to develop as a physical therapist. This study suggests knowledge confidence is influenced by a complex interaction of instructional methods, volume of course content, and level of student engagement with the material.Clinical Relevance : By working to promote studentsÕ confidence in their knowledge we may enhance their patient care skills.