Purpose/Hypothesis : The purposes of this study were:1) to investigate the impact of Service Learning (SL) on physical therapy (PT) studentÕs attitudes about working with older adults and 2) to report student perceptions regarding competence in examination and interpretation of balance/gait and in ability to make recommendations to mitigate fall risk. We hypothesized studentsÕ confidence in examining older adults would increase and anxiety levels would decrease after SL. Also, we hypothesized students would perceive more benefits when actively involved in both the design and delivery of SL.Number of Subjects : Eighty PT students in two consecutive cohorts in a first-year geriatrics course with a SL component participated.Materials/Methods : The PT department established a collaborative relationship with the Senior Citizen Services organization, which identified a community need for falls risk screenings and senior education regarding risk reduction. SL activities included visits to local Senior Centers to provide fall risk screenings, which included balance and gait assessments, education regarding environmental fall risks, and if appropriate, recommendations for assistive device use. The first cohort of students (n=41) were actively involved in the design and delivery of SL activities, generated the screening tools, and created a Ògood room/bad roomÓ model for home safety education. The second cohort of students (n=39) used the screening tools and educational materials the previous class designed, but only delivered the SL. Outcomes were assessed by pre- and post- SL surveys using a Likert-like scale. Responses to questions evaluated anxiety levels in working with seniors, confidence level in essential competencies for the care of older adults and perceived benefit of SL. Data was analyzed with paired t-tests.Results : Both cohorts had similar anxiety and confidence levels pre-SL (p=0.45). All studentsÕ anxiety levels regarding working with older adults decreased post-SL (p<0.01) and all students reported increased confidence in essential competencies for assessing and mediating the risk for falls in older adults post-SL (p<0.01). Moreover, students who were actively involved in the design and delivery of SL activities expressed self-perceived improvement in their skills to interpret results of evaluations, to determine type and severity of balance impairments (p<0.05) when compared to students who only delivered SL.Conclusions : Embedding SL into a geriatrics course improved student confidence and decreased anxiety regarding working with older adults. Empowering students to be actively involved in the design and delivery of SL increased their self-perceived ability to serve an older adult population.Clinical Relevance : To adequately address the safety, health promotion and wellness needs of the growing older adult population, PT programs must prepare students to effectively examine and treat this population. SL is one method, which provides students opportunities to practice and refine affective, cognitive and psychomotor skills in an authentic situation.