Purpose: To determine the effect of using standardized patients during a practical examination on the students’ confidence in core physical therapy competencies. Methods/Description: Students completed an electronic survey prior to and after a musculoskeletal physical therapy practical examination involving standardized patients. The survey contained 20 questions asking students to rate their confidence in core physical therapy competencies using a 5 point Likert scale. The survey was adapted from a study by Armstrong1 involving athletic training students. The post examination survey also included open-ended questions asking for students’ reflections on the learning experience. Group means for the entire survey and individual question responses were compared pre and post examination using the Wilcoxon signed-rank test. Results/Outcomes: Fifty second year DPT students (average age 25.5 years, 33 females) completed the pre and post examination surveys (100% response rate). The Cronbach’s alpha for the survey was 0.91. The mean response for the 20 items of the students’ self-perceived confidence survey increased from pre (4.12 +/- 0.375) to post (4.358 +/- 0.351) examination by 0.235 points on the 5 point Likert scale (95% confidence interval: 0.154-0.316, Z=0.697 , P<0.001). Out of the 20 individual survey items, 6 were significantly increased from pre to post examination. Students reflected that the realistic nature of the practical experience, the opportunity for self-assessment, and the feedback on their interaction skills from the standardized patient led to increased confidence. Conclusions/Relevance to the conference theme: Students’ confidence in core physical therapy competencies was increased after a practical exam experience involving standardized patients. The students described the experience as positive, realistic, and highly valued the feedback from the standardized patients. Limitations are that this was one cohort of a single DPT program using a pre-test post-test design. Future research should involve randomized designs and include objective measures of student performance. Using standardized patients may enhance students’ confidence in core physical therapy competencies and readiness for full time clinical internships.