Cultivating Confidence in Future Physical Therapists

August 25, 2026

When Scott Lowe, PT, DPT, OCS, FAAOMPT, an assistant professor in PCOM Georgia’s physical therapy department, worked as a full-time physical therapist, he began to notice a pattern among the students he supervised and new graduates he mentored. They knew how to evaluate and treat patients, but their confidence could vary depending on what part of the body they were treating. For one student, it might be the cervical spine or, for another, the shoulder.

“Every new physical therapist seemed to have one body region they didn’t feel totally confident with,” said Lowe.

After joining PCOM in 2022, Lowe decided to find out whether those individual experiences reflected a broader trend: Are there certain body regions that physical therapy students consistently feel more—or less—confident treating?

The resulting study, “Self-Reported Confidence of DPT Students in Assessing and Treating Different Body Regions Within Musculoskeletal Physical Therapy Practice,” conducted with Jennifer Wiley, PT, DPT, DHSc, of the University of North Georgia, examined how confident final-year Doctor of Physical Therapy students across the United States felt assessing and treating musculoskeletal conditions across different body regions. The study was published in PCOM’s Journal of Integrated Primary Care (JIPC) in July 2026.

The survey asked students to rate their confidence from one, “very low,” to five, “very high,” both overall and for specific musculoskeletal regions. Of 203 responses, the knee ranked highest, with an average confidence score of 4.24, followed by the lumbar spine and hip at 3.88 and 3.87, respectively. Wrist and hand ranked lowest at 2.63, followed by the thoracic spine and pelvis/sacroiliac joint at 3.2.

Shaping Students’ Confidence

Students’ confidence in treating different areas of the body may vary based on their level of familiarity. Lowe suspects that this familiarity can develop through greater emphasis in the classroom or through experiences students bring with them into the program.

“The lumbar spine may have been higher than I expected, essentially because it’s known to be challenging,” Lowe said. “I think students, classroom educators, and clinical educators potentially put more focus on it. And every year, there are a handful of students in the class who have had their own ACL or meniscus surgery. That may give them more familiarity with the anatomy and rehabilitation involved.”

Less exposure may help explain lower confidence in other areas. Some respondents, for example, said the wrist and hand received less attention because they were viewed as primarily the domain of occupational therapists or hand specialists.

But exposure alone does not confirm whether students’ confidence accurately reflects their abilities. A student may underestimate their ability to treat a patient despite having the necessary skills, while another may feel confident without demonstrating the same level of proficiency. That distinction has made Lowe increasingly interested in metacognition—students’ ability to accurately assess what they know and what they still need to develop.

Turning Findings Into Practice

The findings also give educators a chance to address those perceptions before students enter clinical practice. At PCOM Georgia, Lowe and colleagues have expanded case-based learning involving the three regions associated with the lowest confidence: the thoracic spine, pelvis/sacroiliac joint, and wrist and hand.

Students also build experience through simulation, clinical observations, integrated learning experiences, and classroom exercises. The study recommends that kind of targeted experience more broadly, particularly in areas that may receive less attention, while encouraging students and practicing clinicians to seek additional training or mentorship when needed.

Lowe hopes to eventually study physical therapists in their first years after graduation to see what happens to these confidence differences once they enter full-time practice. Does uncertainty shape which patients clinicians choose to treat—or can repeated clinical encounters ultimately close those confidence gaps?

You May Also Like:

• DO Student Shares Latest Research on Urology Testing
• Te'Jayah Jones Represents DPT Students at APTA
• Caregiving Inspires Ana Juarez's Journey to Medicine