Introduction: Uncertainty exists about the best method for teaching thrust joint manipulation (TJM) to student physical therapists. This dissertation study compared the effects of Peyton's 4-Step (P4) Approach with the "see one, do one" (S1D1) approach on students': (1) Lumbar spine TJM task performance; (2) Attitudes and beliefs towards spinal TJM; (3) Motivation to learn lumbar spine TJM. Review of Literature: The S1D1 approach is used for teaching clinical tasks to students in the health care professions. The P4 approach may better prepare students to practice TJM. Participants: Fifty-eight student physical therapists. Methods: A factorial quasi-experimental design was used. TJM task performance accuracy, time, and outcome were measured. Surveys were used to collect data about students' attitudes and beliefs towards spinal TJM and their motivation to learn TJM. A generalized estimating equations approach was used for data analysis. Results: Fifty-eight students (P4 group n = 29; S1D1 group, n = 29) completed the study. The interaction of instruction with task performance accuracy was significant (p = 0.031). The interaction for task performance time and outcome were not significant. The interaction for students' attitudes and beliefs towards spinal TJM and motivation to learn TJM were not significant. Discussion and Conclusion: The P4 approach was more effective than the S1D1 approach at improving students' TJM task performance accuracy. Instruction alone did not create a meaningful change in task performance time or outcome. Students had a favorable perception of learning lumbar spine TJM. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]