Physical therapy students are frequently ill-prepared to practice in the dynamic healthcare environment immediately after graduation. Implementing other teaching modalities may help to better prepare physical therapy graduates. Medical student and nursing education have effectively used simulation to help prepare students effectively for clinical practice. The purpose of this ex post facto analysis is to assess the effect of simulation on clinical decision-making in Doctor of Physical Therapy students in a physical therapy program in the Northeastern United States. One-hundred and twenty-two students in two class years participated in the study, with 71 partaking in a simulation activity and 51 students serving as the control. The results demonstrated that the students who participated in simulation had significantly higher scores on the CDM Tool than the students who did not participate in simulation. The results also further validated the CDM Tool by demonstrating that second year students had significantly higher scores on the CDM Tool than first year students at both time points. Further research is required to determine how many simulation experiences are necessary for long-term learning and if the changes observed in the simulation lab are similar to those seen in the clinical environment. [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.]