Introduction: Clinical reasoning skills develop through repeated practice in realistic patient scenarios. Time constraints, declining availability of clinical education sites and patient safety are some of the factors that limit physical therapy educators' ability to expose students to realistic patient scenarios. Computerized simulations may be an alternative tool to expose students to realistic patient cases. The purpose of this study was to compare the effects of computerized patient simulations and facilitated group discussion of cases on physical therapy students' clinical reasoning skill, knowledge acquisition and transfer of learning. Methods: A quasi-experimental design using a 2 x 2 factorial analysis with random assignment was used to test differences between web-based simulations and facilitated cases on clinical reasoning, knowledge acquisition and transfer of knowledge. Additional exploratory analysis included efficiency of learning, self-reflection, proficiency and technology acceptance. Results: There were no significant differences between groups for clinical reasoning, knowledge acquisition or transfer of knowledge. However there was a significant within group difference for two clinical reasoning sub-scale scores only for the simulation group. Exploratory analyses revealed no differences between the groups for technology acceptance or confidence. The simulation group became more proficient in identifying the necessary history questions to ask but they were not efficient in doing so. The simulation group completed more tasks than the facilitated group in the same amount of time without the need for a faculty facilitator. Implications: Students in the simulation group did as well as those in the facilitated group without a faculty facilitator. Computerized simulations can be used to teach clinical reasoning skills with less faculty and class time required. [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://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]