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This study assessed changes in Self-efficacy scores produced by each of the four steps of instruction used to teach students a therapeutic psychomotor skill used by osteopathic physicians. Volunteering subjects were an entire class of 83 first- year osteopathic medical students (40 men, 43 women, M age =25.1 yr.). Self-reported Self-efficacy to perform the skill was sampled: (1) after an instructor's demonstration of the skill during a laboratory session, (2) after paired students practiced during the laboratory session, (3) after independent self-paced practice outside class using an instructional handout and videotape, and (4) after receiving individualized feedback on skill performance from an instructor acting as the "patient." The first two steps, representing typical skill instruction, produced mean Self-efficacy scores of 18% and 30%, respectively. On the last two steps, added to implement mastery learning, mean Self-efficacy scores increased to 75 % and 85 %, respectively. The instructors confirmed that all students mastered performance of the skill. Mastery learning was effective in developing both the therapeutic skill and high Self-efficacy to utilize the skill. [ABSTRACT FROM AUTHOR]