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The literature is lacking in studies about what specific types of learning activities are most effective for adult learners. To examine the effectiveness of a learning activity with patient interactions as compared to a learning activity without patient interactions. A convenience sample of third year Doctor of Physical Therapy students participated in this retrospective cross-sectional study (n = 47). Data were a clinical reasoning assignment, the Andragogy in Practice Inventory (API) and Intent to Use Scale, and the Behavioral Engagement Related to Instruction (BERI) protocol. Data analysis included descriptive frequencies, paired t-tests, Wilcoxon Signed Rank Tests and Multivariate Analysis of Variance. Significant differences were noted between the learning activity with and the learning activity without patient interaction on several API subscales: prepare the learner, climate setting, setting of objectives and learning activities as well as in the conceptual reasoning area of the clinical reasoning assignment (p =.005, p =.036, p =.002, p =.047, and p =.038, respectively). No other significant differences were noted in other outcome variables. No significant influence of age or gender was found. This study demonstrated that, overall, both the with and without patient interaction learning activities were compatible with the preferences of the adult learner. [ABSTRACT FROM AUTHOR]