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This study examined the influence of integrated teaching methods on musculoskeletal (MSK) ultrasound self-efficacy and training transfer to practice. A convenience sample of physical therapists novice to MSK ultrasound completed a self-efficacy questionnaire at three points: before asynchronous didactic and simulation training, before synchronous instructor-led training, and before returning to clinical practice. Participants were also interviewed. ANOVA informed analysis of self-efficacy scores and thematic analysis informed analysis of interview responses. Following a thread supported integration. Self-efficacy scores increased across the three stages. Asynchronous activities enhanced knowledge and self-efficacy but didn't replicate MSK ultrasound challenges. Synchronous activities helped participants refine and better assess their skills and readiness for clinical integration. Despite improvements, participants recognized the need for transitional support.