Problem-based learning (PBL) for graduate-level clinical nutrition education was examined over 7 separate semesters with a test of knowledge, measures of self-perceived clinical competence, learning strategies, cognitive behaviors (eg, use of memorization, reflection), attitude toward problem content and format, and time requirements. Mean examination scores increased significantly by 10%, and self-perceived expertise was related to realized knowledge gains. Cognitive behavior changes supported association between PBL and preferred learning skills, thereby facilitating critical thinking. Problem development and curriculum processes are described. Findings endorsed an expeditious transition to a PBL-dominant, graduate-level clinical nutrition course, prior to a supervised practice program.