Comparison of Academic Performance and Preference for Teaching Modality Among Health Professions Students Taught Physiology Modules in the Rwandan Public University.

Background: While online learning offers flexibility and expanded access to educational resources, concerns remain regarding its ability to support the complex conceptual understanding required in physiology education. We compared academic performance and preferences for teaching modality among undergraduate health professions students at University of Rwanda (UR). Methods: A cross-sectional comparative study using historical cohorts was conducted among undergraduate students enrolled in Medicine, Dentistry, Pharmacy, and Clinical Psychology programmes at UR. Academic performance data from students who completed physiology modules during online teaching (2020-2021) were compared with those from students who completed equivalent modules during face-to-face teaching (2022 onward). Mean Assessment Scores (MAS) obtained from official academic records were analysed using factorial analysis of covariance, adjusting for sex and programme. Student preferences regarding teaching modality were assessed using a structured questionnaire and analysed using logistic regression models. Results: A total of 528 students participated in the preference survey, while 516 students were included in MAS analysis. Overall, teaching modality was not significantly associated with MAS after adjustment for sex and programme (p=0.349). However, a significant interaction between teaching modality and academic programme was observed (p<0.001). Online teaching was associated with higher adjusted scores among medical students, whereas face-to-face teaching was associated with higher adjusted scores among dental students. No significant difference was observed among pharmacy students. Most students preferred face-to-face teaching, although preferences varied across programmes. Conclusion: Academic performance in physiology did not differ substantially across teaching modalities after adjustment for programme and sex. However, the association between teaching modality and performance varied across academic programmes, suggesting that programme context may influence how students benefit from different instructional approaches. Most students preferred face-to-face learning despite comparable overall academic outcomes. These findings should be interpreted cautiously because the comparison involved non-contemporaneous historical cohorts exposed to different educational, assessment, and contextual conditions.