Objective: To gather feedback from students about learning activities that would help them engage more fully in a clinical biochemistry component of a second year core pharmacy course and, following the implementation of a blended approach, measure any gains in engagement and learning. Methods: Following traditional lecture-based content delivery in 2010, student suggestions on learning activities that would improve engagement were assessed through a questionnaire. Based on feedback, online modules inclusive of narrated and non narrated presentations, animations, self-assessments, and virtual video-based field trips were offered in 2011 in conjunction with a face-to-face case-based tutorial activity to create a blended learning experience. Student engagement and perceived learning gains were again assessed in 2011 through a similar questionnaire. The impact of the clinical biochemistry redesign on the final grades of the two cohorts was also compared. Results: Student feedback from 2010 indicated that their engagement with clinical biochemistry would be increased by adding more case studies and self-assessments. Students in 2011 reported an increase in perceived learning gains and performed at a significantly higher level on assessments after the introduction of a blended approach that included more case studies and self assessments, but did not report significant increases in engagement. Conclusion: The components most effective for content understanding were those suggested by the previous student cohort, namely case studies and self-assessments, whereas the virtual field trips and online discussions were less effective. The student driven blended learning model correlated positively with increased interest and perceived and actual learning gains. (C) 2013 Elsevier Inc. All rights reserved.