Background: In this study a patient-based physiology practical (PP) was developed to enhance the 1st year MBBS course at Imperial College London. It was anticipated that the interactive patient-based PP, would increase understanding and support students to learn more effectively than a traditional practical (TP).Aim: To objectively evaluate the impact of an interactive PP compared to a TP on knowledge and engagement within the 1st year undergraduate cohort.Methods: The PP was developed to teach blood pressure measurement using specialised software focusing on a hypertensive patient’s journey. The session was taught 12 times by the same tutor; approx. 20 students per session. Prospective evaluation was carried out before and after each session using 6 single best answer (SBA) questions and two visual analogue scales (VAS). The students answered the SBA questions and also rated their own engagement with the session; 100% being: ‘this practical was very engaging’ and how much knowledge they thought they had gained after the practical; 100% being: ‘this practical substantially increased my knowledge’. Data from the PP was compared to that from a TP on measurement of the electrocardiogram. The TP was taught 12 times by a different tutor but with the same cohort of students. Two demonstrators assisted with each session and SBAs were prepared by an author (DJ) who did not take part in the teaching.Results: 239 students took part in the sessions, before the practical. 99% completed the PP evaluation before compared to 98% after the session. For the TP evaluation 98% completed the evaluation before and 95% after. The collated data is shown in Table 1. Before the session, the number of correct answers was significantly greater for the TP compared to the PP (p<0.05). The number of SBA questions answered correctly increased non-significantly after the TP (p>0.05) and significantly increased after the PP (p<0.001). There was also a significant difference in the mean change before and after the practicals between TP and PP (p<0.001). Student VAS scores for ‘knowledge gained’ were significantly higher in PP compared to TP (p< 0.001) and the ‘engagement’ was also significantly higher in PP (p< 0.001). Summary: The interactive patient-based PP significantly improved student knowledge and engagement when compared to the TP. Further prospective evaluation is needed to determine the influence of the tutors and the students’ prior knowledge on the teaching methods.