The purpose of this study was to compare the effects of a student-centered, interactive, case-based, multimedia learning environment to a traditional tutorial-based, multimedia learning environment on second-year dental hygiene students (n = 29). Surveys were administered at four points to measure attainment and retention of knowledge, attitude, and confidence. There was not a significant difference in attainment of these variables between the groups. As indicated by the outcomes of the repeated-measures two-way ANOVA tests, time had a significant effect on the mean overall variables for knowledge (p less than 0.01) and attitude (p less than 0.001), as well as three of the knowledge variables (p less than 0.05) and three of the attitude variables (p less than 0.01) for both groups. One attitude variable (p less than 0.01) showed a positive significant difference between the case-based group and tutorial-based group. A practical examination skill test measured retention of skill. The analysis indicated that the case-based group (100% passed) did significantly better compared to the tutorial-based group (60% passed). Although the findings demonstrated that only one attitude variable was found to be significantly better for the case-based group, the greater increase in the retention of skill has notable implication for dental hygiene education. Future research should examine multimedia learning environments with larger samples and longitudinal data. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]