A comprehensive meta-analysis of the research following Glass, McGraw, and Smith's (1981) technique integrated findings from twenty-five comparative studies from 1990 to 2003 targeting student achievement and distance education in allied health professions. Student achievement was assessed through course grades and resulted in an overall effect size of 0.15, a very small positive effect for distance learners when compared to traditional students. Several dependent variables--education levels, models of distance education, and instructional design components--related to the effect size. In the distance education setting, working professional students significantly outperformed graduate and undergraduate students. Open learning and synchronous instruction were the most effective distance education models of instruction. Instructional design components implemented into a distance education course resulted in greater student achievement scores.