Muddiest point and peer instruction are evidence-based instructional practices that can be used to address student learning gaps. The purpose of this study was to determine the impact of modality (face to face or online) on student perceptions of the effectiveness of combined muddiest point and peer instruction activities in community college anatomy and physiology courses. Data was collected through end of course surveys and included quantitative and qualitative results. While there was no significant difference in student perception of anxiety or contribution to learning among face-to-face and online students, anxiety levels were low and contribution to learning was high for both groups. Both groups generally provided positive qualitative responses, but online students were more likely to provide positive feedback on muddiest point and peer instruction activities than face-to-face students. Negative responses tended to focus on wanting to work alone and dissatisfaction with classmates' contributions. This study was supported as part of the Community College Anatomy and Physiology Education Research (CAPER) project (2111119). https://bibliotheek.ehb.be:2102/10.21692/haps.2023.023