The effectiveness of incorporating an audience response system (ARS) in improving the learning environment and student performance was assessed in a didactic biomedical science course at a large US dental school. Instructors and students were surveyed for their experiences of using Top Hat-based ARS in a multi-disciplinary biomedical science course. Average exam scores and grade distribution for challenging sections on immunology and developmental biology were compared before and after incorporating ARS. Pearson's chi-squared test, likelihood ratio test, Student's t-test and Fisher's exact test using beta regression model were used to assess statistical significance (p < 0.05). Student survey results with 78% (82/105) response rate, indicated that incorporating ARS improved student engagement, reinforced lecture material, and prepared them better for exams (p < 0.0001). Sixty seven percent of student respondents recommended continued integration of ARS questions in lectures (p < 0.0001). Although faculty survey data (n = 5, 100% response rate) were not statistically significant, the majority of faculty agreed that real-time feedback through ARS allowed them to appropriately pace lecture delivery and restructure forthcoming material. The average exam scores and grade distribution for challenging sections showed modest improvement after incorporation of ARS (p < 0.05). There was no significant correlation between final course grades and ARS grades for participation or correctness. Incorporating the ARS in a multi-disciplinary biomedical science course is perceived by faculty and students as an effective instructional approach that improves the learning environment, teaching strategies, and student performance.