Flipped teaching (FT) is an instructional approach centered around students, displacing traditional lectures from the classroom to make room for active learning. Retrieval practice can enhance content recall. This study investigated the effectiveness of lecture-style teaching (TT), FT, and a combination of retrieval practice with FT (FTR) in a physiology course over four consecutive semesters. Student performance in the FT (92.78 ± 3.93) and FTR (92.98 ± 3.73) methods surpassed that of the TT method (89.28 ± 4.67; P < 0.01), with a notable correlation between science grade point averages and the instructional methods employed (P < 0.01). Analysis of the impact of teaching methods on different segments of the class revealed higher scores for both upper and lower halves in the FT (95.78 ± 1.85 Upper; 89.52 ± 2.79 Lower) and FTR (95.95 ± 1.48 Upper; 89.89 ± 2.68 Lower) compared to the TT group (92.44 ± 1.76 Upper; 85.85 ± 4.43 Lower; P < 0.0001). The gender-based evaluation indicated similar performance between male and female students across the teaching methods tested. Although survey data suggested a preference for TT (100%) over FT (58%) or FTR (85%), student performance contradicted this preference. These findings underscore the effectiveness of FT and FTR methods compared to traditional instructional modalities, with male and female students responding similarly to the teaching approaches. Despite student preferences favoring TT, actual performance indicates that FT and FTR methods enhance student learning outcomes.