As universities and colleges seek to reach more students in efficient ways, the use of synchronous distance education (SDE) can be an alternative to traditional classrooms. This study focused on face-to-face SDE, in which classrooms equipped with interactive synchronous technologies allow students in both classrooms and the professor to synchronously see and hear one another. The aims of the study were to aid educators in understanding student concerns, determine whether face-to face SDE was sacrificing overall student satisfaction, and investigate whether satisfaction improved as the program matured. This mixedmethods study utilized a convenience sample of two cohorts of dental hygiene students (n=122) in one program: Cohort 1, which graduated in 2014 as the first class to experience face-to-face SDE; and Cohort 2, which graduated in 2015. The response rate for the two cohorts was 95%. Perceptions of face-to-face SDE versus traditional classroom experiences and characteristics of faceto-face SDE were measured using pre-and post-program surveys. The results showed no difference in student perceptions and expectations pre-course vs. post-course, although Cohort 2 had a more positive perception of SDE than did Cohort 1 (p<0.001). Perceptions of characteristics related to the classroom setting and instructor satisfaction were overall positive (p<0.001). The qualitative data suggested that technological support and faculty familiarity with SDE were substantial influences on students' satisfaction. Overall, there was no significant difference in satisfaction with face-to-face SDE when students compared it to their previous classroom experiences.Ms.