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Background: Significant challenges are arising around how to best enable peer communities, broaden educational reach, and innovate in pedagogy. While digital education can address these challenges, digital elements alone do not guarantee effective learning. This study reports a blended learning approach integrating online and face-to-face components, guided by the Student Approaches to Learning framework., Methods: This study was carried out investigating learning in first and second year medical students over two academic years, 2019/20 and 2020/21. We evaluated: (1) comparison of students engaged with blended learning and traditional learning; and (2) student learning engaged with blended learning approach over a two-year preclinical curriculum. A revised two-factor study process questionnaire (R-SPQ-2F) evaluated students' surface/deep learning before and after an academic year. Learning experience (LE) questionnaire was administered over the domains of learning engagement, and outcomes of learning approach. In-depth interviews were carried out to understand the context of students' responses to the R-SPQ-2F and LE questionnaires., Results: The R-SPQ-2F analysis indicated first year students maintained deep learning but second year students became neutral across the academic year, regardless of learning approach, with workload contributing to this outcome. R-SPQ-2F sub-scales showed that students engaged with blended learning maintained an intrinsic interest to learning, as compared to traditional learning which led to surface learning motives. The LE questionnaire showed students engaged with blended learning had deeper subject interest, and more positive perceptions of workload, feedback, and effectively developed skills and knowledge. However, peer interactions from blended learning were significantly lacking. In-depth interviews revealed that the flexibility and multi-modality of blended learning enabled learning, but the best use of these features require teacher support. Online interactions could be cultivated through intentional institutional efforts., Conclusions: This study highlights the importance of designing blended learning that leverages technology-enabled flexibility while prioritising collaborative, learner-centred spaces for deep engagement and knowledge construction., (© 2024. The Author(s).)