Background: To compare simulation-based teaching (SIM), lecture-based teaching (LEC), and teaching using animal tissue (ANT) in terms of student’ s satisfaction, knowledge gain and learning efficiency. Method: All the students who attended the courses organized by the CSTC from 1 st Jan 2013 to 31 st Dec 2015 were enrolled in the study. Data were collected using a questionnaire delivered at the end of the course. The questionnaire contained 15 questions using a ten-point Likert scale to rate the students’ satisfaction of the course and also the competence before and after the course. Result: 5024 questionnaires were collected with a response rate of 67%. Students demonstrate a higher post-courses score in SIM, LEC, and ANT (P<0. 001). However, neither one course performed better than the others. Student satisfaction was similar among the three courses. When specifically asked to compare the teaching effectiveness of SIM or ANT with LEC, our study showed that the answer is positive with median score of 8 for both. Conclusion: SIM, LEC, and ANT courses are effective teaching modalities. They are equally acceptable for student with similar satisfaction. When compared with LEC courses, students perceived that SIM or ANT courses were more effective in learning.