Research has shown that the present generation of students has a preference for digital literacy, experiential learning, interactivity, and immediacy; therefore, greater use of technology is being brought into university courses to aid in student involvement. Student Response Systems, called clickers, were incorporated as a teaching methodology to enhance student interaction and learning in a didactic pediatric nursing course. This course was taught over Interactive Television (ITV) with students at a distant site as well as face to face, creating the challenge of whole-class engagement. Clickers were used to actively engage students at both sites simultaneously and give immediate feedback to students regarding understanding of lecture material. Clickers also allowed small-group problem solving of questions. Exam grades and level of participation in case studies were monitored and exam scores and final scores were compared to those of a previous class. Student t-tests demonstrated that one of three course exams and final course grades were significantly higher for the students who used clickers in the classroom. Satisfaction feedback also supported the use of clickers as a tool to engage students and enhance learning outcomes.