The aim of this research was to compare the effectiveness of hierarchical sequencing (HS) versus elaboration sequencing (ES) models in improving educational outcome of clinical knowledge when using instructional multimedia programs in postgraduate orthodontic training. Twenty-four postgraduate and 24 undergraduate dental students participated in this study. The postgraduates were following an orthodontic speciality training programme. The undergraduates were fourth- and fifth-year dental students. Twelve instructional multimedia modules were developed, six logically sequenced (LS) discussing six different orthodontic topics. Another six modules on identical topics were sequenced according to one macro-sequencing (MS) model. The implemented MS model was either HS or ES. The only difference between LS and MS modules was the adopted sequencing model. All participants were assigned into consistent pairs of students and were randomly divided into a test and a control group. In each pair, one student studied the LS module (control group) while the other studied the MS version (test group). Pre- and post-evaluation tests of each pair of participants were performed to measure knowledge, understanding and application of each participant with regard to the discussed topic. A multilevel analysis was conducted to assess the estimated effect of the different sequencing models. The level of significance was set at 0.05. At baseline, no significant differences (P > 0.05) were found in pre-test scores between groups. The HS model showed a significant effect on the scores achieved (P = 0.05). The test group showed a significantly higher estimated probability of correct answers to the questions (P = 0.003) when applying the HS model. The HS model may improve educational outcome when using instructional multimedia programs in postgraduate orthodontic training.