Background <p>Repeated delivery of identical instructional content in medical education can result in variability in teaching quality and the phenomenon of content drift. Structured pre-session planning has been proposed to support the maintenance of teaching consistency and quality. This study aimed to evaluate the contribution of structured pre-session planning to maintaining teaching consistency and perceived instructional quality across repeated teaching sessions, using student perceptions and academic performance outcomes.</p> Methods <p>A cross-sectional study was conducted at a medical college during the second term of the 2025 academic year. A single tutor delivered identical teaching sessions to four groups of second-year medical students (<i>n</i> = 147) over nine weeks, implementing structured pre-session planning to ensure consistency. Student perceptions were collected via an anonymous, validated 8-item post-module questionnaire assessing structure and organization, clarity and comprehension, and tutor preparedness and engagement. Academic performance was assessed using a standardized, blueprint-aligned examination administered uniformly across groups. Descriptive statistics, exact probability tests, Spearman correlation analysis, and one-way ANOVA were used for analysis.</p> Results <p>Across groups, 85.7–91.4% of students agreed the content was well-organized and aligned with learning objectives (<i>p</i> = 0.098–0.769), and 82.4–94.3% reported clear explanations (<i>p</i> = 0.140–0.595). Tutor preparedness and engagement received high positive ratings (99.3% agreed or strongly agreed; <i>p</i> = 0.297). Strong positive correlations were observed between perceptions of structure, clarity, and engagement (Spearman’s rho = 0.585–0.874, <i>p</i> &lt; 0.001), indicating interrelated aspects of consistent teaching. Academic performance was highly consistent across groups (mean scores 83.6–84.2%, <i>p</i> = 0.989; negligible effect size η² = 0.00068; overlapping 95% confidence intervals), supporting the reliability of student-perceived teaching consistency.</p> Conclusions <p>Structured pre-session planning may help support the maintenance of consistent teaching quality across repeated sessions, as reflected in both student perceptions and academic performance outcomes. This approach appears to mitigate instructional variability and support equitable learning experiences. Incorporating structured pre-session planning into faculty development practices may represent a practical, low-cost strategy to enhance teaching consistency in medical education.</p>