The purpose of this study was to assess the effect of earthquake instruction on students' earthquake content and preparedness for earthquakes. This study used an innovative direct instruction on earthquake science content and concepts with an inquiry-based group activity on earthquake safety followed by an earthquake simulation and preparedness video to help middle school students understand and prepare for the regional seismic threat. A convenience sample of 384 sixth and seventh grade students at two small middle schools in southern Illinois was used in this study. Qualitative information was gathered using open-ended survey questions, classroom observations, and semi-structured interviews. Quantitative data were collected using a 21 item content questionnaire administered to test students' General Earthquake Knowledge, Local Earthquake Knowledge, and Earthquake Preparedness Knowledge before and after instruction. A pre-test and post-test survey Likert scale with 21 items was used to collect students' perceptions and attitudes. Qualitative data analysis included quantification of student responses to the open-ended questions and thematic analysis of observation notes and interview transcripts. Quantitative datasets were analyzed using descriptive and inferential statistical methods, including t tests to evaluate the differences in means scores between paired groups before and after interventions and one-way analysis of variance (ANOVA) to test for differences between mean scores of the comparison groups. Significant mean differences between groups were further examined using a Dunnett's C post hoc statistical analysis. Integration and interpretation of the qualitative and quantitative results of the study revealed a significant increase in general, local and preparedness earthquake knowledge among middle school students after the interventions. The findings specifically indicated that these students felt most aware and prepared for an earthquake after an intervention that consisted of an inquiry-based group discussion on safety, earthquake content presentation and earthquake simulation video presentation on preparedness. Variations of the intervention, including no intervention, were not as effective in significantly increasing students' conceptual learning of earthquake knowledge.