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This study examined the impacts of technology on interactions in a distance learning course. This study was directed by three categories of research questions: (1) How does technology impact interactions overtime? (2) How does technology impact interactions at host versus remote sites? (3) How does technology impact interactions according to students' perceptions? The population consisted of 14 master's level students in a distance learning course delivered via video conferencing technology (two-way audio and video) at West Virginia University. The students were registered in a Family/Community/Rural Health Systems nursing course conducted during the summer, 2001. The course was delivered to two sites, Morgantown, WV and Charleston, WV. Interactivity was studied using five strategies: observations, surveys, reflection/feedback forms, interviews of two Morgantown and two Charleston participants, and instructor interviews. Interactions in this study showed few fluctuations over time. Teacher to the class (T-C) and students to the class or to students at the other site (S-C) were recorded most frequently in observations, while students' perceptions of interactions indicated that student to student at the same site (S-SS) interactions occurred most frequently. Overtime it was revealed in participants' survey responses, reflections, and interviews that interactions with remote site students and interactions with the technology were impacted the most. Participants agreed that students different site interactions were greatly impacted by the technology. Interactions were described as “stifled”, “artificial”, or causing individuals to be “more forward” than normal. Participants also indicated that interactions between remote site students and the instructor occurred more often than with host site students. In an attempt to involve all participants it is possible that in this environment “forced” interactions occur which require more effort and attention directed towards remote site students. Students' perceptions of interactions may not be directly related to the actual time spent on interactions but rather on the quality of the interaction. The quality of the interactions seemed to have the greatest impression upon students' perceptions. This was evident in participants' survey responses, interviews, and reflections.