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Medical student surgical training has traditionally occurred in the operating room (OR). Present technology allows real time communication between the OR and a remote classroom. We seek to evaluate the value of the teleconferencing (TC) environment compared with the traditional OR environment. Students enrolled in the third-year core clerkship in surgery participated in both TC and OR teaching sessions. A total of 23 sessions were conducted and observed (TC=8; OR=15). In TC sessions, students asked over 4 times as many questions (17.4±8.5 vs. 3.4±3.0; P<0.01) and faculty asked 4 times as many questions of the students (13.1±6.8 vs. 3.1±2.7; P<0.01). In TC sessions, students felt more able to ask questions (P<0.01), left with fewer unanswered questions (P<0.01), and more felt it was a good use of their time (P=0.04). These findings demonstrate that TC is a valuable modality for medical student education.